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Road Trip: Rehab for the ICU Nurse

July 16, 2012

Courtesy of the author; all rights reserved.

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

I took care of Gloria when she was admitted to the ICU after being involved in a high-speed, head-on collision. Although her injuries were very serious, my initial instinct was that she’d recover. I had a good feeling about her; as it turned out, I’d made a mistake in underestimating her mortality.

But everyone did, I think.

For the first few days her plan of care was routine and she progressed as expected. After several surgeries she was being successfully weaned from the ventilator. There was a plan for extubation. Gloria was awake and cooperative with all aspects of treatment.

She had an engaging spirit, and although she was never able to communicate with us well, we became attached to her and quite protective; we often requested taking care of her as our shift assignment, and later become strained and snappish with one another as unexpected complications propelled her along a steep and steady decline. Rehabilitation was ultimately traded for an extended ICU stay; extubation plans were cancelled in lieu of a tracheostomy.

I work among a group of passionate people. We’re determined and diligent. Because of that, a patient’s death in the ICU sometimes feels like a failure. We’re not terribly emotional—or rather, we rarely express or discuss the anxiety and sense of loss we feel when our patient slowly dies in front of us.

Our passion, in Gloria’s case, is most obvious to me in hindsight. We were desperate to bring her at least a modicum of peace and comfort; where medicine fell short, we did what we could to will her spirit well, and the measures we looked to speak volumes about what we regard as essential at the end of the day: loved ones, pets, music, flowers, memories . . .

I just returned from an overdue vacation—a long road trip. As I recounted the highlights of my vacation to my dear friend the hospital chaplain, she observed that the “little things” along the way seemed to be my favorite parts of the trip. And she’s right; wildflowers and cold lakes, unexpected side trips, fireflies and the simple closeness of family have left me with a renewed sense that all is right with the world. Somewhere along the seemingly endless stretch of miles, I even found perspective on the loss of Gloria.

She’s been gone now for almost a month . . . and since I’ve returned I’m no longer bothered by a distracting tug when I pass her old room. I’ve stopped remembering her as broken and dying before our eyes. I remember her, instead, as she was in a picture a friend had taped to the wall of her room—sitting in a red convertible, laughing in the sunshine, full of life and holding her dog.

I imagine she must have been on a road trip, and thinking that brings me comfort.

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4 comments

  1. Great reminder that the little things that imprint themselves in our memories are often the ones that bring us the most peace and pleasure. As always, wonderful insight.

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  2. You’re not the only one who feels failure when you lose a patient. In rehab, we do too.

    We’re supposed to get people back on their feet, up, out and living again. Sometimes, it doesn’t turn out that way, and all that work seems wasted.

    Until you realize that many people tell you, “You made me life better” even though the rest of it may have been short. You draw solace from that, even if the memories bring tears…and even laughter.

    You just never forget.

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  3. Awesome post. At the end of the day we all need loved ones, pets, music, flowers, and memories of vacations that leave us refreshed and renewed. Well written.

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  4. Thanks for the reminder Marcy. I am always happy to see your posts.

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