During DAISY Honoree ceremonies, we hear the manager read “Almost without exception, when a nurse receives The DAISY Award, the humble response is, ‘I don’t deserve this, I was just doing my job.’ What the DAISY Nurse may not realize, however is that when nurses are ‘just doing their jobs’, they have such an important and meaningful impact on the lives of so many people – many more than just their patients." The nature of what the nurses do in the CVICU every day goes ABOVE and BEYOND for their patients and impacts their lives and their families’ lives - creating moments and memories that will last a lifetime. 

Many of the patients in the CVICU are on mechanical circulatory support (MCS) devices including Intra-Aortic Balloon Pump (IABP), Impella, Extracorporeal Membrane Oxygenation (ECMO), Left Ventricular Assistive Device (LVAD) or Continuous Renal Replacement Therapy (CRRT). These patients are placed on 1:1 care because of these life-saving devices. And the patients remember the care that was given to them while they were on these devices. 

In 2023, CVICU nurses cared for 238 open-heart patients, which included 25 ECMO and 5 LVAD patients. This year, we have seen new therapies to care for these patients including verticalization therapy. This bed allows the pt to stand to improve lung capacity and reduce deconditioning, muscle wasting, and ventilator dependence due to bed rest. Though intimidating to some, this verticalization therapy helps strengthen the patient’s core and get our long-term VV-ECMO patients up, standing, and eventually walking, to qualify them for a lung transplant. 

In 2023, CVICU nurses were also able to care for patients on Veno-venous (VV) and veno-arterial (VA) ECMO, Left Ventricular Assist Device (LVAD) and continuous renal replacement therapy (CRRT) - that is four mechanical circulatory support devices- for one patient. The life-saving therapies and the skills to care for these patients are superb. 

But, most of all, the CVICU nurses go ABOVE and BEYOND with the promotion of well-being and health for all of their patients. Here are some examples of the moments and memories that the CVICU nurses created for their patients and their families. 

One of our first ECMO patients was in his room for over four months. One of our nurses, Mike, coordinated with our CVICU attending, respiratory therapist, perfusionist, break nurse, and the patient’s family to bring a ventilated patient on ECMO outside to feel the sunshine. This lovely moment was captured for the patient and his family, to feel the sun on his face and the wind on his cheeks. 

During Covid, we had so many restrictions on visitors that we had to think outside the box. Deepa, RN, coordinated with our interdisciplinary team to have her ECMO pt meet his new grandson outside for the first time. What a moment! 

During this time, this ECMO patient was also the first one to walk in the hallways while on ECMO. Nursing, physical therapy, occupational therapy, respiratory therapy, perfusion and Anesthesia Critical Care Medicine (ACCM) coordinated to walk the halls so he could get on the transplant list. He was transferred to Cedars for a double lung transplant. 

CVICU nurses have made sunshine therapy part of their care. Our patient had been on VV-ECMO for 2 months when he was stable enough to go outside. Another coordinated effort by nursing, perfusion, and the RT to get our patients some sunshine. The family brought his sunglasses and his favorite blanket and joined the ECMO sunshine therapy sessions. - Some patients have a longer length of stay and our nurses go out of their way to coordinate their time outside. Veronica took one of our patients, who had been in our unit for over 2 months, to go outside with her family. The smile from both the patient and the family are priceless.

Our cardiac surgery patients sometimes have complicated courses after the cardiac surgery and have a longer length of stay. Jinhee coordinated with the team and the patient’s family to take her patient outside. The patient had the biggest smile on his face and repeatedly said to his son, “I’m so happy! I’m so happy!” The interaction between the patient and his family was captured so perfectly and shared with his son who was so grateful for the care that all the nurses, especially Jinhee, gave to his father. 

And while there were visitor restrictions, Alexis coordinated for an outside picnic with our Impella patient so his family could see him before his potential transfer and transplant. The patient and their family were able to enjoy a picnic outside in the sun, breathe the fresh air, and enjoy time with their loved one while he was on ventricular assistive device. 

Spending the holidays in the ICU is not the most fun, so Hamzeh coordinated a Christmas outing for our patient to greet his family on Christmas Day. 

And the list goes on. Our CVICU nurses try their very best to ensure that the patients and the families can see their family members in a (somewhat) normal environment and promote a sense of healing. The CVICU nurses live the Florence Nightengale Environment Theory where they use environmental factors including fresh air and direct sunlight to help heal their patients and care for their entire well-being, serving their patients in the most holistic way. And the patients are so appreciative that they return to say thank you to the nurses and the entire care team for working so hard day and night to care for them in their most vulnerable time. 

Take P, for example. He was a transfer patient from an outside hospital with cardiomyopathy, cardiogenic shock, requiring IABP and Impella. Connie, our amazing case manager, was able to transfer him to Cedars, where he received a new heart and kidneys. He came to visit to say thank you to all for saving his life. If you can see his right hand, he is holding the squishy stress hearts we give our patients to help him with strengthening his grip post-operatively. 

Or M, one of our patients from last year, who came to visit. He stood in front of his room where he was being worked up for an LVAD and was cared for by our cardiology, heart failure, and CV Surgery teams. He had an Impella 5.5 placed and then transferred to UCLA to be put on the transplant list. 10 months post-heart transplant and he looks like a whole new person. He stood in front of his old room to say thank you to everyone who took care of him and brought Porto’s to share. 

And BP who walked into the unit with his wife. He is doing extremely well, coming to visit the unit after getting re-fitted for his prosthetics at the ortho clinic and wanted to walk in to say thank you. He told us that when he got admitted to an outside hospital, they told him he was going to die. But here in our CVICU at UCI Health, we never gave up on him. He was placed on VA ECMO & CRRT, and we transferred him to Cedars for a heart & kidney transplant. He continues to go to our ortho team for his prosthetics. And he wanted to take a picture by his room where we saved his life. So, he is eternally grateful. 

And most recently, our LVAD patient from last year. He was implanted here last November and looks absolutely amazing. He visited recently and wanted to say thank you to everyone for giving him another chance at life. 

This is our why in the CVICU. Some recent patient feedback includes: - “Being at your facility was like being at a Medical Resort. What an experience I had there, it made my life different in every possible way, even the discharge was right on. An extremely intelligent staff at that particular hospital and I am impressed and would, without questions, recommend this to my friends. I now take this opportunity to commend in a special way my nurse, Anne. Anne has shown exceptional caring and service in the entire time that she was assigned to my care. I and my family are deeply grateful for her exceptional conduct and demeanor. Anne practiced effective listening, thus resulting in our great communication. Anne was caring, attentive to my needs, and showed empathy and understanding of my situation. And for these, I and my family are grateful. Anne got the commendation form before discharge but inadvertently lost the [form). If needed, / would appreciate receiving from you the said commendation form. Otherwise, please consider this as my formal commendation for Anne for her exceptional service and care." 

Each day, the nurses go above and beyond, forming meaningful relationships with the patients and their families, knowing that time with them is so very precious. Every day the nurses coordinate the care with our amazing interdisciplinary teams – our cardiovascular surgeons and PAs, our ACCM physicians and nurse practitioners, our cardiology and heart failure teams, our LVAD coordinators, our physical, occupational, respiratory and speech therapists, our case manager, social worker, dietician, pharmacists, perfusionists and all our staff to achieve the best possible outcomes for our patients. And every day, they go above and beyond, to get their patients home (and hopefully a happy return visit to us). I am so lucky to be a part of this team and the CVICU nurses are 100% deserving of the DAISY Team Award.