Critical Care Reflection Laura Donaghey

From reading Theresa Brown’s book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between, I found myself answering some questions. I realized I didn’t quite understand what the daily life of a nurse was like but Theresa really put it into perspective. She gave me insight into the life of critical care nurse and explained what it takes emotionally, physically and mentally to take care of such at risk patients.

Being a talented nurse requires strength and determination. As I think about the idea of loving and hating a career in nursing, I come to think about why I wanted to be a nurse in the first place. I have always known I wanted to be a nurse and a caregiver but I guess I never really thought about why. My mother and grandmother are both nurses and they are the ones who told me all along that I should become a nurse but I realized that there is so much more of a motive as to why I want to become a nurse.

Throughout my life, I have always been such a sensitive and caring person to the point where I thought something was wrong with the way I thought or reacted to certain situations. I soon realized that I could use these qualities to benefit me. I feel as though I can change others lives in a way that they will remember forever. For most, there aren’t going to be many times in our lives where we are going to be taken care of by a nurse for a prolonged period of time, but in those times, I think that it’s most important to put the patient first and make their time under my care the best it can be. Circling back to the main question: How do I react to the idea of loving and hating a career in nursing? I say that, while there are going to be times where I hate confronting the death of a patient or telling a patient that they have cancer, those are the times where they need me most. That is where the love of nursing comes in. You have to want to change peoples lives whether it’s to treat them or whether this is the end of road for them. Overall, I want to be the nurse that patients remember and I think the love for nursing outweighs the hate for nursing substantially.

Upon reading Brown’s book and as a fellow nursing student, there were times where I felt connected to her as a person. One part of the book that was most meaningful to me was when Theresa recounted a time with her patient, Jim. Jim was a cancer patient who had been through endless surgeries and treatments, trying to get rid of the cancer. One day, Jim reopened a past wound on his back and the fluid from the wound spread all over his chair, sheet, and floor. In this moment, Theresa had to evaluate, first, where the brownish fluid was coming from and, second, how to react so that she wouldn’t scare Jim. I found reading this part particularly meaningful because not only did Theresa not know what was happening but Jim didn’t as well. Furthermore, Jim didn’t know that Theresa was a new nurse so the entirety of the event was a learning experience for the both of them. Personally, I believe that Theresa handled the situation very well and she was calm and level-headed. Not letting the stress of the situation overwhelm her, Theresa was able to help her patient effectively and efficiently. Similar to how Jim put his trust into the hands of Theresa, my future patients will come to me in times of need and I will remember how Theresa handled the uncertainty of the situation with a tenacious but gentle spirit, keeping her patient’s wellbeing as her number one priority. Not only did Theresa stabilize Jim, she also made him feel comfortable and safe, and reassured him that everything was going to be okay. Even though Theresa was new to nursing and inexperienced, that didn’t matter because she used what she knew and relied on intuition and her nursing knowledge to care for Jim. Importantly to note, patients don’t know their nurse’s level of experience, so it is our job to gain the trust of our patient’s and to show them that you’re confident you can give them the most optimal care.

When thinking about my role as a future nurse, occasionally, I find it hard to relate to some of the stories from the other nurses because I have lack the experience of hands-on care. For example, in the chapter “First Death”, it was extremely hard to read about the first time Theresa witnessed one of her patients pass away. Even though I can only speculate what it must have like for her, I felt as though I was physically there with Theresa. I can’t imagine how emotionally charged that experience must have been for her or any nurse that has to be there to say goodbye. Just recently, my beloved dog passed away and saying goodbye to him was one of the hardest things to do. While a dog and a human are not the same, I felt I could empathize with Theresa and the patient’s family, too. The finality of death makes coping with the loss of a loved one a long and challenging road. Upon reading this chapter, I found myself feeling as though I was in the room with Theresa. Unfortunately, I have experienced the life of something being taken away in my own arms so I could picture myself in that moment and how to understand my own emotions, as well as the emotions of the family. I think that’s what I found most puzzling; how am I, as a nurse, supposed to not show too much emotion as I am the one who is supposed to be there for not only the patient but the family members, too? One part of the reading that resonated with me was when Theresa went over to her recently deceased patient Mary to identify whether she had heartbeat. Theresa discovered the absence of a heartbeat. This was such a profound and terribly difficult experience to read, that I can’t even wrap my head around it. In this moment, Theresa had to compose herself, put the stethoscope on Mary’s chest and achingly

wait for the sound of something that was not there. Theresa was thinking to herself, “ What if I had just missed the heartbeat? What if she reached up and grabbed my arm?… But the thing about death: is it’s completely final,” and out of our control (Brown, 2011, pg. 40). Theresa stayed strong for Mary’s family, which takes such composure and inner strength. It occurred to me that, in a moment like this, the family greatly depends on the nurse in the room for immediate comfort and emotional support. Even though Theresa was dealing with her own emotions, she was attentive to the family’s needs and she knew she had to be strong to do her job in a professional manner. This scenario is a moment a nurse could never forget and I had never thought about being in a scenario such as this one but is important to be mentally prepared for your, “First Death,” because it is inevitable in the field of nursing.

Throughout this book, I found myself relating to Theresa on multiple levels. However, there was one time when I questioned Theresa Browns’ skills. When a patient of hers, Mary, was nearing death, Mary’s sister requested that a priest be present to perform the last rites. During this time, it was also Thanksgiving weekend and so not many people were available to come in. As Theresa searched around for a priest, she was contacted by a Nigerian priest with a thick accent and long name, Umanankwe. Theresa was skeptical of his abilities because his name was complex and in a language other than her own. I don’t think that this was right of her to be skeptical and it showed a lack of cultural competence. Priests are there for people during times of need, regardless of how they talk or where they come from. I feel as though she should have never questioned Umanankwe’s ability to serve as a priest. She recognized the fact that she was being arrogant for judging the validity of Umanankwe’s abilities as a priest. I can see how Theresa may have been worried about how the family would react, as they were a group of white

Catholics, but I don’t think it was right of her to assume the family wouldn’t want someone of this race as a priest. In fact, Mary’s family ended up knowing the priest, for he gave a sermon at their church once. If it were me, I would have not questioned Umanankwe and I would have went on with my duties.

Reading Critical Care: A New Nurse Faces Death, Life, and Everything in Between, by Theresa Brown, gave me insight into the medical world of critical care and what it takes emotionally, physically and mentally for a nurse to tend to patient’s who are in such a vulnerable state. Reading her real life stories helped me understand what goes through nurses minds everyday while treating patients. This book answered a few of the questions I had going through my head as a nursing student and I will use this knowledge in my future as a nurse.

References

Brown, T. (2011). Critical care: A New Nurse Faces Death, Life, and Everything in Between. New York, NY: HarperOne.