The patient was admitted for an Orthotropic Liver Transplant. His surgery was complicated by possible graft dysfunction, requiring massive resuscitation. Due to the massive resuscitation needs, he developed Pulmonary Edema and Acute Respiratory Distress Syndrome, requiring Veno-Venous Extra-Corporeal Membrane Oxygenation therapy. He arrived to the CTICU after his lengthy 12-hour surgery and was severely hypotensive, requiring 4 vasopressors, and developed an Acute Kidney Injury, requiring Continuous Renal Replacement Therapy. He was a very very sick patient.
Lauren Robert admitted the patient directly out of the operating room. That first morning that he was admitted to the CTICU, Lauren stayed well past her shift to ensure that the day nurse was set up for the best possible day. She was helping settle the patient, ordering replacement medications, and organizing care with the physician staff. During this time, she started to build rapport with the patient's family. She took time to explain the norms of the CTICU and what was happening to the patient. Seeing multiple machines and IV pumps can be intimidating for a family, Lauren took the time to explain what she could with grace and humility.
Lauren took care of the patient again on Thursday, Friday, and lastly on Sunday. During each of those shifts, Lauren continued her relationship with his family. She was on a first-name basis with his 3 adult children, his wife, and his brother and sister-in-law. When the family came in, they seemed relieved that Lauren was back in the room, taking care of their father, husband, and brother. She is smart, noticing small changes in the patient's care and adapting her care to those, like properly titrating medications and turning the patient frequently to prevent pressure ulcers. She is strong; taking care of a VV ECMO patient requiring CVVH is mentally taxing. A nurse must be in the room much of the shift and is unable to take care of any other patient while they are caring for a patient like this. On top of this, Lauren continued to develop a relationship with his family, providing them care and the support she could while taking care of the patient.
On Monday, the patient's family decided to withdraw care at 1700. Lauren came in at 1700 on her own accord to say goodbye to the patient and his family. Lauren is compassionate and empathetic; she took time out of her own day to say goodbye to a patient she took care of for only 4 shifts and to a family that she built a relationship with during the patient's stay. I do not think that many nurses would perform such a selfless act. The CITCU has the best nurses, but in the 4 years I have been here, I have never heard of a nurse coming in on their time off to say goodbye to a patient and their family. As CTICU nurses, we see death often, some of us have become immune to it, but Lauren still comprehends the impact that it has on a family. For this selfless act, Lauren is a true DAISY Nurse.