Icu Nurse Quotes

Van Houten, I’m a good person but a shitty writer. You’re a shitty person but a good writer. We’d make a good team. I don’t want to ask you any favors, but if you have time – and from what I saw, you have plenty – I was wondering if you could write a eulogy for Hazel. I’ve got notes and everything, but if you could just make it into a coherent whole or whatever? Or even just tell me what I should say differently. Here’s the thing about Hazel: Almost everyone is obsessed with leaving a mark upon the world. Bequeathing a legacy. Outlasting death. We all want to be remembered. I do, too. That’s what bothers me most, is being another unremembered casualty in the ancient and inglorious war against disease. I want to leave a mark. But Van Houten: The marks humans leave are too often scars. You build a hideous minimall or start a coup or try to become a rock star and you think, “They’ll remember me now,” but (a) they don’t remember you, and (b) all you leave behind are more scars. Your coup becomes a dictatorship. Your minimall becomes a lesion. (Okay, maybe I’m not such a shitty writer. But I can’t pull my ideas together, Van Houten. My thoughts are stars I can’t fathom into constellations.) We are like a bunch of dogs squirting on fire hydrants. We poison the groundwater with our toxic piss, marking everything MINE in a ridiculous attempt to survive our deaths. I can’t stop pissing on fire hydrants. I know it’s silly and useless – epically useless in my current state – but I am an animal like any other. Hazel is different. She walks lightly, old man. She walks lightly upon the earth. Hazel knows the truth: We’re as likely to hurt the universe as we are to help it, and we’re not likely to do either. People will say it’s sad that she leaves a lesser scar, that fewer remember her, that she was loved deeply but not widely. But it’s not sad, Van Houten. It’s triumphant. It’s heroic. Isn’t that the real heroism? Like the doctors say: First, do no harm. The real heroes anyway aren’t the people doing things; the real heroes are the people NOTICING things, paying attention. The guy who invented the smallpox vaccine didn’t actually invented anything. He just noticed that people with cowpox didn’t get smallpox. After my PET scan lit up, I snuck into the ICU and saw her while she was unconscious. I just walked in behind a nurse with a badge and I got to sit next to her for like ten minutes before I got caught. I really thought she was going to die, too. It was brutal: the incessant mechanized haranguing of intensive care. She had this dark cancer water dripping out of her chest. Eyes closed. Intubated. But her hand was still her hand, still warm and the nails painted this almost black dark blue and I just held her hand and tried to imagine the world without us and for about one second I was a good enough person to hope she died so she would never know that I was going, too. But then I wanted more time so we could fall in love. I got my wish, I suppose. I left my scar. A nurse guy came in and told me I had to leave, that visitors weren’t allowed, and I asked if she was doing okay, and the guy said, “She’s still taking on water.” A desert blessing, an ocean curse. What else? She is so beautiful. You don’t get tired of looking at her. You never worry if she is smarter than you: You know she is. She is funny without ever being mean. I love her. I am so lucky to love her, Van Houten. You don’t get to choose if you get hurt in this world, old man, but you do have some say in who hurts you. I like my choices. I hope she likes hers.

The hospital will never be healthy for patients if it's not a healthy environment for nurses, where their voices are heard and where they can care for their patients and use the full extent of their knowledge, abilities, and skills. After all, hospitals today have become one big intensive care unit: all patients need intensive caring.

This book was started during the first wave of COVID pandemic, when pictures of bodies loaded into refrigerated trucks were coming out of New York. It came about because an ICU nurse emailed us and asked us to post something, anything, because reading our work on her short break between grueling shifts kept her sane.

ICU is a hard place for me since it’s often the last stop for our sickest patients.

Its's not enough to keep people from dying. We have to save the life that they want to return to, the one they had before they came to us." This was critical care nurse Mary Ann Barnes-Daly's mantra...

A group of grandmothers is a tapestry. A group of toddlers, a jubilance (see also: a bewailing). A group of librarians is an enlightenment. A group of visual artists is a bioluminescence. A group of short story writers is a Flannery. A group of musicians is--a band. A resplendence of poets. A beacon of scientists. A raft of social workers. A group of first responders is a valiance. A group of peaceful protestors is a dream. A group of special education teachers is a transcendence. A group of neonatal ICU nurses is a divinity. A group of hospice workers, a grace. Humans in the wild, gathered and feeling good, previously an exhilaration, now: a target. A target of concert-goers. A target of movie-goers. A target of dancers. A group of schoolchildren is a target.

Nearly everyone who is asked where they want to spend their final days says at home, surrounded by people they love and who love them. That's the consistent finding of surveys and, in my experience as a doctor, remains true when people become patients. Unfortunately, it's not the way things turn out. At present, just over one-fifth of Americans are at home when they die. Over 30 percent die in nursing homes, where, according to polls, virtually no one says they want to be. Hospitals remain the site of over 50 percent of deaths in most parts of the country, and nearly 40 percent of people who die in a hospital spend their last days in ICU, where they will likely be sedated or have their arms tied down so they will not pull out breathing tubes, intravenous lines, or catheters. Dying is hard, but it doesn't have to be this hard.

The nurse smiled and gestured to two cameras pointing at each patient—one to monitor the patient himself, the other to observe the charts. The nurse told us that these were fed by Skype directly into the intensive care unit in one of the hospitals in Washington, DC, where there was a Syrian-American ICU specialist looking at the monitors twenty-four hours a day, and adjusting the patient’s medication and ventilation based on the clinical parameters.

The stereotype of Italians said that they were chaotic; the hospital in Bastia said otherwise. There was still a sense of sorrow all around, but greater calm. The reception was staffed again. I asked them if I could see Matilde, and because I was a blood relation I was allowed to do so, with a nurse by my side. The day before I’d been able to walk into the ICU by myself, but only a few hours later the normal protocols had been reinstated. Almost normal, because I still had to zigzag between the beds set up in corridors, to get to Matilde.

I kept thinking how grateful I felt to have been part of this magnificent team. For five months we had been one unit, all specialists and all tackling the same problem together. The staff at the pediatric ICU and the consultants in the children's center reacted spectacularly. They rallied behind us and spent countless hours without charge, working to make this operation successful. As pessimistic as I was about the eventual outcome of the surgery, I still felt a glow of pride in being able to work side by side with the best men and women in the medical field. And the end of the surgery wasn't the end of our teamwork. The postoperative care was as spectacular as the surgery. Everything in the weeks following the surgery confirmed again our togetherness. It seemed as if everyone from ward clerks to orderlies to nurses had become personally involved in this historic event. We were a team--a wonderful, marvelous team.

I also worried that the linguistic contortions embraced by highly educated liberals antagonized the 62 percent majority of the country that lacked a college degree and that resented being told to change their nomenclature. When The Lancet medical journal tried to avoid dehumanizing trans people by referring to "bodies with vaginas", many women felt dehumanized. I heard from an ICU nurse in Idaho who was told to ask each patient for their identity: male, female, both or neither. Some patients were bewildered, others offended or hurt. The nurse told of the unintended effect on one patient: "One woman, post hysterectomy with complications, burst into tears and said, "I hope I'm still a woman." The concern about stigmatizing trans people is legitimate, but overreach seems to me a fit to hard-right Republicans who campaign against wokeness; it's a self-inflicted error by Democrats.

Learning from the nurse that the patient was a chronic alcoholic, this made sense. Magnesium levels are frequently quite low in everyday, heavy drinkers.

Finally, it was a hospice nurse, a gentle black woman, who broke the silence and said, “Now that is only the second or third time in all my years that I have heard that trumpet right after somebody died.

a registered nurse in the Grudge ICU,

doctors and nurses make decisions at a rapid clip, about 100 decisions a day per patient, according to research at Emory. Or more than 9.3 million decisions about care during a year in an ICU. So there is ample room for error.

It was for his own good. And the beast inside me roared. Every day it got louder. Nobody could tame it. Josh could calm me, but I wouldn’t let him close enough to try. Nurse Valerie buzzed me into the ICU. I slid the container of cupcakes across the counter of the nurses’ station. “Nadia Cakes.” She beamed at me. “You’re too good to us, girl.” She pulled the cupcakes down in front of her, looking over the assortment. Sloan had assigned me the job of bringing thank-yous to the nursing staff. Donuts, cookies, flowers. I tried to bring something every couple of days. The nurses had made all the difference in this situation. Valerie tapped her pen absently on top of the clear container and eyed me. “Can I ask you something?” I leaned over the counter, sorting her pens by color. “What?” I liked Valerie. She was my favorite nurse. She was no-nonsense. We’d hit it off immediately. “What did that boy do to you? ’Cause I can’t see any reason on my end why you’re not all over that man like white on rice.” Josh.Somehow in the last few weeks, the hospital staff had gotten wind of the Josh situation. “Valerie, we’ve talked about this.” She arched an eyebrow. “Have we? ’Cause you came off a little evasive if you ask me.” I shook my head at her. I wasn’t getting into it. She twisted her lips and gave me a knowing grin. “That man drives you crazy.” I snorted. “I don’t need him to drive me crazy. I’m close enough at this point to walk.

The only sounds at the late hour were the faint jingle of a phone ringing in the nurses’ station, the ping of an elevator, the faraway sound of the wheels of a cart, and the gentle beep of Brandon’s vital signs monitor. They wouldn’t allow any flowers or personal items in the ICU, but Sloan had snuck in an engagement photo. It sat on the table next to the bed. Her and Brandon on the beach, the surf crashing around their feet, her tattooed arm over his shoulder, them looking at each other. Both of them laughing. I looked back at him and sighed. “You’re going to have some gnarly scars, buddy.” They’d started the skin grafts for the road rash on his arm. “But you’ll get to do everything you planned to do with your life. One of us is going to get the girl. I’ll help you any way I can. Even if I have to wheel your ass to the altar.” I could picture his smile. With any luck I’d see it in a few hours. A knock on the door frame turned me around in my chair. “Hey, cutie.” Valerie came into the room for her vitals check. She turned the lights up, and I stood and stretched. As if sleeping in a chair wasn’t hard enough, the activity every two hours was the final kicker. I wouldn’t call anything I did on these overnight shifts sleeping. Maybe napping, but not sleeping. Every two hours Brandon was moved. They checked his airways, changed out bags, looked at his vitals. I don’t know how Sloan was handling doing this almost nightly for the last three weeks. Sloan was a good woman. I’d always liked her, but now she’d earned my respect, and I was grateful Brandon and Kristen had her. “Did you decide what day you want to bring the kids to the station?” I asked Valerie, yawning. She cycled the blood pressure cuff on Brandon’s arm and smiled. “I’m thinking Tuesday. You on shift Tuesday?” “Yup.” She wrote down some notes on Brandon’s chart and then gave me a raised eyebrow. “Any updates with your lady friend?” I laughed a little. “No.” The whole nursing staff knew about my depressing love life. I’d gotten hit on a few too many times by some of the younger nurses. I couldn’t claim to have a girlfriend, and I wasn’t married, so it was either “I’m gay” or “I’m in love with that girl over there.” I’d gone with the latter, and now I wished I’d said I was gay. They didn’t know why Kristen wouldn’t date me, just that she wouldn’t. It had turned into the favorite topic of the ICU. A real-life episode of Grey’s Anatomy. I rarely got through a Brandon visit without it coming up. The drama escalated when Kristen had been hit on by the nurses’ favorite single orthopedic surgeon. According to the nurses’ gossip circuit, Kristen told him to go fuck himself. And apparently she’d actually said, “Go fuck yourself.” After that everyone was sure she was holding out for me. Only I knew better.

Visitors stream in and out of the rooms and corridors. There are families to see, questions to answer, a new admission from the ED. It’s one thing after another—randomly, it seems—bouncing from one story to the next. Mr. Gunther, headed for the NIH, leaves with his wife. She gives me a long look as they head toward the elevator. I wish her well; living with Pascal’s wager can’t be easy. Mr. Kinney, a dapper corporate attorney, is also getting out of here after a rough two weeks. His pancreas is totally destroyed, replaced by puddles of necrotic fluid, yet he refuses to accept the fact that his fondness for single-malt scotch is the reason why. His wife gives me a long look, too, then they’re gone. Jim, the Cardiology fellow, shows me the echocardiogram he just did on Mr. Warner, our guy with HIV. Nothing there, Jim says, no vegetation, no sign of endocarditis. We consider what this means, make a plan. Up on 10 Central, Mr. Mukaj’s bladder irrigation backs up painfully again but there’s nowhere else we can put him, no empty beds in the ICU or Step-Down Unit, no place where he can have his own nurse with him all the time. We bounce this around, too, decide to try this, then that, we’ll see. Mr. Harris, our patient with Marfan syndrome, a plastic aorta, and a septic hip joint, spikes a fever again. Not good. We make a plan. And so it goes, on into the evening. On days like this, doctoring feels like pinball: nonstop random events—intercepted here, altered there, prolonged or postponed by this or that, the bells and boinks sounding all around—and sometimes you can’t be sure whether you’re the guy pushing the buttons, manipulating the levers, and bumping the machine, or whether you’re inside the machine, whether you’re the pinball itself.

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