FRIDAY, MARCH 9: In the ICU, a lot can happen in a day.
When I arrive at 9:30am nurses and doctors are busily moving about the department tending to four patients. The computer screens monitoring each patient’s cardiac rhythm provide a high-tech soundtrack.
The department is only half full, but it is a hive of organized activity. Overnight, staff have had to deal with a death in the unit.
A female patient was brought into ICU from the Emergency Department late in the evening but she passed away. The last 24 hours have also seen two patients, who came into the ICU for post surgery treatment, transferred to a general ward to continue their recovery.
They have now been replaced by a man who has suffered a potentially fatal aortic aneurism. Doctors are waiting to find out if and when he can be flown to Boston for further treatment. Another patient who has just come out of the operating theatre has come into ICU for the initial part of his recovery.
As I leave the unit, an alarm buzzer starts to ring. It signals that somewhere in the hospital someone has suffered a cardiac arrest.
Ronnie Coburn, clinical manager, says: “If that person survives they will come to the ICU next. We need to be ready to receive him or her. We also have another pending post-op admission later today.
“By the end of the day anything could have happened. We are prepared for all kinds of cases.”
Unit treats babies, seniors, gunshot victims — and everyone in between
More than 450 critically ill patients receive life saving treatment in the Intensive Care Unit every year.
The doctors and nurses working in this state-of-the-art department deal with life and death on a daily basis.
The wave of gun crime and violence that has gripped the island has forced the team to adjust to new challenges as shooting victims and armed guards have become more commonplace in the unit.
Dr Elaine Campbell, who has worked in ICU for the last 19 years, said: “The shootings certainly increased our workload dramatically.
“All of the seriously injured gun shot victims came to us. And that had an impact on the staff and the other patients in the unit.
“To have armed police outside the unit was a new experience for us all in here.”
The ICU team has learned to live with the extra police presence that comes with some patients.
But they remain focused on treating each and every patient the same, whether it’s a drugs mule that has swallowed bags of cocaine or a gang member who has been gunned down in the street.
Senior Nurse, Merline Daley, has been an ICU nurse for 13 years and arrived in Bermuda five years ago.
She said: “One of the things I have seen coming from Jamaica is that the police are very respectful of the patient.
“Whether they are a drugs mule or part of a gang the level of respect between the police and relatives is always there. The officers always go the extra mile.
“And for our part we treat every patient the same. It is our priority to ensure that every patient receives the same high standard of care.
“I love the passion that exists in this department and the feeling that comes from seeing a patient getting better.
“We often see patients at death’s door so to see them walk out of here on the road to recovery is an incredible feeling.”
In 2011 454 men, women and children were treated in the ICU.
Just over 16 per cent of the patients had to be airlifted off the island for further treatment, while road traffic accidents accounted for 29 of the admissions.
Patients vary from babies with meningitis to elderly people suffering from acute pneumonia, which is especially common in the winter.
The unit itself is made up of nine individual rooms. One is reserved for paediatric patients, while another is set aside for dialysis treatment only.
Two of the rooms are fitted with special air control systems, to transform them into isolation units.
Each room is also fitted with ventilators and heart monitors as well as dialysis and IVF equipment.
All the information is fed back to the central nursing station, which looks a little bit like the bridge of the Starship Enterprise with all its computer screens and digital displays.
The staff in ICU are also able to monitor the cardiac rhythms of patients in other parts of the hospital on the central display.
At least five or six nurses and a doctor are on duty at any one time in the ICU.
Clinical Manager Ronnie Coburn has been a constant presence in the ICU at King Edward VII Memorial Hospital ‘for many decades’ and witnessed first hand how equipment and technology has improved.
She said: “I can not imagine working anywhere else. It is different minute to minute and you never know what to expect.
“You don’t turn off your emotions, you just learn how to control them.
“It takes a special kind of person to work in ICU. It is very much about working as a team. It is busier in the ICU now than it ever was before.
“The level of technology has improved a huge amount while I have been here too.”Noreen Landy’s job title may say she is responsible for keeping the Intensive Care Unit spotless, but that does not touch upon the vital work she also does with the patients.
She is a constant source of encouragement and hope to the men, women and children who find themselves in the ICU.
The great grandmother tries to get to know all the patients that come through the unit, and always makes time for a moral-boosting chat on her rounds.
Her colleagues simply describe her as the ‘mother’ of the unit.
She says: “Even when the patients are in a critical condition and unconscious I still talk to them as I clean their rooms.
“I tell them to keep on fighting and that everything is going to be alright. The patients who are awake say they look forward to me coming around first thing in the morning for a chat.
“It is the most incredible experience to watch as a patient gets stronger and slowly recovers.
“There is nothing better than seeing them leave the unit.
“But on the other side of that you see people who do not recover and that can be emotional.
“I have even had my own son in ICU before and I had to take my mother’s hat off and put my trust in the doctors and nurses.
“I see how they work together on a day to day basis so I had the utmost confidence in them.”
Every week day Ms Landy gets into the hospital for just after 7am and starts her methodical cleaning purge of every part of the ICU.
She’s been working at KEMH for just over 13 years, the last three of which have been in the ICU. Her star-emblazoned uniform is a testament to the effort she puts into her job.
She says: “I am very proud to be a part of this team and they have been very supportive of me.
“The hardest thing for me is seeing children in the ICU. Luckily that does not happen that often.Seeing a patient on life support and fighting for their life is hard.
“I don’t think many people can take it. I do a lot of praying. I just ask God for help to keep me strong. But I love my job and the people it allows me to work with and meet.”