He rose again-a lesson learned

by cav5

5,441 Unique Views | 9 Comments

An article explaining the very real lesson between becoming confident and knowledgeable and overconfident and knowing "too much".

  1. 38
    my second year working in the icu brought about changes, both good and bad. i was becoming more competent, more independent, and more secure in my knowledge base as not only a nurse but an icu nurse. however, with this level of confidence and skill came with it something close to impudence, a firm belief that if i hadn’t seen it all then maybe i had seen enough. i find that in life, at least mine, that whenever i tend to get to this point, the universe makes sure that i learn that there is never “enough”. every day is a learning day. every day is a day when you might know “enough”-enough but not all.

    it was 10:00 p.m, the night before easter sunday. a 70 year old patient was being transferred straight from surgery into the icu because he was not doing well and his no-code status could not be honored in the recovery room. he had come out of surgery with his pupils fixed and dilated, respirations were shallow with very little air flow, and he was not responsive neurologically. everyone thought it best to transfer him to the icu where he could get care if he should recover while at the same time honor his no-code status. that is, until a very young and new physician decided that we should intubate.

    i was mad.

    i was upset that this patient’s wishes were not being honored. i was furious that yet another family would have to make the decision to “pull the plug” after three days of waiting and hoping, only for it to be fruitless. i was enraged they would have to suffer needless guilt and sorrow for ending their father or grandfather’s life because a young doctor didn’t want to make “the hard call”, particularly when this man had made sure that that would never happen.

    i was mad.


    however, despite all protests, the young doctor called the family and urged them to intubate “just until the anesthesia wears off”. so, we did. during the next hour i gave him iv’s, got him settled, and talked to him.

    “bud, i am thinking she should be voted off”

    you see, bud was an affectation that i took to calling most of my male patients, i had run out of many other subjects to talk about, and survivor was very big at the time.

    it was then that he turned his head. yes, he turned his head and looked straight at me. my patient had literally come back from the dead…on easter sunday.

    after an hour bud was sitting up and asking for ice chips via hand gestures. it turns out, all he needed was respiratory help until the anesthesia had worn off. in fact, after he was fully awake with a normal co2 level he was so fine that the tube came out the next morning and he was free to go home in less than a week.

    come to find out, the pre-op paperwork failed to mention that he had a pre-existing eye disease that made his pupils always fixed and dilated. oh, and that the primary name that the patient responded to was his nickname…”bud”.

    i learned a lot that night. i learned that survivor was one of bud’s favorite shows. i learned he agreed with my choice of who should be voted off-something he watched first hand and tube free the next night. i learned that paperwork, while very tedious and time consuming, really is that important-the smallest things could literally mean life or death.

    i learned that if it had been up to me and my “enough” that bud would have never gone home to his home, his family, and his favorite tv show.

    i learned that that you can never know “enough”.
    Last edit by brian on Apr 3, '11
    Joe V, brian, RetRN77, and 35 others like this.
  2. Read more articles from cav5

  3. Get email updates about new articles...

  4. About cav5

    I am currently a school nurse working for the department of defense overseas. I have been doing school nursing for 10 years. Prior to that, I worked as an ICU nurse for almost two years.

    cav5 joined Nov '10 - from 'Apo, AE, US'. cav5 has '13' year(s) of experience and specializes in 'School Nurse; ICU'. Posts: 71 Likes: 223; Learn more about cav5 by visiting their allnursesPage


    Find Similar Topics

    9 Comments so far...

  5. 0
    Well said.
  6. 1
    Thank you for sharing this story. We all need a little dose of humility. It helps us keep perspective.
    Last edit by cherryames1949 on Feb 11, '11 : Reason: gross misspelling
    cdktRN likes this.
  7. 0
    I'm trying to see what this article is trying to get across. I'm hoping it isn't a lesson in ignoring someone's advanced directives because of a fluke.

    BTW. When you said he "had literally came back from the dead," I think you mean he "figuratively" came back from the day. You "literally" used the wrong word.
  8. 4
    Quote from UserG
    I'm trying to see what this article is trying to get across. I'm hoping it isn't a lesson in ignoring someone's advanced directives because of a fluke.

    BTW. When you said he "had literally came back from the dead," I think you mean he "figuratively" came back from the day. You "literally" used the wrong word.
    I do believe the point was fairly obvious.....KNOW your patient's condition/anomalies pre surgery....so proper assessment can be made after! yes, your grammar point is well taken. However, before the baseline was known, it certainly would have appeared to be literal.
    RetRN77, alem-tsahai, curlyq28, and 1 other like this.
  9. 8
    Quote from UserG
    I'm trying to see what this article is trying to get across. I'm hoping it isn't a lesson in ignoring someone's advanced directives because of a fluke.

    BTW. When you said he "had literally came back from the dead," I think you mean he "figuratively" came back from the day. You "literally" used the wrong word.

    WOW.

    I would like to THANK the OP... What I took away from this article was that we as nurses at times become complacent, thinking we "know" everything (especially more than some interns/residents) and that we need to take the time to sit back, listen and be open to learning/trying new things. I am a firm believer that you can learn something from everyone. I do not believe the articles purpose had ANYTHING to do with the subject of advance directives, but with the attitudes many nurses develop of being a "know it all"
    RetRN77, marda, Angie O'Plasty, RN, and 5 others like this.
  10. 2
    Quote from AggieQT
    WOW.

    I would like to THANK the OP... What I took away from this article was that we as nurses at times become complacent, thinking we "know" everything (especially more than some interns/residents) and that we need to take the time to sit back, listen and be open to learning/trying new things. I am a firm believer that you can learn something from everyone. I do not believe the articles purpose had ANYTHING to do with the subject of advance directives, but with the attitudes many nurses develop of being a "know it all"
    In every way I agree with you AggieQT!! Even as an LPN I have had patients that came to my unit for End-Care, only to wake up and go home a week later and live for years. I really try to learn something new from each day and each patient. They have a way of reminding me that Nursing, like the rest of the Medical Profession, is a study, which means constant learning.
    colzanurse and cherryames1949 like this.
  11. 3
    Wow! It was a miracle that you spoke exactly the right thing at exactly the right time. Sounds like God to me.

    I read nothing haughty or amiss in any way in OP's story. OP, thank you for sharing this most encouraging event.
    RetRN77, 4Karrie2, and annlewis like this.
  12. 1
    What an incredible story! Thanks for sharing!

    When we get too comfortable- it's sinking sand.
    RetRN77 likes this.
  13. 1
    Sometimes we know just enough to be dangerous. Thanks for sharing a little humility.
    RetRN77 likes this.


Top