My brother drops me off at the Fifth avenue entrance of the Mount Sinai Hospital, conveniently located on the border of Spanish Harlem and the Upper East Side. I hear a good morning from the security guard and I make sure to look up from my coffee cup to greet him back. After all, who knows if I’ll see him again. Pray some duas, (prayer in Arabic) and exhale on completion as I approach my unit. I started in the Cardiothoracic ICU a year ago. Prior to that, I was a med surg nurse with six ambulatory patients but now as I enter the automatic doors I am greeted with one and sometimes two bed bound patients, often attached to the trumpet of the ventilator and din of the cardiac monitors. As their ICU nurse I begin to make their problems my own.
When 7am hits, bedside handoff is given, I check my drips, ventilator and my patients intact sacrum, get an initial ABG, and make my voice heard during AM rounds. I am amazed at that the next time I look at the clock that often three hours have passed. The pace is very fast, clinical judgment and critical thinking are at its peak. I am in my element. The constant monitoring of the patient’s physiological changes, hemodynamic status, titrating vasoactive drips, and preventing barotrauma from high ventilator settings keep me driven to stay ahead of the patient. To envision the worst possible scenario and being able to tackle it long before it surfaces. Working in the CTICU i have developed meticulous attention to detail and being able to keep my composure through tough times, whether it be an open chest or dealing with a family of a patient with a total artificial heart who is now deciding to withdraw care.
The ICU has prepared me to look much further than hemodynamics and to understand patient suffering internally understanding their histories, lab values, CVP, PAP, and putting it all together. Similarly, externally we look at their psychosocial status, did anyone come to visit? How can I effectively teach the families to care for their loved one LVAD when they get home?
After shadowing a CRNA, I knew that this is where my worlds would converge. Not only would I keep my nursing skills but I would be able to do much more. Being able to be an advanced practitioner to under my patient’s physiological status to adequately help alleviate suffering internally and also being able to explain it to their families thereafter externally that their family did well and was up and talking again. Furthermore, after CRNA school, I hope to take my degree further than the walls of American institutions. I hope to take my skills as an anesthetist to aid in relief efforts around the world. To educate others on proper techniques of anesthesia and nursing practice so they can be empowered to do it on their own.
As the day ends, I say goodnight to the security guard and run past the revolving doors accepting that the day does not end there. I get to into the subway and sit there and — people watch, often seeing my patients faces on them. These people can all be my patients one day. I wish i can tell them to stop smoking or eating that bag of chips. I don’t want you to have a heart attack dear, I think in my head.