—By Lauren Williamson, Senior—
This summer I am working in the Coronary ICU (CICU) at Houston Methodist Hospital. Houston Methodist has both a cardiovascular ICU and a coronary ICU. Patients in the cardiovascular ICU are most likely just coming out of open heart surgery, whereas patients in the CICU are either awaiting a heart transplant, have experienced complications during a heart transplant like an infection, or have been diagnosed with heart failure. Overall, coronary ICU patients tend to be more critical due to the fact that they’re awaiting surgery and are in an unstable condition, versus CVICU patients.
As you can imagine, I have already learned an enormous amount of information just from working on the unit for a few weeks. Just like clinicals, my shift starts at about 0645, when I receive the night shift nurse report. I then complete a full head-to-toe assessment on both of my patients, and prioritize my tasks for the day based on my patients’ acuity. Once my assessment has been documented, the rest of my shift is filled with medication administration, procedures, visits from doctors, respiratory therapists, echo technicians, and more! Time management is crucial so that I have enough time to give my patients the emotional support they need as well. However, no matter how well you time manage, you will always have scenarios that arise that require your attention and will therefore cut into other tasks. This could include one of your patients going into cardiac arrest or a patient’s family needing additional teaching on their plan of care.
Thus far, the most rewarding thing for me has been the relationships I have made with my patients and their family members. I’m seeing patients as they enter one of the most vulnerable and life-altering times in their lives, which makes my role as a nurse that much more important. Many of my patients have been living with chronic heart failure for several years, but have now reached a point where they are unable to survive without either medical equipment or a new heart. Several patients are therefore required to stay in our unit for months on end while waiting for a new heart. With patients both progressing to less acute departments, or dying while on my shift, the patients’ families are relying on me for support through it all. While education regarding medications and procedures are important to some family members, what I have found to be the most comforting is simply freeing myself up to them as much as my schedule allows. Simply knowing that I am physically and emotionally available to them often times allows them to drop their guard and share both laughs and tears with me. These relationships I have formed with different family members have grown so much so that even when their loved one moves on from my unit, some have come back to my unit just to update me on the progression of my previous patient. While this task of emotional support isn’t technically in a nurse’s job description, it’s why I look forward to coming to work each day.