By Ali Tehrani, MSN, RN, CCRN
Valentine’s Day was quiet in the ICU. I just had one patient who was stable and eventually could transfer to a regular unit. I was thinking of ways to surprise my wife for Valentine’s Day. Should I purchase a beautiful card and some flowers on my way home? Should I make a reservation at one of her favorite restaurants for dinner? I wanted to show her my passion and appreciation for her.
But then, everything changed, and I had to forget about my Valentine’s Day plans.
The ED nurse called to give me the report on a new patient being admitted to the ICU. The patient was a 62-year-old woman who had open heart surgery three weeks ago. She was on a high dosage of warfarin and was actively bleeding in her lower GI system. She had an INR of approximately 4.2, with a hemoglobin of 20 and a hematocrit of 7. She was in shock and in critical condition.
Because she needed one-to-one critical care, I immediately transferred my stable patient to the regular unit to focus on the new admission. At around noon, the new patient arrived by stretcher, with her husband at her side. She was very pale and weak and repeatedly said, “Am I going to die? I don’t want to die.”
Calmly I took her hands and looked into her hopeless eyes. I promised her nothing would happen to her while I was there, and I would not leave her until she stopped bleeding and improved. I explained my plan of care, and she told me she believed me and trusted me. As an RN with many years of experience, I thought for sure I could save her. Immediately I called her physician to get all the necessary orders, which included two bags of fresh frozen plasma transfusions, IV Vitamin K, alternative drips and most importantly, a STAT GI consult for a bedside esophagogastroduodenoscopy to stop the source of the bleeding.
I also continued to tell the woman and her husband that everything was under control and she would be fine. I remained with her and took no breaks, changing her pads every hour, keeping close watch on her blood pressure and checking her vital signs every 15 minutes.
After waiting for several hours for the GI consult, I called the physician consultant, explained the patient’s critical status and asked him to see the patient immediately. During the night shift report, the GI physician and her primary physician both arrived. When the patient asked me to stay with her during the procedure, I said, “I am not going to leave you alone, as I promised you.”
Instead of going home, I remained with the patient to help with her bedside EGD procedure. I sent a text message to my wife and told her I was busy and I would be late.
Everything happened just as I expected. After the procedure, the bleeding stopped and the patient’s vital signs and lab results returned to normal. It was another example of an ICU collaboration with an excellent patient outcome.
When I finally was leaving my very late shift, the patient hugged me in front of her primary physician and husband and said, “You are my real hero. You saved my life. I’ll never forget you.” She gave me a beautiful bouquet of red roses her husband had brought her for Valentine’s Day.
That was one of the best moments of my entire life. I thought how lucky I was to be a nurse and to be able to save people and change their lives. We can show our compassion, love and kindness to people and receive wonderful feedback from them.
When I arrived home, I gave the bouquet of red roses to my kind wife and told her the whole story, and how I learned the real passion of Valentine’s Day. •
Ali Tehrani, MSN, RN, CCRN, is a staff nurse in the SICU at St. Joseph Health Mission Hospital
in Mission Viejo and Laguna Beach, Calif.
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