Adult Tower 4A MSICU
August 2023
Adult Tower 4A MSICU
Baptist Medical Center Jacksonville
United States
Christine Kiely, BSN, RN, CCRN
Blanca McKean, DNP, RN, NE-BC
Alexandra Biess, BSN, RN, MEDSURG-BC
Amanda Hill, BSN, RN
Amanda Johnson, PharmD, BCCCP
Amanda Maynard, BSN, RN, SCRN
Amy Riggan, ASN, RN
Andres Salim, BSN, RN, CCRN
Anna Bowen, BSN, RN
Ashley Neal, BSN, RN
Ashley Pavlas, ASN, RN
Ashley Wildasin, CNA
Ashlynn Depew, BSN, RN, CCRN
Betty Jo Miller, BSN, RN
Brad Nazworth, BSN, RN
Briana Griswold, BSN, RN, CCRN
Brigitte Carantes, NA
Brittany Ruby, BSN, RN
David Ha, ASN, RN
Dawson Stewart, CNA
Deborah Davis, BSN, RN, CCRN
Jason Bellardini, MD
Mark Crowe, MD
Jennifer Fulton, MD
Vinoo Ramsaran, MD
John Wachira, MD
Eltoya Humphries, BSN, RN, CMSRN
George Wadsworth, PharmD, BCPS
Gracell De Chavez, BSN, RN
Hazel Borja, BSN, RN, CCRN
Heather Whittlesey, BSN, RN
Hope Foltz, BSN, RN, CCRN
Isabel Jacobs, PharmD
Janice Keller
Jean Hayes, ASN, RN
Jeann Edodoleon, BSN, RN
Jenna Decubellis, BSN, RN, CCRN
Jennifer Alejandro-Garcia, BSN, RN
Jessica Martinez, ASN, RN
Jocelyn Wrubleski, BSN, RN, CCRN
Julianna Isaacson, BSN, RN
Kaitlyn Tanner, BSN, RN, CCRN
Karan Blackwell II, CNA
Karen Carter, CNA
Karly Mindnich, BSN, RN
Kayla Hancock, BSN, RN
Kelsey Welch, BSN, RN
Keri Ellison, ADN, RN
Kimberly Haines, BSN, RN
Kristen Medina, BSN, RN, CCRN
Kristian Butler, BSN, RN
Kristyn Squibb, BSN, RN
Lauren Papay, BSN, RN, CCRN
Maria Lucas, ADN, RN
Mariah Sauceda, BSN, RN, CCRN-N
Mary Cheryl Ylio, BSN, RN, CCRN
Matthew Hilleman, BSN, RN
Michelle Ann Cruz, BSN, RN
Natalie Beaver, BSN, RN
Natalie Gunter, CNA
Pam Bernabeu, CNA
Pamela Petry, BSN, RN
Pili Johnson, BSN, RN
Rachael Mia, BSN, RN
Rachel Henry, BSN, RN
Roisin Kanupp, BSN, RN
Samantha Steinkraus, BSN, RN
Seth Apostol, BSN, RN
Sherwin Jacob, BSN, RN
Shynne Dungala, BSN, RN
Val Apostoli, NA
Zeljka Lubura, BSN, RN, MEDSURG-BC




In the MSICU we have emergent situations: we have code blues, and it is not unusual to see people die. We know how to handle these situations and we handle them well. However, to do a 2-hour code on a 23-year-old, 27kg patient, with special needs that we have grown attached to is not something we are familiar with.

We had our sweet patient, with her mother at her side, cardiac arrest in front of our eyes. The heart rhythm changed unexpectedly and was caught very quickly. Her heart stopped, the monitor showed asystole and the only sign of life was the occasional wink our patient would give us. She has been our patient a few times within the last year. She is special needs, has chronic trach, and interacts with a quick mouth movement of yes or no. Her mother is her biggest advocate and knows all the nuisances of her needs.

When we lost her, the MSICU all organically moved into their code positions with Dr. Wachira leading the helm. The code lasted for hours, we would get her back and then you could watch the life fade from her body. Her primary RN, Jessica Martinez never left her side, doing pediatric compressions on our adult patient the entire time. The patient is familiar with Kristyn Squibb, RN the most and she stayed where she could see her the entire time. Kristyn rubbed her hair so she could feel her presence and watch the little changes that we had to look for for signs of life.

Staff moved effortlessly around each other, working together in a calm manner, ultimately to the point where we got her back and she survived. I have personally been involved in many codes. I pride myself on my 'we can do it' attitude. However, this code shook me to my core, as it did the whole team. However, we never lost hope, we never gave up. We supported the doctor, the mother at the bedside, the father on the phone, and most importantly we never gave up on the patient and as a result, she survived and went home to finally open the Christmas presents that her family had holding for her.

The day was traumatic for all involved, but we persevered because we had 19 other patients depending on us to keep moving forward. I don't think I have ever been more proud of the MSICU team and their efforts in this particular code and that is saying a lot because I am proud of them, their loyalty, their commitment, and their brilliance every time I work.