We had a very difficult day in the PICU on Sunday and I am so grateful for the teamwork.  We had a patient who needed to be intubated and we knew this would result in a rocky path for him.  He required multiple code medications, fluids, blood products, electrolytes, and an abdominal procedure at the bedside by the surgery team.  At the same time, we had other admissions coming and other patients in the unit to care for.  

Amanda Daly was this patient’s bedside nurse and she did a phenomenal job managing the patient’s medical needs, delegating, and making sure the parents stayed informed and had chaplain support.  Danielle King had an intubated patient herself and discharged a patient just in time for me to tell her she would be admitting another intubated patient from the ER.  While managing this she was still incredibly helpful with this patient.  She was calm and helped with many hands-on tasks needed in the room.  Alisa Dunn had two other patients herself.  One thing I love about Alisa, is she can often walk into a room, see needs, and gets them done without asking.  She knew the patient needed more IV access and was able to obtain another IV even though it was difficult because of the patient’s poor perfusion. This was just one of the many things she helped with. Callie Zirpel happened to be at MRI with her intubated patient when Amanda’s patient decompensated.  As soon as she came back from MRI and settled her patient.  She was a great set of hands and made sure to check on the other patients in the Unit.  Jill Bauer came over from the adult world and picked up Amanda’s other patient, helped Danielle settle her intubated patient from ER, and then admitted another patient from ER herself. In the midst of this, she also helped us clean up Amanda’s patient from all the procedures and did multiple tasks for other nurses who were busy helping Amanda.  From drawing labs to giving pain meds and checking in with other patients, we could not have done it without her.  

Ang Krueger was the Peds CCL that day and spent close to four hours straight in the PICU.  She was my sidekick the entire afternoon, recording the entire intubations, resuscitation, and procedure, grabbing meds and supplies, drawing up fluids and blood products, and making phone calls to many ancillary departments.   She also helped me find another nurse to take incoming patients and staff the night shift so I could focus on patient care.  Ang always remains calm and speaks up if she notices something a patient might need even though she doesn’t routinely work in the PICU.

Taryn Califano was the Peds flex nurse.  She came up to the PICU to administer chemo to another patient around the time we were intubating.  Taryn monitored this other patient during chemo infusion and answered many call lights. After chemo was complete Taryn stood in Amanda’s patient’s room the entire abdominal procedure, pushing fluid and blood products for close to two hours.  She was crucial to keeping this patient’s hemodynamic status stable during a very critical procedure.  

Carolina (Gladys) Diaz was our respiratory therapist for the weekend. She is wonderful.  Though she was spread thin across the hospital, she remained in the patient’s room for 3+ hours.  A majority of this she was manually bagging the patient after intubation through the entire abdominal procedure because the patient was too sick to even tolerate the ventilator. Carolina (Gladys) switched out ventilators multiple times between conventional and high frequency and was a great troubleshooter.  We are so grateful for her expertise.  Stacy Batt was working in another area of the hospital as a respiratory therapist and came to the rescue in the middle of multiple other needs in the hospital. She helped take another patient to a long MRI and was also extra hands for Carolina (Gladys)!  Thank you, Stacy!  Mir (Dr. Ali) was our fearless leader, He briefed everyone before the intubations and made sure we had anesthesia present due to the critical nature of the patient.  He remained calm and focused on the patient.  

Gokhan (Dr. Olgun) came in on his day off to help admit two patients from the ER and made sure other patients were taken care of since Dr. Ali needed to be focused on Amanda’s patient.  We were so grateful for his help to make sure orders were entered so nurses had what they needed to take care of these patients.  Samantha Holm (Sr Administrative Assistant) was the Peds PCA. She came up to the Unit and set up three rooms for other admits, helped make sure rooms were stocked, and restocked every cart in the Unit, which were completely torn apart. Even though she doesn’t work in the PICU often, she did a great job.  We couldn’t have kept the unit running without her.  

Dr. Keckler was the pediatric surgeon on this weekend. Thank you is not enough.  Dr. Keckler quickly got us more central access and then performed an exploratory laparotomy and rerouted a difficult ostomy at the PCIU bedside.  He had to leave the child’s abdomen open due to so much swelling.  His knowledge, skill, and calm demeanor in an environment where he isn’t normally performing procedures, were incredible.  He kept the family updated personally and thanked Taryn for keeping this patient hemodynamically stable. This meant so much to her – especially as a nurse who does not work in the PICU routinely.  Thank you Dr. Keckler for being an incredible asset to our team.  Dr. Rebekah Wood was the surgery resident on this weekend.  She was calm and after the procedure helped us understand how the abdomen was packed and how we could best position the patient for comfort and safety.  Krystal Weber was the patient placement coordinator for the hospital.  She was so kind, patient, and understanding with our delay in moving patients up from the ER due to resuscitation.  She also assisted in finding Jill Bauer to come to take patients for us.  I was grateful for her understanding and for keeping the ER in the loop for me.  Though this was a difficult day, I am grateful for all of these individuals who helped keep the ship sailing.