Thread by @rn_critcare

It started as a normal shift... I mean, whatever normal looks like for us these days. I was extra staff so I busied myself with little projects, helping with turns and baths and dropping off meds. I was present but not really invested in this shift

I check in on the new nurses. They are always my favourite. They have just as much to teach me as I do them. Today they want to know the quickest way to the blood bank in case of MTP (massive transfusion protocol). I take them to show them, it's better than giving directions.

Next I pop over to check on a new admission. It's like a game of Red Rover: people from inside the room are calling out the things they need to the people outside the room. It's a flurry of activity. It usually is with a new admission, especially an unstable bleeding trauma.

They've just initiated MTP, what are the odds after my tour moments ago. No matter, I realize I'll be setting roots in this bay for a while. I ask who's lead and my co-worker jokingly mimes handing over the crown to me. Now I'm really committed.

One thing that we have learned in these situations is having a "lead" during crisis situations helps keep communication fluid. This is especially important when you are in an N95 it can feel like you are trying to get orders from Charlie Brown's teacher.

From outside the room I'm trying to explain the 'rocking U' for the rapid transfuser, from the top: close, clamp, unclamp, open and then reverse. Give 1:1 PRBC/plasma so it's like we're giving whole blood.
There's talk of a Minnesota tube. Never a good sign.

After an hour helping from outside the room it's clear that staff inside are ready for a break. After donning from head to toe I head in to send others out. First thing that hits me is the smell of blood, even through the 2 masks. And it is everywhere. Everywhere.

I'm not sure how 3 hours go by but here I am, scooping blood off the bed , helping with scopes, keeping products infusing, pushing meds, starting infusions, waiting to hear the plan.
The surgeon asks for help removing his PPE, a breech at this point would be disastrous.

I look around the room: the RT has been suctioning the steady stream of blood coming from her nose and mouth. Another nurse is hanging platelets and fibrinogen. The PSW has just showed up from her 6th trip to the blood bank & the nurses outside the room are checking products.

The social worker is on the phone updating family. The charge nurse is talking to blood bank. There's surgical staff, anaesthesia and ICU team members making plans to go back to the OR.

I wish she knew how many people are invested in saving her life. Maybe she'll find out.

We quickly get the monitor switched over & while we wait for OR team to don PPE we get started giving her a quick wash, scooping clots off the bed and throwing out soiled towels. We are just about to change the pad under her when the team comes in to take her to the OR.

We ask for 1 minute to finish so we can show her what might be the last kindness she receives in this life.
Then away she goes.
I stand in the middle of the room trying to process all that transpired. The cleaner comes in to mop, & points out the clot on the bottom of my shoe.

My throat is dry. I need out of these masks and I need water. Check on the new nurse whose patient this was. She is shell shocked. I reassure her this assignment could only ever be a team effort, this patient belongs to all of us now.
I fill my water bottle and head home.

The next morning I come back to see the room is empty. Dammit, after all that she didn't even make it. Not surprising but always disappointing.

I see the nurse from yesterday & ask how she's doing. She says she's happy to be out of the covid bay & that her pt is doing well.

It takes me a second to realize she's talking about the pt from yesterday... Who is alive & in a new room because of a negative covid swab! I could cry. Shit, I AM tearing up. Less surprising actually to anyone who knows me.

I pass her Surgery crew in the hall. I have to admit I am in awe of what they did in the operating room. Turns out a bath & warm blanket wasn't the last kindness she received.

And once again, for the countless time, I am so proud & honoured to be a part of this team.