Critical Care Exemplar

1)

In the novel, Critical Care, author Theresa Brown encounters her first condition A, or cardiac arrest, in which her patient passed away. Theresa was expecting to have a calm shift, when her patient in the oncology unit who was previously in a stable condition began to bleed profusely from her nose and throat.  I was surprised that Theresa knew exactly what to do in the situation of her patient entering a life threatening situation. It seemed as if the moment she learned that her patient was hemorrhaging, she told her fellow nurses to call the patient’s doctor, as well as get suction for the blood. She immediately began to give CPR when the patient lost consciousness, as well as had an absent pulse, until the condition team arrived. These efficient responses to the situation appear to be a testament to the training nurses receive in nursing school. The process that the nurses memorize and have down to, what it seems like muscle memory when an uncertain situation arises, is a truly remarkable skill set that I aspire to learn one day.  Experiencing a patient death seems to be a frustrating event, in the sense that you may be mad at yourself for believing that you could have done more for the patient. I believe that each nurse needs to assess how they feel in their own way at the time of their first, or any patient death that they experience. Then, they need to do what they believe is best and healthiest for them to cope with the feeling that they experience. For Theresa, it was focusing on the positive aspects of life, such as her children or finding as many reasons as possible to laugh. For another nurse, it could be talking through the experience and how they feel with a spouse, coworker or close friend. The response to a patient’s death is going to be different for every nurse.

3)

         An example of a hierarchy within Theresa’s unit is the perceived power that her charge nurse appears to have over the unit concerning duties that all of the nurses are responsible for, and can carry out if they are free. Anna, Theresa’s charge nurse, asked Theresa to help move a patient while Theresa was busy with the separate task of filling out discharge paperwork so that a patient could be moved from the hospital in a more efficient manner. However, Anna was talking to another nurse on the floor who was completely free, but seemed to be friends with Anna, so Anna did not ask her to perform the task of helping to move the patient. This hierarchy is evident in how nurses who have connections with Anna are receiving the preferential treatment of not being asked to carry out a task despite them being free. Anna exploits her authority to unnecessarily force a task on Theresa that could have been completed by another nurse. Anna asks her in order to make matters more difficult for her as an act of revenge for Theresa’s decision to leave the unit. Egalitarian treatment is seen when Sarah, her boss’s boss, goes to check on Theresa after her condition A. Sarah shares her own experiences with death as a new nurse and attempts to relate to Theresa, as an attempt to help her. Despite Sarah having more authority than Theresa, she talks to Theresa as an equal, freely advising her on how to handle dealing with patient deaths.

4)

In the chapter, Condition A, Theresa describes how there was no part of nursing school or life that prepared her to tell a family member of a patient that the patient has passed away. This resonated with me because it has been an aspect of the profession that I have been nervous about ever since deciding to study nursing. I’ve always thought about how I would tell somebody that their close family member has died and if I would be prepared or not. It worries me that Theresa was not given any guidance about how to break the news of a death to a family member, considering death is an occurrence that happens a fair amount in the medical field. This incidence leads me to hope even more that I will receive guidance at some point before I experience my first patient death, so that I will have some idea about how to break the unfortunate news to a family member. Any guidance on this matter is better than none.

5)

Theresa relates her love and hate of nursing to a poem. I can very much see the idea of both loving and hating nursing. I feel like I will hate aspects such as dealing with death, the repetitive duties that must be carried out and unnecessary hierarchies created by my coworkers, but in the end I will be able to know that it is all worth it, as it leads to saving lives. Enduring some of the lackluster traits of nursing not only lead to saving lives, but also to carrying out the duty of helping the patient to get better. No matter how bad the situation I feel that I may encounter, I will love the sense of purpose that nursing will provide me with. I will always be able to live with myself knowing that my sense of purpose lies in helping others through the worst days of their lives, as well as assisting to improve their quality of life.