Louise: On a typical Saturday night, the TICU would get a few admissions — four would be a busy night. The TICU is a 16-bed unit with a sister 16-bed unit Trauma Step Down (TSU). The two units work closely together sharing a leadership team. Many nurses begin working on the TSU then, once they gain experience, transfer to the TICU. This strategy is to grow and retain nurses who have the highly specialized skills of critical care trauma, including burns. Typically, the TICU is a very controlled calm environment with the team of RNs, RRTs, nursing assistants and physicians working collaboratively together as a well-oiled machine. This night the TICU looked more like the trauma bay with supplies, equipment and team members working feverishly together.
Jim: On a typical day, I would start by rounding on the patients and their families in TICU and TSU. The sickest of our patients would have 1 RN to 1 patient. On June 12, we had 4 RNs working on 1 patient and transfusing cooler after cooler of blood products. Team members had the same look on their face — one that looked like they were all holding back a bucket of tears. I got a list of all of the patients who were in my units, and most of them were listed as “Doe’s.” I went room to room to round on all of the survivors in my units, and in the back of my mind I was praying to God that this was a nightmare. I spent a majority of the first week in a conference room with law enforcement trying to find family members for those who didn’t have family at the bedside.