Wednesday, September 30, 2009


The ICU today was FANTASTIC! We were all basically thrown at the unit, and with a 10 bed unit, 8 of us, plus ANOTHER student from another school, pretty much all the nurses had students to do the heavy lifting, which they seemed to really enjoy. MY nurse was totally AWESOME. Our patient was really honestly an ICU patient- she was really truly unstable, with resps in the 30s, HR in the 120s-140s, BP all over the place.
And end-stage MS. Really tragic. She was REALLY young for it- in her 30s, and her "admitting complaint" was MASSIVE pneumonia. She realised upon admission that she was probably terminal, and made herself a DNI...but NOT a DNR. This put us all in a bit of a quandry- we needed to suction her, we could hear the ronchi from the nursing station- but she would fight tooth and nail against the NG suctioning, which would bring up little bits of THICK mucus, but it didn't feel as if we were doing much good. For REAL help, she would need something about the size of a garden hose, which would have to be put down her throat through her MOUTH, but she couldn't tolerate it. She would need to be tubed for us to reach her lungs, which we couldn't do. So...we did our best, rolled her side to side, restrained her arms by tucking them inside the covers (she would rip off her NRB mask in panic, which would make her de-sat into the 70s, even when I would HOLD it there, and remind her that she NEEDED the mask.) The hardest part was that she was mouthing "help! I cant breathe!"
But it was both challenging, and really DIFFERENT...I loved it.


Anonymous said...

Actually crap like that is why I dont work the unit anymore.


little d, S.N. said...

I think I loved it just because it was faster-paced than the CPU. ED is where I'm happiest.