Right Where I Want to Be
I'm back in the ICUs again. These aren't just any ICUs. They are in one of Houston's major hospitals, the place you want to be if anything bad happens to you. This is where I want to be. This is what I think of when I say ICU. These are among my favorite patients. They're critically ill and medically complex. And as soon as I read my first chart I started wondering if I belonged there.
Therapeutically I know what to do with these patients. I know what monitors to watch and what the readings are telling me. I can tell if someone is getting ready to crash. I don't worry about those things. I worry about missing something or not doing enough or doing too much. I worry that I'll inadvertently do something wrong and not realize it. These are thick charts. There's lots of information that isn't always legible. I could miss something. I even worry about pulling out lines. Every ICU therapist has probably done that at least once. I know someone who pulled out a PEG tube. Other than her being shocked, nothing happened. Therapy may not be the most important thing on their agenda but it's a part of the healing process. A chair may be all that separates them from a pneumonia or worse.
Most of them are in the hospital due to circumstances beyond their control like an MVA or brain injury. One minute they were fine. The next minute here they are looking at me through a haze of confusion and pain. Sometimes there is family present. I try to avoid doing treatments during visiting hours but it happens. It's hard to work with someone who is minimally responsive while the family is intently watching. They're looking for hope that things will return to normal. Doctors often have little to say to them because they just don't know. So the families are watching and looking for hope even though they don't understand why I'm doing what I am. I feel bad when the patient isn't doing well and the family is expecting miracles. I tell them the process is just starting. I tell them to be patient. I assure them I saw something. I know what they hear and I what I say aren't the same. This is the hardest part. I sometimes walk out of rooms feeling bad because I got a glimpse of who the patient once was while knowing the prognosis isn't good.
Still I enjoy what I'm doing. I look forward to each day. I pick up as many ICU patients as I can. I accept my concerns and fears. I'd be more upset if I wasn't worried. As long as I'm worried I'm doing my best. I'm not just going through the motions so much as trying to make a difference. That's all I can do. I just hope it is enough.