first night off of orientation!

[LoveActually]

Tonight will be my first night off of orientation - whoa! I'm a new grad - had my first 6 weeks on a tele floor, and I'm on my 8th in the ICU. I am feeling a mixture of extreme terror and excitement - ha!

My hospital has been really good to me so far - TONS of experiences, classes and education, wonderful tele & ICU preceptors and CM's and decent colleagues for the most part. Maybe I am in some kind of honeymoon phase, but since I started every single day I think about how much I love being a nurse, and how I feel like I'm doing what I was meant to do.

A few weeks ago my preceptor and I were taking care of someone with severe ARDS & sepsis secondary to H1N1. She was on a rotoprone bed and the 1st night she was doing awful, and the second night she went from really bad to worse - we didn't think there was any way she was going to make it. No lung sounds except in very upper lung fields and barely. She was on drips of Levo, dobutamine, vasopressin, epi. They were all over the max. She was on a gazillion different antibiotics, and was on an insulin drip too. Every half hour we would check her sugar we had to go up on the insulin trip and sometimes bolus her with up to 12 units. She was making NO urine. Massive edema. Toes turned purple. Mottled knees. We started her on Xigris which my preceptor said is totally last ditch. I took her temp and when the thermometer said 105.8, I got weak in my knees and didn't believe what I was seeing. 105.8!!! I put ice packs everywhere and managed to bring her down to a cool 103.5. I prayed for her and her family. We did not expect she would make it through the day.

But she did, and the third night she improved to our astonishment. It was the most amazing feeling in the world. I have chills thinking aobut it. 4 pressors were cut down to 2. She made a little urine. Her skin was pink. Temps weren't so high. And she actually had breath sounds.

Several days later she was off of the vent.

I had the pleasure of taking care of her last week before she got transferred to tele. She was drastically weakened but mentally intact. I stopped by her floor the other night to say hi, but she had left for rehab.

I feel blown away just thinking about the whole thing.

Anyway, just wanted to share. Please keep my patients and I in your prayers tonight - we need them

[fiveofpeep]

Thats an incredible story. Good for you :)

It reminds me to never give up on those patient's who seem like they are CTDs

[detroitdano]

Enjoy it, you'll never see that again LOL.

That's an amazing story. I've seen my share of very ill intubated patients walk to their stretcher for a transfer days later, but they're far and few between. If they get septic and go into MODS it's usually a long road back if there is one at all.

[ONCRN84]

Good luck. Mine was terrible and I'm seriously considering jumping right back out of the ICU.

[CoffeeGeekRN]

God bless you in your diligence for caring for this patient. You definitely made a difference in her care.

[tri-rn]

WOW, strong work! Great job, it sounds like you had a real effect on this patient and that's such a great feeling.

Can someone pls define - "CTDs? Thx

[Sugarcoma, RN]

CTD = Circling the drain

[sunnycalifRN]

Nice job!! Welcome to the ICU. It's stories like yours that are the "rewards" of working in the ICU and you will always remember them.

[armyicurn]

What a trooper! Good job. I am sure you've learned tons with that case.

[youknowho]

To the OP-Hope you had a good 1st night off orientation mine is next week and I am trying not to think too much about it! Still have 2 more evenings with my preceptor so I have a list of questions since I still have her :)