Rosemary Ramirez
January 2015
Rosemary
Ramirez
,
RN
Intermediate Care
University Medical Center Brackenridge
Austin
,
TX
United States
Let me tell you a story about a nurse who does our profession proud.
Being a Level 1 trauma center brings its sad moments as well as its miracles. I was assigned to a patient who had been in a serious motor vehicle accident. The collision left her with multiple pelvic fractures and injured her two children. Both children were at Dell Children's Hospital, one was recovering from broken bones, but the younger child had a critical traumatic brain injury.
The patient's physical needs were dwarfed by her unimaginable emotional trauma. When her family gathered the courage to tell her that her baby was brain dead, the whole unit was pierced by her wails of grief. Her plea was to see and hold her child.
The team drew together to formulate what seemed at first to be an impossible plan. Brainstorming began, in search of ways to unite mother and son. My patient had recently been admitted to a critical care area, with severe pain and limited mobility due to her injuries. Her child was in PICU on a ventilator with ICPs climbing to the 60s.
I was overwhelmed and emotionally drained by the situation. Then a hero came along.
It was 7am, change of shift, and Rosemary Ramirez assumed care of the patient. She immediately took charge of the situation. Her bilingual/bicultural assets were a blessing, but it was probably her natural nursing ability and good horse sense that saved the day. She got a report on the little boy from the PICU RN and received an update from the team of social workers, chaplain, and surgeons; then went to meet her patient.
There were at least 10 family members in the room at this time. She respectfully asked them all to step out, so that she could focus on the assessment of the patient, taking care that her medical and physical needs were not sacrificed to the horrible situation. After explaining her plan to the patient, the patient calmed down and allowed Rosemary to do her job to keep her safe. After the assessment, Rosemary told her everything that she knew about her son's condition and the plan for the day. She was granted permission by the patient to update all visitors present.
Rosemary then introduced herself to all family members, and invited each one to identify him or herself and describe their relationship to the patient. She then carefully explained the situation, emphasizing her appreciation of their support of the patient, and instructing them on specific ways to help the patient. The family's number one concern was the condition of the young child. Rosemary called the PICU RN to get the most current assessment of the boy. She bravely answered all questions of the family concerning brain death.
That evening when I returned to work, I heard the rest of the inspiring, heartbreaking story. Rosemary had received permission from the trauma surgeon, the orthopedic surgeon, and the administrator on call to transport the mother to Dell Children's Hospital to see her son. She traveled by ambulance with Rosemary in attendance. Rosemary stayed with the patient for the visit, not only as her critical care RN, but as her advocate and support person. She attended to important details, such as positioning her stretcher, so that she could reach and caress her son, probably for the last time. When the patient's older son, still a patient at DCMC, wanted to see his brother, again Rosemary was there. Concerned about the young age and emotional state of the big brother, she contacted a child life staff member and suggested that a photo of the younger critical child be taken and shown to the older child first. In this way the older child was gradually introduced to the frightening appearance of his baby brother's swollen and traumatized body. The brothers were brought together with the mother present. Rosemary was there to care for her patient, and along with the great team at DCMC, to help the two little boys. Hours later, she returned to UMCB with the mother. Though the experience was taxing for the patient, she was a bit more at peace after her visit with her two sons.
As for Rosemary, she resumed the care of her other two patients on her return, and all were in great shape when I came on to assume care. When I told her that I was in awe of the job that she did, she shrugged it off and went on to praise others and elaborate on the good work by the people at DCMC. I think she deserves the Congressional Medal of Honor, but please at least give her the DAISY Award.
Being a Level 1 trauma center brings its sad moments as well as its miracles. I was assigned to a patient who had been in a serious motor vehicle accident. The collision left her with multiple pelvic fractures and injured her two children. Both children were at Dell Children's Hospital, one was recovering from broken bones, but the younger child had a critical traumatic brain injury.
The patient's physical needs were dwarfed by her unimaginable emotional trauma. When her family gathered the courage to tell her that her baby was brain dead, the whole unit was pierced by her wails of grief. Her plea was to see and hold her child.
The team drew together to formulate what seemed at first to be an impossible plan. Brainstorming began, in search of ways to unite mother and son. My patient had recently been admitted to a critical care area, with severe pain and limited mobility due to her injuries. Her child was in PICU on a ventilator with ICPs climbing to the 60s.
I was overwhelmed and emotionally drained by the situation. Then a hero came along.
It was 7am, change of shift, and Rosemary Ramirez assumed care of the patient. She immediately took charge of the situation. Her bilingual/bicultural assets were a blessing, but it was probably her natural nursing ability and good horse sense that saved the day. She got a report on the little boy from the PICU RN and received an update from the team of social workers, chaplain, and surgeons; then went to meet her patient.
There were at least 10 family members in the room at this time. She respectfully asked them all to step out, so that she could focus on the assessment of the patient, taking care that her medical and physical needs were not sacrificed to the horrible situation. After explaining her plan to the patient, the patient calmed down and allowed Rosemary to do her job to keep her safe. After the assessment, Rosemary told her everything that she knew about her son's condition and the plan for the day. She was granted permission by the patient to update all visitors present.
Rosemary then introduced herself to all family members, and invited each one to identify him or herself and describe their relationship to the patient. She then carefully explained the situation, emphasizing her appreciation of their support of the patient, and instructing them on specific ways to help the patient. The family's number one concern was the condition of the young child. Rosemary called the PICU RN to get the most current assessment of the boy. She bravely answered all questions of the family concerning brain death.
That evening when I returned to work, I heard the rest of the inspiring, heartbreaking story. Rosemary had received permission from the trauma surgeon, the orthopedic surgeon, and the administrator on call to transport the mother to Dell Children's Hospital to see her son. She traveled by ambulance with Rosemary in attendance. Rosemary stayed with the patient for the visit, not only as her critical care RN, but as her advocate and support person. She attended to important details, such as positioning her stretcher, so that she could reach and caress her son, probably for the last time. When the patient's older son, still a patient at DCMC, wanted to see his brother, again Rosemary was there. Concerned about the young age and emotional state of the big brother, she contacted a child life staff member and suggested that a photo of the younger critical child be taken and shown to the older child first. In this way the older child was gradually introduced to the frightening appearance of his baby brother's swollen and traumatized body. The brothers were brought together with the mother present. Rosemary was there to care for her patient, and along with the great team at DCMC, to help the two little boys. Hours later, she returned to UMCB with the mother. Though the experience was taxing for the patient, she was a bit more at peace after her visit with her two sons.
As for Rosemary, she resumed the care of her other two patients on her return, and all were in great shape when I came on to assume care. When I told her that I was in awe of the job that she did, she shrugged it off and went on to praise others and elaborate on the good work by the people at DCMC. I think she deserves the Congressional Medal of Honor, but please at least give her the DAISY Award.