February 2014
Melissa
Settar
,
RN
PICU
The Children's Hospital of Philadelphia
Philadelphia
,
PA
United States

 

 

 

If you asked Melissa about her morning in the ICU today caring for her patient, I'm sure she'd say "I didn't do anything special". I beg to disagree. As the Oncology Chaplain, I've followed this patient closely for over a year. He is 18 and was diagnosed with ALL in the 4th grade and has had an arduous journey ever since.

Last September, he had a bone marrow transplant. A week ago he was admitted with weakness in his legs; it was getting hard to walk. Yesterday he coded on the Oncology unit, came up to the PICU and this morning was awakening from sedation and trying to speak which was impossible because he was still intubated. He was agitated, weepy, and in near panic.

His mother, grandmother and aunt were at the bedside. I came to check in on him and watched a remarkable moment unfold that left me in awe of Melissa's compassion and skill as an ICU Nurse.

It took some effort, but with a print out of the alphabet, he was able to spell out what he wanted to say. He had been deeply traumatized. "I felt everything", he said.

Melissa instantly understood what he was communicating. When he was intubated, he was aware of everything, but unable to communicate. As he grappled with a few more sentences we realized that he couldn't breathe well and could not convey to the team that he couldn't breathe. In short, he was suffocating, knew it, and was terrified.

Melissa took control of the situation and did what needed to be done exquisitely. In a gentle and loving way she got close to him and told him exactly what happened and why. She explained that because his oxygen level was dropping so rapidly, the team had to move quickly to intubate him. It was touch and go. She managed to be compassionate and express how sorry she was that this has happened, but also gave him the information he needed. She was reassuring and somehow, in the midst of all of this, also was able to get him a little more pain medicine so he could feel less anxious.

Yes, it probably was an "ordinary" moment in the ICU. But Melissa handled it with extraordinary grace, compassion, poise and intellect. She didn't miss a beat. His family was reassured and he was made to once again feel safe. A situation that could have become even more upsetting was quickly brought under control.

PICU nurses do extraordinary things every day and every night. But this was one I happened to see and wanted to take a moment and share it with you. Melissa Settar is a remarkable nurse.