Kathleen Anderson

Worked as a staff RN on a 10-bed acute hospice care unit, providing end of life care that was not possible to provide in a home hospice setting, such as continuous IV and subcutaneous infusions of Dilaudid, Morphine, Fentanyl, Ketamine, Ativan, Versed and other comfort meds. Provided continuous monitoring of symptom management, adjusting care as required in a team-based environment. Patient and family education regarding the dying process was an important part of the position, balancing information about the patient's disease progression with tact and compassion. Worked closely with all team members including aides, chaplains, social workers, physicians and team coordinators to provide the best possible care to the patients and their families during what is the most difficult of life's transitions for many people.

Worked as a staff RN/rotating charge nurse on a busy 12-bed thoracic and cardiovascular surgery postop unit (TCVPO) where we received patients directly from the OR, intubated, sedated and often on multiple vasoactive drips. Patients were weaned to extubation as soon as tolerated, vasoactives were weaned, invasive hemodynamic monitoring discontinued when no longer guiding therapy and the uncomplicated patients were transferred to the step-down unit within 24-48 hours. More complex cases required IABP, CRRT, LVAD or ECMO support for varying lengths of time, and we occasionally cared for long term patients at very intense levels of care. During periods of acute patient decompensation, "open chest" procedures were performed at the bedside, requiring the bedside nurse to titrate drips, draw frequent ABGs and labs, administer blood products and provide pertinent information to the surgical team over an often hours-long procedure. Families were updated by nursing staff throughout the procedure, and by the surgeon afterwards.

Staff RN/rotating charge nurse/preceptor on an 8-bed cardiovascular surgery postop unit which had an adjacent 8-bed step-down unit from which patients were discharged to home. We received the patients directly from the CVOR, intubated, sedated and with invasive hemodynamic monitoring in place for management of vasoactive drips and volume status. We weaned to extubation as tolerated, and once the patients were hemodynamically stable off pressors we tansferred them to the step-down side, usually within the first 48 hours postop. We rotated between the two units, and provided all discharge teaching to the patients and their families.

After taking 4 years off in order to stay at home with our young children, I was hired at Mercy General as a staff RN in the combined 20-bed Medical/Surgical/Cardiac ICU. That is where I oriented to the exciting world of cardiac surgery, which remained my passion for the next 20+ years.

We received patients directly from the CVOR, intubated, sedated and often on multiple drips. IABPs and CRRT were occasionally seen. Being a community hospital as opposed to a teaching hospital, we relied heavily on protocols related to weaning of drips, volume replacement and the administration of blood products, especially after hours.

I was initially hired as a Nurse Extern on the Oncology Unit during my final year as a nursing student at Bronson. Following graduation in May of 1997, I was hired into a newly-created hybrid position which rotated every 2 weeks between the MICU and Oncology, but after the first year I worked exclusively in the MICU.

Skills acquired during that time included extensive assistance with bedside procedures such as insertion of central lines, Swan-Ganz catheters, arterial lines, chest tubes, para- and thoracenteses, intubation and extubations. I became proficient at venipuncture, IV starts and arterial punctures while learning to be a critical care nurse and an ICU team player.