There was a patient on the unit who had been here for a long time, had coded, experienced multiple intubations, and was on and off CRRT. Amazingly, the patient was oriented and able to communicate with family despite all this. Vinh had started his shift as the patient was crashing with family at the bedside. After calmly asking the family to step outside to talk to the ICU physician, Vinh stood at the head of the bed as the patient started to get bagged. There were moments when the patient randomly had moments of lucidity and would look around the busy room with fear written all over his face. In those moments, as he was stabilizing the patient's head, Vinh would look at the patient, call his name to get his attention, and tell him that we were all there to help him. The patient would maintain eye contact with him until he lost consciousness again. Eventually, the family decided to no longer escalate care and was able to be with the patient in his last moments.

It was a death that the entire unit felt that morning- one that was particularly hard to compartmentalize as we nurses do. Nonetheless, Vinh spent the rest of his shift open for admission, helping cover breaks, co-sign blood products, and help with new admissions. He showed the utmost compassion for this patient and his family and even amidst the chaos, provided comfort in a moment that mattered most. His work ethic is always admirable, but how he carried himself that day is one I will never forget. 

***

During his shift, RN Vinh took care of two patients and their extended families.

One patient was recommended for comfort after a lengthy hospitalization (40+ days) including multiple ICU stays. A doting husband and two adult sons were coming to terms with the decision to change Code Status to DNR and transition to the Village hospice ASAP.

The other patient was a new diagnosis who had yet to have a single outpatient appointment with their COH hematologist. In addition to a wildly aggressive leukemia, the Pt suffered a catastrophic brain bleed. His partner of 62 years was inconsolable. The adult children, their partners, the grandchildren, and their partners. There were also siblings, in-laws, and various cousins. Over 14 people were present at bedside when the priest performed end-of-life Sacraments. Another half-dozen filtered through in the ensuing hours.

One might consider caring for patients who are trending towards comfort, with emotionally-appropriate family, might constitute relatively easy ICU assignments. No concerns around a potential crash that will lead to a Code Blue response. No concerns around ultra and complex needs like CRRT. No moral injury and frustration around prolonged futile and medically-inappropriate care. But also without the closure of providing care at the time of death and bringing family to their journey's destination.

RN Vinh offered constant care, education, and support to one family that featured a career litigator and a pediatric intensivist, and another family that featured no less than 20 individuals were losing their family pillar and patriarch. Each loved one demanded a piece of RN Vinh, and he gave generously.

At one point, the day had RN Vinh triggering memories of his days as a hospice LVN.

By all accounts, it was an exhausting day for the supportive medicine team, for the social workers, and for the chaplains. As luck would have it, each of those teams had split the responsibility of supporting those two patients (and their families). The only constant on both sides was the one in front - RN Vinh.

RN Vinh is consistently an RN par excellence. Credit to his daily efforts that pass through the ether undetected. Special kudos to his work that weighed on many spirits in the ICU on that day.