My father was admitted through the ED for chest pains. He was admitted to C1 overnight and had a cath procedure for stent placement. He was scheduled for discharge. However, unbeknownst to us, he has some type of underlying adrenal gland and pituitary gland issues. His sodium levels dropped to 125 and he experienced sudden neurological changes that were so drastic we had to call an MRT and he had to be sedated and admitted to the ICU. His three grown children (myself and two siblings) and wife were at his bedside and the providers let us know that the next 12 hours would be critical and he would either show signs of improvement or may not recover. As you can imagine we were completely in shock as he had been admitted for chest pains which made the sodium issue entirely unexpected.
Kathy arrived for the night shift right when the intensivists were explaining how critical the next 12 hours (7p-7a) would be for my father. Not being a clinician it sounded very important and overwhelming to micromanage the increase of the sodium levels- they wanted to bring his sodium back up but not too quickly... words like "permanent brain damage" and "may not recover" were in the conversation. Out of precaution, they were also treating him for meningitis, tick-borne illness, possible stroke, etc. due to the neuro changes.
Kathy immediately got to work and truly did not miss a beat for 12 hours. She was like a hummingbird buzzing all around my father tending to his lines and drips and ports. He was given a central line and had 3% saline running along with three types of antibiotics (for possible meningitis) and sedation medication- plus his post stent medications. Her silent strength was palpable and while we were all trying to wrap our brains around the situation we all felt reassured that she was absolutely competent and confidently carrying out the doctors' orders precisely. His afternoon labs came back and his sodium had dropped to 123. Then three hours later they came back and his sodium was 121. We were scared that meant he would not recover as he had been on the 3% saline for a little bit. Kathy knew that five of his six grandchildren and his three children's respective spouses were in the C1 family lounge. His central line dressing was bloody (possibly because he was on blood thinners for the stent?) but she prepared my father the best she could from a visual standpoint so all 5 grandchildren and 3 in-laws could take a turn to say goodbye. It was a surreal moment but Kathy's calm demeanor was silently fortifying our family.
Kathy answered all of our questions while she stayed in constant motion (although we tried to stay quiet to not distract her from her work). She conferred with the providers as they determined the next steps hour by hour. She knew that we were counting the minutes to receive the next sodium lab results and when it came back at 122 she truly seemed to share in our joy that the number had not dropped further. She continued her constant efforts swapping out bags and bags of medicine and performing all of her other tasks. The next sodium lab was 125 and we all took a cautious sigh of relief. Kathy helped my step-mother set up a recliner to sleep and my siblings and I went to the C1 family lounge to be close just in case anything reversed course. Around 4 am I came back to the ICU and thankfully my step-mother was asleep but Kathy was still right by the bedside caring for my father. She gave me the warmest smile and reassuring thumbs up. It was a whirlwind of emotions to go from almost losing the head of our family to being ok but not entirely out of the woods. The possibility of brain damage was still a concern until he was able to be taken off sedation to wake up.
By Friday morning the providers really wanted to ensure he could take his PO stent medicine to prevent a clot but when they tried to put in a feeding tube he pulled it out. Discussions of more sedation, a vent, and a second attempt for a feeding tube occurred but we ended up waiting a few more hours and at 2:30 pm the providers reduced the sedation to see if he would wake up enough to take PO meds. He opened his eyes and was able to say his last name when asked his name. For the next 24 hours, he would sleep for a bit, wake up and repeat all the same questions but Kathy who was his nurse again Friday night reassured us that it can take time for the brain to re-boot. She was patient and kind and every time my dad would wake up she would help us re-explain to him what was going on. Each time he woke up and had a conversation he would retain more info. He does not recall anything from Thursday afternoon through Saturday afternoon. His sodium level increased to 131 and then 138 and he was transferred to C2 on Saturday afternoon and discharged home on Sunday.
Dad wrote a long letter to the hospital president recognizing all of his caregivers from the ED, to C1, the ICU, and C2 and it may seem odd but Kathy (the only RN he doesn't consciously remember) is the one who left the greatest impact on him and his family. It must be slightly overwhelming to wake up with your last memory being a discharge discussion on Thursday only to find out it is Saturday and you almost died. At a time when my father could not physically care for or comfort and protect his family, Kathy Wise was his intercessor. He is forever grateful to the tireless nurse who saved his life although he would not recognize her in person. What a stunning example of the power of nursing. He is truly in awe of the providers and entire team that recognized his neuro changes and took quick action, but Kathy was at his bedside for two 12 hours shifts carrying out the meticulous plan all while bolstering a family that was in shock and scared they were losing a husband and father.