To you ICU nurses

JulieCVICURN, BSN, RN · Apr 20, 2010

Honestly, I can't think of any off the top of my head who have "made it" long term. I'm sure there are some that I just haven't heard from, but it seems like these types of patients end up moving from ICU to Tele and back again several times over the course of a couple/few months before they end up either passing away or in LTC. I can't recall a success, but that's probably because the ones who make it through don't come back to me, so I don't remember them.

DuluthMike · Apr 20, 2010

Not an ICU nurse but the mortality rate for ARDS is about 40%

catshowlady · Apr 20, 2010

I can't think of one who has made it long-term off of the top of my head either. IME, they make it to an LTAC, and end up passing there.

:paw:

ETA: I forgot - there was one lady. Last one I would have ever thought would make it. She hadsome chronic issues: she had hepatitis (not a new dx, can't remember if it was B or C). Was on pressors, too. She walked back in to see us about 6 weeks later.

ukstudent · Apr 20, 2010

Depends on your definition of making it. About 50/50 die in the ICU. Of the ones that don't, most end up with a trach and peg. Then after going to step-down (if they can get off the vent) and bouncing back a forth a few times, if the are still alive they go to a LTAC facility.

If your definition of making it, is getting back to baseline (independent living) they I have to say it is very very rare.

NightNurseRN · Apr 20, 2010

Thank you for the replies... The pt. im refering to is a family member of mine

I cant stop feeling guilty because I told him he would be fine before his surgery :(

PostOpPrincess, BSN, RN · Apr 20, 2010

By the time they would get to be, their lungs were almost fibrotic and the jet vent wasn't working.

So.....

I've seen most go downhill and not survive...

RNperdiem, RN · Apr 20, 2010

I have heard of a couple that went home. They were young trauma patients who were otherwise healthy.

Otherwise, I'm not sure what becomes of the rest who we move out trached, pegged, frail and weak.

Indy, LPN, LVN · Apr 20, 2010

If talking to your family member will make you feel better, nightnurse, could you do that? Maybe he/she is sedated and doesn't look like they can hear you, but maybe it will help. Just apologize for thinking you would be able to know what would happen. And try, really try, to let it go. You are not in charge of this one, and major surgery always equals major trauma to the body. There are people who simply can't overcome the trauma- think of it this way, if you were hit by a bus what would you expect?

I'm sorry you're having this burden, but it's only a burden to you personally if you accept it as such. (And feel free to tell me to shut my preaching mouth, since I'm not in your shoes.) Find someone to give you a big hug- I would hug you if I were there. Pray and hope, but know that you didn't cause the outcome.

JulieCVICURN, BSN, RN · Apr 20, 2010

Thank you for the replies... The pt. im refering to is a family member of mine
I cant stop feeling guilty because I told him he would be fine before his surgery :(

First of all, I had actually edited my post to apologize for not being more tactful in case it was a family member you were talking about but it apparently didn't take, so I'm sorry about that. Second, do not feel guilty. Would your family member have decided any differently had they known the outcome was iffy? If the bypass was needed, it was needed. Otherwise, there was probably NO chance of recovery. With an MI, your options might have been limited anyway - I'm guessing with a CABGx5 the person probably was not a candidate for stenting, so surgery wasn't necessarily the wrong choice.

I recover exactly these sorts of patients from CABG all the time and ukstudent pretty much hit the nail on the head. Still, I think that it's important to remain realistic, but that doesn't mean you have to give up hope.

NightNurseRN · Apr 20, 2010

First of all, there is no need for anyone to apologize. I deliberately did not say it was a family member because I wanted the truth no matter what :) so thank you! Second- the doctors actually say things are looking better today, his lungs look better on xray and his O2 is staying up after a little weaning from the vent. I know there are ups and downs but today we are happy :)

cherrybreeze, ADN, RN · Apr 20, 2010

Thank you for the replies... The pt. im refering to is a family member of mine
I cant stop feeling guilty because I told him he would be fine before his surgery :(

Oh, NightNurse, please don't feel guilty.

I don't know much about ARDS or the stats about prognosis, but you could not have predicted that this would happen to your family member.

It also sounds like he was facing a surgery that he didn't have much choice about undergoing. Of course you told him he'd be fine...that's what people need to hear, when they are scared. It's not wrong to believe it, and you can only focus so much on what *could* go wrong...it is important, IMO, for someone to go in to a surgical situation with as positive an attitude as possible. Even if you HAD feared a poor outcome or complications, could you have pictured saying to him, "things aren't going to go well afterwards?" Of course not. I believe it's one of those "little white lies" done to benefit the person it's told to. I don't think, though, in your case, that you were doing that even.

It was a complication you couldn't have predicted, and I believe that your family member, in the back of his mind, was aware that complications were a possibility with such a major operation. I don't believe for a second that he thinks you weren't being truthful with him, or blames you in any way, shape, or form, for his NOT being "fine" post op, so you shouldn't blame yourself, either.

I hope this makes sense. I wish your family member (and you!) the best.