Last time, Sarah Jane walked us through the beginning of her life as a preceptor with a new nurse on the ICU. She gave some great advice on putting the patient’s best interest first, and helped lead the way through a bloody trauma. Now, the time with her new nurse was coming to a close–but not without some excitement.

As I was saying, during the homestretch, we had two very memorable patients that were great teaching opportunities for me-and great learning experiences for the new graduate. One was a patient that was a cardiac arrest and then had an anoxic head injury and the other was an organ donor.

The first patient I had gotten as an admit the night before because I had picked up extra hours on the unit. The night I admitted him, before I left that morning, I had maxed him out on two pressors and started a third. So I was definitely shocked when the orientee and I came in that night to work and the patient was still alive. I thought for sure he would have coded and died during the day. The dayshift crew had been kind enough to bring the code cart in the room and have the patient hooked up to it because they had shocked him earlier in the day. My orientee had never seen a code in the ICU or anywhere at this point in her nursing career. Unfortunately, she made up for lost time very quickly as our patient coded three times that night.

The first time, she got to see how her co-workers play a vital part in the code. We answered the questions to ensure that the docs had the most recent and up-to-date information on the patient. The second and third times the patient coded, I let her get involved, helping with chest compressions and push meds. After the third time we coded the patient and got him back, the family said enough was enough and not to code him again.

The patient passed away about an hour or so later and we helped the family as best as we could with grieving. (We had gotten pastoral care involved early on in the process.) We had pretty much allowed open visitation from the beginning because I was sure the patient wasn’t going to last the night. The patient had a large family and everyone felt like they had the chance to say goodbye.

The other memorable patient we had on the new nurse’s last week of orientation had a huge diffuse bleed for no apparent reason. By the time she got to our hospital, she was trying to herniate. The day shift nurse had gone through the process with the family having the patient declared brain dead. Then Life Connection nonprofit agency designated by the government to administer organ donation in Northwest and West Central Ohio, took over the patient care. They had us draw a whole bunch of labs, kept really close tabs on the patient, and were available to us all night long.

We were really busy during the night with all the updates we were giving Life Connection and with trying to find the best way to treat the patient. Once the patient was pretty much stabilized, we just had to wait for them to place her organs, an OR to open up, and for those teams to come in and get the organs.

The really cool thing was we were getting to keep a kidney locally, so they were in the process of finding someone for it. When all was said and done, they were able to place her liver and two kidneys.

One of the best things about having an organ donor is that usually the orientee gets to go to the OR with the patient and see everything. I saw my orientee after she went down there and she said it was the “coolest thing ever.” She said it was the best A&P (anatomy & physiology) lesson she had ever had.

Editor’s note: You can write to Sarah Jane, the columnist behind The Preceptor Place, at janesarah18@hotmail.com.