Finding Love (GxG) -completed-

Chapter 10- Emotional

My alarm went off at 430AM, much earlier than I wanted. Begrudgingly I got up and shuffled to the bathroom to do my morning business. It occurred to me that I would get to see Kam today, and suddenly the early morning was much more manageable. After my morning cares were complete, including shower, I hurried back to my bedroom covered in only a towel. Before shutting my bedroom door, it occurred to me I didn’t see lights on downstairs or under Gwendolyn’s door. I knocked to make sure she was up but no answer. After the second set of knocks, Gwyn answered, “yes?”

“Umm we have clinicals today right?” Elise was slightly confused because it was so unlike Gwyn to oversleep.

“Oh fiddlesticks! Yes, I’m so sorry Elise. I’ll be down shortly.”

“Gwyn, you have half an hour. Get ready, but try to relax.” Elise giggled to herself about Gwyn freaking out while dressing. Next, Elise headed downstairs to start the coffee brewing.

Elise was sitting at the table, coffee cup in hand when Gwyn came flying down the steps twenty minutes later. 

“Gwyn, take a breath. It’s okay. We will make it on time as long as you calm down and don’t get us in an accident.”

“Yes, right, okay. I just keep thinking… thank goodness you woke me or we would have been late. I fell asleep studying last night and forgot to set my alarm.” Gwyn tied her shoes, took a deep breath and looked at Elise.

“It’ll be okay.” Elise handed Gwyn her travel mug with coffee in it just the way her friend liked it, stood up, pushed in her chair, and grabbed her back pack. Elise had finished getting ready while waiting for Gwyn. Normally the pair would be fifteen to thirty minutes early, but today they would just be on time.

After dropping their bags in the conference room the students used on clinical days, the 6 students assigned to the ICU today joined the shift nurses in the nurses station. Kameron and the other nurses were already present at the nurses’ station when Gwyn and Elise walked up. Kameron met Elise’s eyes and smiled before turning back to the other nurses present. Students had been assigned to patients 24-36 hours ago, but the shift nurses had yet to be assigned at that time. All patients on this ICU are level 2 or level 3. Level 3 patients are still unstable and either need advanced respiratory support and/or have at least two failing organ systems. Level 2 patients are “step down,”  either improving from level 3, need more intensive care or observation, or postoperative care. Since Mayo has an Emergency Department with a Level 1 Trauma Center, it’s a smorgasbord of opportunities waiting for nursing students, and it’s exactly why we are all attending college here. 

Gwyn was assigned to Registered Nurse Stacy and a patient that was ventilator dependent. I, Elise, was assigned to Registered Nurse Erica and an elderly  patient suffering from sepsis that was beginning to affect multiple organ systems. Tricia, Mark, Kristopher, and Caroline were all assigned in our unit but in different areas. The only other student I paid close attention to was Kristopher because he was assigned to Registered Nurse Kameron. That lucky dog! 

After our assignments, we went to our assigned rooms to receive a bedside report, then complete our initial assessments. My patient had issues with hypotension during the night, so was receiving blood pressure support, two different antibiotics, and extra fluids. These intravenous medications are given in an attempt to stabilize the blood pressure long enough to decrease the infection, and stop the insult to the organ systems. I had some experience with intravenous access and pumps last year, but this would be an excellent experience. My and Stacy’s patient was somewhat confused, so was 1:1. This meant we did not leave the room unless someone else was present to prevent falls and self-injurious behaviors. We made note of the IVs that were running, the amounts in the bags, the rates they were set at, and checked all the IV sites to make sure they appeared patent and free from signs of infection. At 930AM, I, Kristopher, and Tricia took a ten minute break to meet with our instructor, overseeing our clinical experience. During this break I updated my instructor that we had been able to decrease the blood pressure support slightly and our patient seemed less confused than was reported 24 hours ago. The patient was alert and oriented (A & O) times two yesterday, but A & O times three today. Kristopher informed us his patient (and Kameron’s) was in a serious accident two days ago and is in a drug induced coma and on a ventilator so his lungs, spleen, and brain can heal. Tricia’s patient was hospitalized with pneumonia that was worsening with oral antibiotics and nebulizer treatments to the point of the patient requiring oxygen, IV antibiotics, and possible intubation if things didn’t begin to improve. According to Tricia, her patient was on the low end of normal as far as blood Oxygen saturation but Carbon Dioxide levels were higher than normal as was respiratory rate. Tricia reported Respiratory Therapy, Pulmonology, and Infectious Disease Physicians are to be seeing this patient after 10AM, to assess if the treatment being given is the best plan. We returned to our patient rooms and at 10AM, Gwyn, Mark, and Caroline took their break. 

The instructor returned and helped us to deliver scheduled medications and treatments  under her supervision. Any treatments or medications not scheduled but PRN or emergent, were to be given by the staff nurse but observe by the student. One instructor simply cannot be in every room at all times and would not make patients wait until the instructor is available to deal with issues that arise. Unfortunately, issues that arise in the ICU can be life threatening if not dealt with in a timely manner. The rest of the morning went on without issue.  In the same groups as our morning break, we took a fifteen minute break for lunch before finishing our afternoon. In the afternoon, Nurse Erica had to return the blood pressure support to earlier levels and then to the maximum level for our patient, the fever increased, and the patient’s level of consciousness became altered. Unfortunately these were all negative signs for my patient since they had tried multiple antibiotics already to treat the sepsis. The patient was in septic shock, and the survival rate for septic shock in elderly individuals is about 50%. It was now 1:45PM and time for me to leave my clinical site and meet up with my group. I felt awful leaving when my patient’s condition was worsening but had to meet with my instructor. As I was leaving Kameron came out of her room and she almost ran into me this time. Kam laughed, “Woh, sorry there stranger,” and steadied me by my upper arms. 

I wasn't in a laughing mood. I was trying not to break down in tears for my sweet patient that I had been joking with this morning, that may very well be dying. I had never worked with an individual, other than my father, that had not gotten better after medical treatment. I looked up and tried to smile but failed, “Oh hey Kam. Sorry, I gotta go.”  

I side stepped Kam and went into the conference room for post-clinical report. I made it through the report and road home with Gwyn, listening to her talk and giving generic answers and sounds where expected. We arrived home about 230pm, I slipped off my shoes inside the door, thanked Gwyn for driving and flew up the steps to my bedroom. Once the door was closed, I dropped my bag, divested myself of my uniform by dropping it on the floor, and crawled under my covers on my bed in tears. Eventually I cried myself to sleep.