In the Pediatric Intensive Care Unit, exceptional attention to detail and precision is a necessity. My patient was doing ok until they weren’t. We were talking about Paw Patrol then they were decompensating, and turning blue. In less than 30 seconds I had to recognize the problem and intervene.
I started oxygen and called for additional help. Other nurses arrived and started more interventions. I stepped aside to call the resident to come to bedside, then the respiratory therapist. The patient continued to deteriorate rapidly, turning into a life-threatening event, I then called a Pediatric Code Blue which is paged throughout the hospital for the Anesthesia team and the Code Team to come.
Anesthesia comes with emergent medicines and devices to intubate immediately to create an airway when the patient is no longer able to breath on their own. The code team comes with the MICU Attending (that’s the most senior cardiac doctor) to assist. Then like 20 other people show up, all consulting teams – social work, spiritual care, Pediatrics doctors, Burns doctors, our fellow ICU nurses on the unit to support with chest compressions or get other medication, they support in whatever way is needed.
This all began with an alarm beeping. It is my responsibility to notice and recognize the slightest changes in the patient’s conditions, then take action to adapt to the evolving situation very quickly. I started the chain of safety mechanisms. Kids are young and vulnerable, often unable to express themselves with under developed language abilities or they have complex medical conditions and unable to communicate.
I didn’t know, one of the required skill sets to work here would be emotional strength and stability, to balance empathy and compassion for the most vulnerable patients with the ability to handle rapidly deteriorating conditions, suffering, and the possibility of death while working with high-tech medical equipment.
The PICU in a trauma center is an intense place to work, even for an experienced registered nurse. Every day is hard, every day is a learning experience. I am challenged every day.
I am told this is what it may be like during May-September, in what is called Trauma Season. Trauma season is when kids are off from school, and there is not only one life threatening event that rolls in through the door, but multiple life threatening events occurring on the unit at the same time. This brings new meaning to summer.
withoutapillow 