Critical Care

Raising the white flag isn’t about surrendering to a broken system

Nicole M. King, MD

Physician

March 20, 2022

So here I am. I just finished updating my CV so I can apply for associate professor this fall.

And I hadn’t touched it since last year. It needed a lot of work.

I look at this, and I think, “Wow.”

And then I also think: What about all the “stuff” that’s not on there?

The difficult pregnancies.

My son’s struggles his first 36 months of life.

My husband’s year-long deployment as a new mother of …

Don’t look in. What you will see is uncomfortable.

Owais Durrani, MD

Physician

January 26, 2022

Don’t look in: No, this isn’t a typo, it’s the sentiment many of my colleagues and I feel right about now. After a long stretch of shifts over New Year’s, I needed a mental break, so I logged into my trusty Netflix account and front and center was Don’t Look Up, the Leonardo DiCaprio dark satire about a comet hurtling towards earth (spoiler alert) and humanities failed efforts to take …

Our patients become an inextricable part of our lives [PODCAST]

The Podcast by KevinMD

Podcast

January 13, 2022

“The weekend after Isabelle’s discharge, I take my shoes outside onto the driveway. The sky is a brilliant blue, and green tinges of leaves poke through shells of buds; the wind slips through my fleece. I scrub the spots of blood with an antibacterial wipe, and tan shoe polish comes …

The worst code I ever ran

Rehaan Shaffie, MD

Physician

January 10, 2022

There is value in reflecting on the most difficult experiences, as it affords an opportunity to examine how we act, react and change in response to the forces around us. The most difficult experiences in medicine are often not discussed, as there is typically not a space in which to begin such stories. So, without further preamble or justification, here is my worst experience in medicine, one which I’ve never …

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The worst code I ever ran

Our patients become an inextricable part of our lives

Benjamin Rattray, DO, MBA

Physician

December 4, 2021

In the early evening, I stand in the grocery store checkout line. A young mother in front of me presses a pig-tailed toddler against her hip as she rummages for her credit card, and a man with silvered hair and a monogrammed shirt shifts impatiently behind me. As I watch the toddler, I’m hit with a twinge of nostalgia. I think of how I used to pull my daughter’s hair …

The degradation and devaluation of nurses

Debbie Moore-Black, RN

Conditions

September 19, 2021

Where do I begin? Maybe at the beginning.

Let’s start with the degradation and devaluation of nurses across this country.

For decades, I lived the devaluing of nurses. Daily huddles from our nurse managers, ER nurses, ICU nurses, and behavioral health nurses. Emails and huddles about downsizing. Nurse-patient ratios. Decreasing nursing staff and increasing patients. ICU nurses typically had a 2:1 ratio and, depending on the patient’s acuity, a 1:1 ratio. But …

How do we explain the unexplainable? Are there words for the things we’ve experienced?

Rachel Basham, RN, CCRN

Conditions

September 14, 2021

I’m usually good with words. The last year and a half of being a “front line nurse” has left me struggling to find the words. The frustration, anger, trauma, and sadness have so muddied my mind that I find it hard to sort through all of the complexities and put a name to them.

A patient told me the other day, “I know at least 60 people who have had COVID, …

Millions of Americans without ICU doctors due to the “Biden ban”

Seth Rabinowitz

Policy

September 6, 2021

Americans are dying in ICUs in far greater numbers than would otherwise be if not for a newly misapplied 57-year-old rule banning the only American board-certified ICU doctors available in many cities from providing critical care, leaving only nurses to do the doctor’s job in treating ICU patients.

There is a severe national shortage of only 25 percent of the needed board-certified intensive care unit doctors — known as critical care …

The horror of keeping a loved one alive at all costs

Debbie Moore-Black, RN

Conditions

July 23, 2021

He was in his ICU bed without movement or brain stem involvement. His weight was down to 90 pounds.

His six-foot frame and skeletal body made me gasp.

After countless sessions with the patient’s daughter to make her 92-year-old dad “comfort care,” the intensivist sadly hung his head down low.

The daughter insisted on doing everything for her daddy.

It was my night shift, and I knew what was to be expected. Another endless …

Being the angel of death during a pandemic

Emily D’Amelio, RN

Conditions

June 24, 2021

I was looking forward to March 2020. My boyfriend and I had a long-awaited vacation to Aruba we were looking forward to. Everything is packed, plans are finalized, and the world shuts down three days before our trip. Frustrated, we refuse to believe that a “virus” is worthy of shutting the world down. “What’s the difference between this and anything else?” “Who cares? It’s just a virus?!” “I am still …

A beloved COVID ICU patient turns to comfort care

Debbie Moore-Black, RN

Conditions

March 2, 2021

Everyone loved Mrs. Maria. She was everyone’s mom, grandma, teacher.

Maria grew up in poverty. Though her family was poor, she knew her parents and siblings loved her and loved each other. But the one thing she knew her passion was at was school. Every morning she couldn’t wait to go to school and learn more. And she knew one day she would be a teacher.

Throughout the years, Maria excelled in …

Maybe life is happening: the power of language in patient hand-offs

Aleks Olszewski, MD

Physician

February 4, 2021

“But if thought corrupts language, language can also corrupt thought.”
– George Orwell

The “difficult” family

At 2 a.m., on my first night shift as a pediatric resident, a patient, Casey, transferred from another hospital. She had a rare, progressive chronic illness, was medically complex, and was currently receiving treatment for an acute systemic infection. Shortly after she arrived, she became difficult to arouse. When I asked her mother questions, I was …

Pay attention to science and medicine, or else you may be the next careless victim

Debbie Moore-Black, RN

Conditions

November 23, 2020

I enter the hospital to work again. I must work as I have three small children and a husband presently out of work because of COVID. He is “non-essential.”

A violinist is playing at the employee entrance. I know they do this to lift our spirits. But it’s a slow, sad string that reminds me of the titanic. And yes, every day I clock in, I feel as if it’s a …

I am an emergency and critical care physician. I had COVID-19 infection twice and I’m tired.

Kara Ward, MD

Physician

November 22, 2020

I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired.

My first infection was early on in the pandemic. I had to place a Blakemore tube in a young man who was going to die from his massive bleeding from cirrhosis. I didn’t know then that the patient was positive for COVID, as he didn’t have any “typical” symptoms. I placed the tube …

Understanding critical care in the ICU: then and now

Sara L. Merwin, MPH

Conditions

October 31, 2020

Late one evening, an ICU physician calls a family to say Dad’s breathing rate had slowed to such an extent that he did not believe Dad would survive the night without life support. This seasoned doctor added that he had never seen patients come back from this condition on their own. Although Dad had do not resuscitate orders and his children had agreed with his wishes to forego extraordinary measures …

I am an ICU nurse. We are drowning.

Lauren Powers, RN, CCRN

Conditions

June 9, 2020

I am an ICU nurse. I love what I do; It’s not just a career: It’s who I am. No other job could offer me the intimate opportunity to support and guide a total stranger through the worst (and occasionally best) days of their life. Nowhere else would I leave feeling humbled by what I do every day. Nothing compares to that. Simply put: You don’t find that sense of …

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I am an ICU nurse. We are drowning.

A young doctor struggles against the emotional devastation of losing a patient

Paul Rollins, MD

Physician

May 14, 2020

We worked tirelessly attempting to resuscitate this mother of five for almost an hour. Her husband was called, and he notified us that he would be there shortly. In the end, our heroic measures were simply not enough. It is fearful to imagine being told your wife and mother to your five children is no longer alive on Mother’s Day. The uncertainty of what killed her is a tough pill …

A physician’s personal experience with sepsis and ventilator support

William Lynes, MD

Conditions

April 29, 2020

The coronavirus pandemic has turned the world, and all of its citizens, around, never to be the same again. As an ICU and ventilator survivor, I focus on the drama of the patient’s room, and the reality of what is truly a tragic experience. Nineteen-ninety-eight seems like yesterday, and while it was 22 years ago, it is fresh in my mind.

The vacation abroad that fall was a sunny respite from …

You’re just the anesthesiology resident

Anonymous

Conditions

April 14, 2020

You always knew they didn’t care about you. The administration, I mean. But you knew that going into it. It’s just four years that you have to endure until you can be respected, until you make the big bucks, until you’re treated like a human being. Four years is not that long.

But you knew this going into it. That they didn’t care. You’re just a resident. Now more than ever, …

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You’re just the anesthesiology resident

Grieving the end of life experience from an ICU nurse

Alexandria Frangedak, RN

Conditions

March 28, 2020

The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone.

This is just what we have to do to keep society …