Our white scrub dresses clashed with the green clean flip flops we were required to wear in the Medical Intensive Care Unit. These were a requirement by St. Paul’s Hospital in order to lower risk of infection of patients from the people outside to patients who were very sick. The brand new 12 bed unit had 8 patients with a wide array of illnesses that we encountered on our first shift. We were assigned to one patient each with a student nurse partner. We enjoyed the companionship on our first day there. For the final 2 days we worked independently. The staff and our facilitator were very supportive during these days.
We were able to practice and perfect many skills that were introduced to us in during our SICU immersion. These included neuro assessments, as well as Central Venous Pressure readings, general assessment, vitals, tube feed by hand, medications, suctioning, turning and position, ET and oral suctioning, working with ventilators, CPR, and hyperventilation with an ambu-bag. Many of the patients we worked with had low consciousness (about 5/15 on the Glascow Coma Scale) or were ventilated and therefore were challenging to communicate with. We made use of note pads, body language and shaking and nodding of heads. Even when we could communicate with the patient there was a slight language barrier so we relied on patience and the help of the nurses. Sometimes verbal communication was not necessary, it was more nonverbal that was more important and meaningful for interaction. A simple touch to comfort a client or a family member of a dying patient can be more effective than words.
This rotation weighed heavily on our emotions because 3 of our patients passed away over this short amount of time. This was the first time for 4 of us to experience death of a patient. It was a new experience because we really saw how our responsibility during end of life care switched from focus on the patient to family centered care. It was disheartening to see families in so much distress. On top of this, we had to gain a comprehensive grasp in addressing these situations with barriers such as language, and cultural practice. Because of this, a few of us were able to assist with post-mortem care.
We feel fortunate enough to have had the opportunity to rotate through the different wards that we did. Each place taught us life lessons that we will apply in our practice. We learned of the caring nature, patience and kind-heartedness required for all. We may not have been able to have this same experience at home, we learned things in a different way that will forever affect us.