Cancer Watch 08 :: SICU Day 1

For anyone who’s spent any amount of time in a hospital, you know it’s not a restful place. Anyone who has spent any time in an ICU of any kind knows that it’s not only not restful, it’s an ordeal to be survived or not. Those are your two options. When I arrived at my room in the SICU, my wife and my mother were in the room waiting for me. The rules of the SICU only allowed 2 visitors at one time, so my wife’s parents were waiting outside. (They had been with her all day since I went into surgery for support.) The nursing staff, although helpful, weren’t all that interested in me except for the Dantrolene I.V. bag that had to be shielded from light with a black bag. Again, it’s rare so actually seeing a patient using it is an experience so I was a bit of a novelty.

Day 1 in the ICU

One nurse made it her mission to get my wedding ring off of my finger. I’ve been married for over 21 years now, and for the last 10 or so I’ve not been able to get my ring off as my finger has become too fat to slide it off over the knuckle. I’ve always meant to go into a jeweler’s and get it resized but it’s one of those things that you just never get around to. So there I am, my body feels like it’s made of lead due to the Dantrolene and she’s trying all of these tricks to get my ring off. Ice, surgical lube, wrapping my finger with gauze, etc. Nothing worked. Finally I just told her to cut it off. It was going to need to be cut to be resized anyway, so just get it over with already. They broke out their ring cutter and a minute later off came my ring. They gave it to Kerry for safe keeping. In hindsight, that nurse very likely did the very best thing for me of any nurse for my entire stay in the SICU. She saved my finger.

Another rule of SICU – shift change happens from 7-8:30, both AM and PM. During shift change, no visitors are allowed, no exceptions. During shift change the nurses hand over the patients to the oncoming shift, change bedding, take care of bathing, etc. I had finally gotten to see my wife after a day of hell and she was kicked out of my room after only an hour. The rules are there for a reason, but they just plain suck. It’s lonely while you lay there, waiting your turn for whatever poking and prodding they have in store for you. With this being a new experience for me, I had no idea what to expect. I soon found out.

Night Shift

My night shift nurse was named Jared. He was very professional, very competent, but as I was to found out later that night, relatively devoid of compassion. Soon after I met Jared and he checked my vitals and such, he called in a female assistant to help him change my bedding and bathe me. Now I know when you check into a hospital that you pretty much have to leave your dignity at the door, I get that. But I was so not prepared for a sponge bath administered by a man and a woman, who were talking to each other all the while like it was no big deal and I was just an inanimate object laying there in the bed. I suppose if I were in their shoes I would likely adopt the same mental state to get through it. It was over fairly quickly, The water was warm, I was clean and in a clean gown and ready for bed.

Although there was a T.V. in my room, I had neither the desire nor the energy to watch it. There was a large LED clock on the wall opposite my bed with numbers at least 2 inches high. So large that I could read them easily without my much needed glasses. That clock became my constant companion as I began to count the hours that I was in that bed. Crazy as that sounds, it actually helped keep me sane.

My room was quite possibly in the worst possible location on the floor. On one side was the main nurses station where all of the alarms from each room on the floor were coming in as well as all of the calls. I heard each and every one of them all day and all night. On the other side was the construction for the new emergency wing that is being built. Fortunately that was only going on during the day, but it was quite a racket. Welding, cutting, hammering riveting, you name it, it was going on right outside my window. I had a ringside seat. I was a captive audience you might say. Now the clock might make a bit more sense. With the cacophony of alarms and construction noise, watching the time tick over on a regular basis was something constant, something real in an unreal situation.

Jared came in around 10 PM for my pain assessment. The hospital used the “1 to 10″ scale. How bad is your pain? 0 being no pain at all, 10 being the worst pain imaginable to you. For me, a 10 on that scale is when I fell and fractured my spine, so I was in pretty good shape. The neck wasn’t bothering me at all really. I was usually in the 2 to 3 range, which was the goal. 4 and up is when they start to give you something for it. He checked my IV and the Dantrolene was out so he went to get another bag. I don’t know if there was too long of a delay or what, but when the new bag started it hurt badly. I looked at the site and I could see blood backed up into the tubing for several inches, even I know that’s not a good sign. He shrugged his shoulders and walked out. The blood never did completely clear from the tubing. The line was blocked or the vein had collapsed.

Around 1:30 AM I awoke to a very sharp pain in my left side. I managed to hit the nurse call button and summon Jared. He came in and I explained what was wrong. He did his assessment and said it was likely muscular strain from the spasms earlier. Makes sense. He gives me a shot of morphine to dull the pain, which I did not want, having had a bad experience with morphine from my previous surgery. I can’t blame him as he had no way of knowing my wishes.

About 2:30 AM I awoke again to the pain, this time not only in my left side but in my sternum. A crushing pain, making it hard to breathe, let alone think straight. I thrashed around in my bed, trying to figure out what to do until I managed to hit the call button again. When the desk nurse asked what was wrong all I could gasp was “chest… hurts…” Jared wandered in again a few minutes later to me thrashing and kicking the foot of my bed. I was out of my mind with pain at that point. When I told him it felt like someone was sitting on my chest he ordered and EKG and a chest X-Ray just to rule out any heart problems and doped me with more morphine. 1 EKG and portable chest X-Ray later it was decided that my heart was fine. Later that morning during rounds with the doctors, it was decided that the pain was likely from the surgeons digging down around behind my sternum to get the cancerous lymph nodes out and the anesthesia had finally completely worn off.

The reason I say that Jared was devoid of compassion was the way he reacted to everything. He wasn’t quite a robot, but pretty darn close. There was no sympathy, no empathy for me as a patient or what I was going through, just basically what are your symptoms and how can I safely shut you up for the night. To me, ignoring the blocked IV was inexcusable. It was obvious, even to me that it had failed. He chose to do nothing about it and let it become someone else’s problem, namely the next shift nurse. Thanks Jared.