This past weekend was my last weekend working in the ICU. I'm moving on to a new endeavor where I will be teaching doctors and nurses and the rest of the hospital staff how to use a new computer system we will be rolling out. For once I have a real Monday through Friday job and will be home on the weekends, something I haven't had in the last five years. This will be a great adjustment period. I am so very excited to learn something new and apply myself in a completely different way. My creative side longs for a new direction these days.
That being said, I also acknowledge that I will miss the ICU greatly and am also reflecting on the memories of the last four years growing and learning and becoming a nurse in the ICU. I think back to my first days and how welcoming they all were. The ICU is an incredibly tense environment was definitely my most intense "first day of work" of any job I've ever had. But the nurses were fairly patient with me and truley did want me to succeed. I had so many questions those first weeks. I kept a post it note under my keyboard to keep track of how many questions I asked each nurse, not wanting to irritate any of them. The nurses have such an incredible work load they usually don't have time to answer 75 questions a day from the new girl. I remember my tour during my interview and one nurse in particular telling me, this is where the cool people work. She was right. It was no random act that I ended up in the ICU.
My favorite days were the ones that started with a full house and more patients waiting in an ER that was busting at the seams. We were in crisis mode and had to strategize and move quickly. I'm not sure any of the rest of the nursing staff would agree, but I loved it. We would rush out our healthiest most stable patients to the step down units and get a STAT clean on the dirty room and turn it over just in time to get a new sicker patient admitted. The piles of orders to put in as quickly as possible, the faster the orders were put in, the faster the patient could be treated and the faster they could start healing or stop dying. I loved the pressure. I was told on more than one occasion that I was a sick girl. The more patients rolling in, the more alarms going off the better.
I have enjoyed about 99% of the doctors I worked with. They are truley the most complex intellectual creatures I've ever been around. I remember recently sitting in the middle of a conversation between an intensivist and a nephrologist talking about fluid shift and electrolytes and metabolic acidosis. They were
arguing loudly debating about whether to use some drug or another. I never felt so stupid in my entire life. I could barely follow the dialogue much less understand a single concept. Should they give the life saving drug whose side effects could quite possibly kill the patient? Hmmmmmm... While reading the article, the doctor looked up at me. "That being said, we can't not condone..." What does that mean he asks me. Me? This patient's life could depend on my interpretation of the phrase "can't not condone". You're the one who went to ten years of medical school. Please don't involve me. I don't recall what decision was made but I do remember the patient surviving. I felt blessed to spend time in the presence of these unbelievable people.
The ICU is lead by the doctors however, it's the nurses that define
intensive care. That's exactly what it is, around the clock intensive care. Each nurse is assigned two patients, sometimes only one. This is because of the level of care required. Every function and every need of each patient is carried out solely by the nurses. Many of the patients are in medically induced comas of sorts. The daily care that went into their ICU stay will never be remembered. When you drooled they suctioned you, when you pooped, they cleaned you, when you sweated, they bathed you. Not to mention running your life sustaining machines and equipment. Every alarm and bell was answered and reset or addressed. Your crazy intense family functioning in crisis mode was consoled and reminded to take care of themselves. ICU nurses are the most nurturing group of people I've ever spent time around. That being said, you don't work in the INTENSIVE care unit if you're not, well, intense. I remember my early days when a nurse would yell or snap at me during a code and I would take it personally. I realize his heart stopped, but there is no need to yell at me.
I didn't do anything wrong, in fact, if I
wasn't here, your job would be alot harder. So you better start learning to appreciate me. I soon realized that none of the snapping or yelling or eye rolling was directed at me even though it may look that way from an outsider. These are simply reactions and coping mechanisms showing up out of the desire to have control over a sometimes uncontrollable situation. ICU nurses like control, I think that's why I fit in so well. I think many of them would agree that they would prefer a vented sedated patient over one that wanted to get up out of bed and go to the bathroom or GOD forbid want to take a shower. Let's just use a bedpan. These same intense nurturing group of nurses were also fabulous teachers. I learned so much from them and I spent a great deal of time with each of them individually so I learned more than one way to do many tasks. Thank you Judy for your conveyer belt sheeting and Chris for explaining why I can't change the abbreviation for Potassium from K to P (it's a little bigger than just a hospital policy). I was given a periodic table of elements. That cleared things up. Thank you Patti for being my role model, if I end up in the ICU as a nurse I long to be even half as good as you. You were so intimidating my first... well year. Thank you for holding me up to your standards even when you had to do my work just to guilt me into doing it myself. I will miss you so much. I have so many other people to thank, but this is like the Grammy's and the "end your speech now" music is starting to play. You have all embraced my desire to become a nurse and fed that desire everyday, calling me in to watch really exciting (or disgusting or painful or life threatening) procedures. I thank you for your patience and insight each and every day.
Working only weekends, I flew under the radar as far as the supervisors were concerned. I only really saw them during yearly evaluations. I do want to thank them for taking a chance on some strange girl in housekeeping. I would also like to thank them for resetting my start time when I failed to show up for work on time for the first three months of my job. Never having worked in the medical field I was unaware that you are actually required to show up earlier than your actual start time. Whoops. I would also like to thank them for not being upset when they found out that I hid the fact that I was pregnant during our interview and for not being even more upset when I very quickly needed to be put on FMLA with another pregnancy. Supervisors, you have all been very understanding and thank you for all the long talks in your office on education goals, career choices and birth control. My mom lives over 1200 miles away and you have been like surrogate mothers to me. However, revealing to me that I was a time keeper's nightmare was a little harsh during my last evaluation. Maybe I should just be remembered as the time keepers special little project. Thank you also for nominating me for this new position where I can grow as a nurse and put my creative side to work for awhile. I know you weren't excited about having to train a replacement and start all over with someone else. Also thank you for taking my
begging and pleading recommendation into consideration when I requested you take another chance on another strange girl (not really strange, Sorry Molly) from housekeeping as my replacement.
Speaking of replacements, thank you Molly for agreeing to become my replacement. Thank you for not crying on day one of your training and thank you for actually showing up to day two. We never made it through a single lesson without being interrupted by a call light or a nurse or a doctor needing something. I'm sorry my training was so scattered, but well welcome to the ICU you will be interrupted eight bazillion times though out your day and you just need to remember to put on your smile and say, I would love to..... Of course I have time... I wasn't doing anything else... You are going to be a wonderful replacement, keep your chin up, it gets easier.
The patients in the ICU were so entertaining almost as entertaining as their families. I have so many funny stories and so many heart breaking ones as well. I loved the delusional patients that would have to be tied up for our safety and theirs. I also loved guiding families through their last moments with their loved ones. It was such a privilege to be included in these precious hours and to be part of something so personal and important in these people's lives. I even enjoyed post mortem care. I wanted to know that these patients were given respectful care right up to zipping the body bag and assisting security with loading the body onto their cart. It was amazing to see patients that would roll into the unit dying and days or sometimes weeks later would graduate to the step down unit. I learned so much from all of them most importantly the effects on the body of drinking, smoking and eating. Any of these done in extreme will most certainly buy you some time in an ICU.
In the last four years I've grown older, wiser, more confident and more thankful that I was able to be part of such an exciting unit.
Thank You ICU for shaping me and helping me to put life into perspective and
helping me stock an awesome first aid kit, for giving me the opportunity to work on this exciting new venture.
