Life in CTICU
A chest was to be opened by the bedside. We quickly converted the ICU room into an operating room. The 56-year-old CABG x 4 had been bleeding from her chest tubes profusely, almost like water running from a faucet. She had not stopped her Plavix in time, before her unexpected surgery. Our CT Fellow wrapped himself in a sterile blue gown. An Anesthesia Fellow was standing by the head of the bed administering drugs. I was scrambling, hanging blood and FFP as fast as I could while Aimee began titrating drips as the monitor showed a dropping, cascading downward spiral. Scott was managing the crash cart, staying one step ahead with calcium gluconate syringes.
The patient wasn’t mine, or Aimee’s or Scott’s. She belonged to a new grad who had just completed her orientation to the CTICU — a young, unseasoned nurse in critical care. She had stepped out of the room overwhelmed by the adrenalin rush that we seasoned nurses felt during events like these. The surgical blade sliced through the patients’ sternal incision. Bright red blood sprayed out of the patient’s chest towards the Fellows’ face masks. Retractors were set in place. The rush was on to find the “bleeder.â€
As we worked together, I saw the new grad cringe at what she observed. To lighten the seriousness of the situation, Scott set into motion a few laughable “Greys’ Anatomy†scenarios. We all chuckled and laughed as the bleeder was finally sutured with 3-0 silk ties. The patient’s blood pressure returned to normal and we decided to pack the chest and leave it open for the night in case more bleeding began later. I hung more FFP to correct the patient’s coags. Soon we were cleaning up the room, converting it back to a typical patient room.
Later on in the shift we seasoned nurses (combined years in critical care 13+10 + 20 = 43 years), began discussing whether we thought new grads should be working in an ICU such as ours. Our unit has a high acuity and requires constant problem solving abilities. We had noticed that many of the new grads who are orienting in our ICU have no critical care experience. They are fresh out of school and perhaps lack critical thinking skills, something that we believe comes with years of experience.
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