I had the privilege of being in charge and watching/helping Kristina while she cared for her first Therapeutic Hypothermia patient. This is a special population to all of us in CICU because we put in a tremendous amount of 1:1 time, get to know the patient's family all the while not knowing for a minimum of 36 hours if the patient is ever going to wake up. We are optimistic and realistic with families at the same time.
This patient that Kristina was caring for was a young gentleman in his early thirties, with several young children, who had suffered a cardiac arrest. He had social and substance abuse issues that had contributed to his current state of health. As charge, it was rejuvenating to watch her excitement at each step of progress he made. It was clear that his family and his outcome were very important to her. She came in an extra shift when there was a need because she wanted to watch his case start to finish.
At night it can be difficult to convince a covering team to change therapies but she was a very strong advocate for him when we had trouble lightening his sedation to allow for a better neuro assessment. He would become wildly agitated without command following. She advocated to change his sedation which was very successful. On day five she was a strong advocate to get him extubated at 2200. She was not going to take no for an answer. I was really impressed at the bond Kristina formed with this family as it was not an easy family to work with. She had to do some clear appropriate limit setting during the cooling phase with the family but she was still very genuine caring and empathetic. This family respected her for her clear direct rules. They needed that. I was with her when the patient was extubated and his first string of words on upon extubation was a string of expletives that continued all night. She did not let this rattle her or change her compassionate care, she was firm and compassionate with him gaining his respect. All of this is exemplary nursing.
A few days later, this patient had been moved out to R9 and Kristina was on a day shift. She walked out of CICU to go to lunch and saw commotion and several doctors around his room. She went down to see what it was and found he was threatening to leave AMA. Kristina went in to talk to him and with the rapore she had formed during the five shifts she cared for him in CICU she was able to talk him into staying for another day. He respected her and listened to her.
While she was in talking to him, his wife walked in with their two elementary school age daughters. They were immediately very verbal that they were hungry and wanted lunch. When the mother made no effort do anything, Kristina offered to take the girls down to the cafeteria so they could talk. She took the girls downstairs, bought them lunch then ate with them in the solarium until her lunch break was over so the physicians would have time to further discuss the patient's care with him.
This gentleman will have long term heart problems and was in need of education. This gave opportunity for him to have this education with his wife without the distraction of two young children. It was critical he stay and have the chance to talk to the physicians. Unfortunately this patient and family have so much on their plate, they likely will never understand all Kristina did for them and they will likely never follow up to tell Kristina how they are doing but I am sure she will remember them because they touched her life and she touched theirs.
I answered the phone on the unit last night and it was a daughter of the patient Kristina had cared for the night before when we worked together. The caller's brother had not been able to let go of his dying mother keeping all aggressive care going. After caring for the patient for four shifts and building a rapport with the son, Kristina along with the SCU Fellow was able to help him accept that withdrawing care was the most compassionate avenue for his mother. She made the process very smooth and was very attentive that she died peacefully an hour later in a situation that he could accept. The sister that called me was so relieved and thankful that the ordeal had ended peacefully. She was a disabled nurse who clearly understood the events of the five days but was not able to be there and help make decisions and help her brother understand. Even though she was in close contact with Kristina the night before she needed to call back and thank Kristina and express her gratitude again. Kristina's actions were clearly still heavy on her heart.
Kristina goes above and beyond to advocate for every patient in her care.