The Big Outing

As an ICU nurse, I often do not see patients for a long period of time. I see them in their weakest state and try to nurture them back to a state of mending. Often I will tend to patients that can't make their needs known because they are on a mechanical ventilator. I love caring for the sick, and I enjoy the challenge of making them better. The other side of the coin is that I see patients deteriorating and often I find myself reassuring and comforting families that we are caring for their loved ones and assist them onto their final phase of life. The thing I miss most in working in the ICU is seeing people go home. Hardly ever do I discharge a patient back to their homes. I use to enjoy wheeling a patient down to their cars and seeing them drive away happy to be released from the hospital.

Yesterday was a gorgeous day. One of those perfect days that you don't want to end. In the summer time I always try to eat my lunch outside on the patio off our cafeteria. Yesterday was one of those days when I was sitting out by myself, reading my novel and trying to forget that I had to go back upstairs to work in a half an hour. The sky was a perfect blue with not a cloud in the sky, and there was a nice breeze that would come by and make the temperature perfect.

Upon returning to the unit and to my two patients I found myself with an idea. I was going to take my patient outside today.

My patient has been in our unit since March. He has had many complications and is now ventilator dependent. He has been outside one other time since March. One time. One time in almost six months. Not to mention that he was in our unit starting in January, and was transferred out to another sub-acute facility. So really, counting his two ambulance rides, he has been outside 3 times since January. I called the doctor and got the approval to "Go outside, let him enjoy it".

Yesterday was a good day for my patient. He had his speaking valve in his trach and was eating ice cream. Chocolate ice cream is his favourite. His doting wife was at his bedside, just happy to hear his voice again. He hadn't had his talking valve on in about a week. He ate 2 cups of Chocolate Ice Cream. He was happy. I walked into the room as he was watching TV. He loves all the old shows, like "Leave it to Beaver", "I love Lucy", all that stuff. It is always on in a loud volume because his hearing isn't that good.
He smiles at me as I stand beside. It is nice to see him smile, his chocolate coated lips. I take a wash cloth and wipe off his lips and say to him.
"Can you do me a favor?"
"Sure, darling" He says as he looks at me with anticipation.
I ask him to keep his pulse ox monitor on for the next 30 minutes because I want to watch his oxygen level. He has a habit of taking his finger probe off. I would too if I had been wearing it for 6 months.
He shakes his head and says okay. Then I drop the bomb shell on him.
I tell him "If your oxygen level remains stable, I was wondering if you would like to go outside for a bit today. It is a perfect day, not too humid..."
"OH yes!" He grabs his finger probe and puts it on his finger. His wife squeals with joy at the bedside saying "Really Kelly?"
I shake my head, saying I have gotten the "OK". I tell him it will be about 30 minutes. He looks at the clock and calculates how many minutes it will be until 30 minutes are here. His wife grabs her cell phone and races out to call their 6 kids. The definition of happiness is radiating from both of them.
As I am in the room, getting prepared to go outside. Getting the cardiac chair. Unhooking his j-tube, unhooking his Picc, getting the right oxygen hook up and oxygen tank and unhooking him from the monitor, my patient turns to me and says
"Where are we going to go?"
I say back to him "Where do you want to go?"
He looks at me straight in the eyes and says simply "Home."

Three of us pull him over to the chair. We sit him up he says he his uncomfortable. We lay him back and put more pillows under his sore bottom. 3 pillows in total. We sit him up again and he says it is "okay" and he wants to go.

His wife and I head outside me pushing a chair that really did have a mind of its own, and is pretty tall and hard for me to see over. We head down the hallway to the doorway and it is tiled flooring. Thunk, thunk, thunk. We get to the outside door and we are outside. The air hits him in the face and he smiles. Then he grimaces. He is in pain. So much pain that he wants to go back upstairs. The tiled floor had shifted his position in the chair and he was no longer comfortable. His bottom is again sore.

The great outing only lasted 5 minutes but it was worth it when he grabbed my hand as I was busy hooking him back up and he said to me "Thank you."