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November 2003, Volume 33 Number 11 , p 32cc6 - 32cc7


  • Sandra K. Plach RN, CCRN, PhD



  • Abstract

  • Worst fear realized

  • Celebration of life

  • Abstract

    I'd learned to wall off my emotions in the ICU. Then Todd arrived.

    After 15 years as an intensive care unit (ICU) nurse, I'd learned to keep part of my feelings under lock and key to avoid becoming too emotionally affected by the often-tragic circumstances in the ICU. But caring for Todd changed all of that.

    Seventeen-year-old Todd was driving his motorcycle to school one rainy morning when he failed to negotiate a sharp curve in the highway, lost control, and crashed. He was wearing a helmet, but his friend Jim, who was riding with him, wasn't. Jim was killed instantly. Todd sustained internal injuries and multiple fractures to his sternum, ribs, left leg, pelvis, and jaw. When his head hit a large rock, his helmet was shattered on one side, resulting in a coup-contracoup brain injury with a depressed skull fracture.

    I was Todd's primary nurse. Over the week following the accident, Todd frequently hovered near death. He had seizures three to four times a shift despite increasing doses of anticonvulsants and sedatives. He developed acute respiratory distress syndrome, diabetes insipidus, and a sinus infection related to his nasally inserted endotracheal tube. (His extensive jaw injuries prevented inserting the tube through his mouth.) After several days, he had a tracheostomy.

    His physical care needs were overwhelming, but I knew that he was still a person under all the tubes and machines. I spoke to him frequently as I cared for him. I wanted to keep him engaged in life, to help him fight and yearn to get better.

    Todd's family was devastated by his accident, so we held a family conference each day to keep them up-to-date on his condition and to offer support.

    The meetings became a time of solace and bonding for Todd's family and friends and for us, the caregivers. ...

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