Well, I just finished my second clinical in Savannah, GA, and am back home. I have to admit that I had some reservations about heading down to Savannah for two months for several reasons.
First, I was not really looking forward to being away from home for that long and second, I was a little intimidated by the idea of working in the critical care units. As it turned out, and as is typically the case, things weren’t nearly as bad as I thought they would be. My time there absolutely flew by and the experience was incredible.
Of course there were many challenging moments as you would expect working with critically ill patients. Dealing with bowl and bladder issues, dementia, isolation precautions, and even death were all part of the job description. I was amazed at how quickly I adapted to the ICU environment, however, and playing an important role in helping people during some of the most trying times of their lives really made the personal challenges that I faced seem very trivial.
I’d like to tell you about an experience I had with a patient that will help to paint a picture of the amazing impact that you can have when working with people who are at their most vulnerable. My patient, who I’ll refer to as ‘Jane’ to protect her anonymity, was one of the first patients that I worked with on the first day of my clinical. Jane was very sick with multiple co-morbidities and her prognosis was grim. For the first four or five weeks that I worked with Jane she was typically sedated, intubated and on a mechanical ventilator. I would always talk to her even though she wasn’t awake and tell her what I was doing as I worked passively with her to try and preserve her range of motion, prevent contractures, etc… in the hopes that she would someday be strong enough and medically stable enough to get out of her bed.
When the day finally came when Jane no longer required sedation I developed a system where she could communicate with me by squeezing my finger or blinking her eyes in order to answer my yes/no questions. Finally she was taken off the ventilator and as I entered her room that day her first words to me, barely audible, were “I don’t want to die.” It was gut wrenching to say the least.
Jane continued to get stronger, however, and participated actively more and more in her therapy as she slowly gained strength and endurance and during my last week she was able to stand with help for a few minutes at the side of her bed. It truly was amazing to see. After my last day was over I went on rounds to visit and say goodbye to some of the patients who I had developed a relationship with during their time in the ICU and who were now scattered throughout the hospital on non-critical floors. I, of course, saved Jane for last and headed back down to the ICU to wish her luck.
Most of the nurses knew that I had really developed a strong bond with Jane over our two months together (most patients aren’t in the ICU that long) and when I entered the ICU an RN came running over to me to tell me that the order had just come down to transfer Jane out of the ICU and to another non-critical floor. To say that made my day would be a monumental understatement. I used to tell her all the time not to take it personally but that she needed to get better in time to get the heck out of the ICU before I left and it turned out she did. She waited until the last possible moment, but she did. She was sound asleep when I entered her room so I just gave her hand a little squeeze, swallowed the lump in my throat, and headed back to the office to get my things and head out.
My clinical instructor met me there and, before I left, handed me a huge card that she had secretly been passing around the hospital for days. As I opened what seriously had to be the biggest card ever made with six flaps to unfold I was amazed at how many people had signed it. There were nurses and doctors along with all of the various therapists that I had worked with over the past two months all wishing me luck and telling me that I would be missed. It was really nice. And then I noticed, right near the center of the card, a little note that looked like it had been written by a small child with letters squiggly and barely legible. It read, “I hate to see ya go, Jane.” It was weakly written by hands that could barely move even two weeks earlier but the impact it had on me was powerful.
My experience with Jane and other patients like her validated for me what I already knew, that physical therapists play a vital role in helping patients to maximize their functional independence and quality of life and that this field is where I’m supposed to be.