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Passing Through the ICU

On February 1, 2021 my guy, Jerry, went in for a foot surgery.  A bunion, a hammer toe, arthritis.  Outpatient.  A week recovery and he’d be back to work.  A few days later he developed a blood clot which turned into a pulmonary embolism which made him go into full cardiac arrest.  He coded in Denver’s Presbyterian St. Luke’s Medical Center emergency room and needed so many chest compressions that it broke five ribs.  He then spent two and a half weeks in a touch and go ICU world, much of it on a ventilator.

I realize I was lucky that I could even be by his side.  The Covid protocols relaxed just the day before he was admitted.  Many people who had family and friends suffering from coronavirus were not able to see loved ones once they disappeared through the hospital doors.  That’s agony.  They had to trust the hospital ICU staff without being present to witness the work they do.   Well, I saw the work they do. Every day for about three weeks.    

As I’ve watched Jerry’s trauma unfold from his bedside, I saw first hand the care that happens in a hospital with the most critically ill patients.   Being in this environment for an extended period of time, I had a chance to observe the ICU as I waited to see if someone teetering between life and death would come around.  So here are my takeaways.

  • Nurses deserve every accolade there is.  I don’t have enough superlatives to describe them.  They are highly skilled, very efficient, yet so very caring.  I asked a couple young nurses what was the first thing they learn in nursing school and they said that caring is as important as curing.  Nurses don’t complain even after a year filled with Covid.  They take messy tasks in stride, hold your hand day by day and are vigilant about the recovery of their patients.  They are the liaison between you and the doctors.  They make you feel like family.  Many of the nurses I have met in the hospital are travelling nurses.  They’re from all over the U.S. and work in places they want to visit or where they have family.  Nurses execute the plans and are the superstars. 
  • Doctors round in the mornings so you can see them every day if you’re around.  In the ICU, where hospitals deal with their most acute patients, doctors are direct, transparent, accessible and available to chat.  I found them to be good about keeping me informed and they were straightforward with me about the risks.  They also were realistic about the potential outcomes.  Between intensivists, hospitalists and specialists you start feeling like you have a whole team on your side.
  • That said, medicine is not just science but also an art.  As teams strive to treat the critically ill, they are managing risks, solving puzzles and weighing consequences.  Many medications cause side effects and can impede progress.  That said, the body reveals an incredible amount of information, and it’s interesting to watch doctors and nurses pivot as they make sense of the science.
  • Watching life in an ICU is a study in teamwork.  Over the course of our stay we had over two dozen nurses and therapists and a dozen doctors from different specialties.  Not to mention all the nurses aides.   It’s a well-oiled machine.  Transitions are mostly seamless and everyone is skillful, even on the graveyard shifts.  They take copious notes so new people on the team can pick up where the last one left off.
  • If there is no news, that’s good news.  Doctors and nurses will call you if they are changing course or you need to make a decision.  It got to the point where my breath would catch every time the hospital called.  These days, it’s a nurse calling to tell me Jerry just wants to chat on the phone.   I can breathe again.
  • Days are up and down.  There can be setbacks.  In our case, we had to return to the ICU following days of improvement.  With the most critical patients you have to be in the moment.  Progress or lack of it is day by day.  It can be very slow and stressful.  With that said you need to celebrate every milestone.  Coming off a vent, getting out of the ICU, sitting up, these are all milestones. 
  • Familiar faces are part of healing.  I can’t imagine how hard it was for families of Covid patients who couldn’t help to buoy the spirits of those who were ill.  Critically ill patients need advocates to speak up and notice things. These things are communicated to doctors and nurses and therapists and end up in the record.  Family is part of the team.  
  • Lean on social workers and those who minister.  They are there for the families of the hospital’s sickest patients. They provide psychological and emotional support and spiritual guidance.  They help you evaluate tough choices and give perspective.  They meet you where you are, whether you’re holding it together or you’re a mess.  They give hugs and hold hands and check in to make sure you are surviving the ordeal too.

It is now mid-March and Jerry is out of the ICU and on the mend in the hospital. Recovery from critical illness happens, but it can be very slow.  Eventually he will go into rehab. I hope those who are reading this never have to learn what I did.  But should your journey take you into a hospital ICU with a critically ill loved one, perhaps you will find these takeaways helpful.  Outcomes vary and the uncertainty makes it essential to have support and learn patience.   I get strength from this quote by Cheryl Strayed.  It’s about healing but to me it also describes the enormity of the ICU and the fight to get out of it.  “The place of true healing is a fierce place. It’s a giant place. It’s a place of monstrous beauty and endless dark and glimmering light. And you have to work really, really, really hard to get there, but you can do it.”

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