Episode 1: Going Against the Grain
“I do ICU so I can knock people out and don’t have to deal with them.”
My zealous student nurse heart plummeted and shattered. My preceptor seemed to fit the “ICU stereotype”. I couldn’t fathom the sentiment. Despite my 19-year-old ignorance, I knew I was “called” to work in the ICU. In that moment, I wasn’t sure how I would fit in.
Looking around the bleak monitor-lit ICU I felt haunted by the lull of alarms and ventilators. My sense of destiny did not flicker, but my enthusiasm was extinguished.
Years later I was guided to start my nursing career in an ICU that maintained and brought life to each patient. There was no “snowing” patients. In fact, there was hardly any sedation at all. Despite the high acuity of patients, this team had an unspoken covenant to keep each individual strong and home-bound.
What does this look like?
The unit is bright and alive during the day. The hallways are tracks frequented by patients pushing their walkers and staff and family members guarding their ventilators, IV poles, Foley catheters, rectal tubes, chest tubes, etc. You hear coaching, cheering, counting of feet walked, and sometimes singing of “You Can Go the Distance”.
Passing patient rooms you see them up in the chairs tolerating their ventilators and watching TV, on their computers/phones, playing video games, or writing messages to their families and staff. They are working on cognitive therapies with occupational and speech therapists on IPADS.They are expressing their pain and anxiety and have it appropriately treated.
They are informed of their conditions and are participating in therapies. They are autonomous and are guiding their treatments. They are connecting with the world around them and keeping their brains and bodies intact during their acute and critical illness.
In the evening they take their third walk for the day. Expert respiratory therapists hook extension tubing to the ventilator to allow patients to feel fresh running water in a real shower room. They are worn out, lights go off, and they are allowed to have real sleep.
I am honored to watch some of the most compassionate people on earth serve their fellow man. They take their role in patient’s futures as sacred.
It is because of knowledgable and willing nurses, techs, respiratory therapists, physical, speech, and occupational therapists that my patients walk out of the ICU. It is their dedication and teamwork that make tracheostomy and rehab/LTAC admissions almost unheard of for our patients.
When early mobility is presented in critical care conferences the common response from physicians is, “We couldn’t get our team to do that”.
I am convinced those voices are from those that have not tried. I believe in the goodness of medical personnel. I truly believe the majority of healthcare providers signed up for such heart-wrenching and back-breaking work because they want to make a difference. They aspire to save lives.
Will we support our teams in changing inhumane sedation practices? Can we forget the “easy way” of deep sedation? Can we see our patients as human again? Will we work together to do what is BEST for patients? Will we rise up and give patients their lives back?
https://podcasts.apple.com/us/podcast/episode-1-intro/id1497431005?i=1000464321508
