Intensive Care Unit (ICU). The Intensive Care Unit is probably one of the most famous hospital units. Almost every layperson understands what the ICU is all about. Often, what people visualize when they hear the very word “ICU” is that there is this patient, with a whole lot of tubes inserted into every possible orifice, with a lot of IV Fluids, who is on Mechanical Ventilation and is attached to a lot of monitors and other contraptions, who wears a gown, and most of all, who are near-death.


This is precisely the final appearance of a client admitted in Intensive Care. The most certain thing is, this client is admitted in here because at any moment of the day, at any sudden and random time, this client may undergo cardiopulmonary arrest, respiratory arrest, or may have another fatal aberration that endangers his very life.


I have experienced having my duty at the ICU at various medical centers; from the time I was still on my RLE subject in college, until the time that I have become a fully licensed, professional, registered nurse. ICU is one of the most exciting areas a registered nurse can be exposed to.

It is one of the areas I dreaded at first, because of the highly toxic environment, and the problematic technicalities of the job there. I was a ward nurse, and then I was given a chance to be exposed to the ICU for a temporary period. I have to admit it; chills made their way down my spine because I was scared.

I am not yet fully-trained in ACLS and Basic ECG, and I am to be exposed there. I had no choice. I could not tell my boss, “Ma’am, I do not like it there. I think I am not yet ready”. I am a nurse, and I am licensed, and I must be flexible. I have dreaded every day that passed by since that assignment. I realize that with each day that passes, I am getting nearer and nearer to working in the area I am so scared of.

December came, and I was finally transferred to the area. Everything is so different from the ward, the contraptions, and the monitors. I am like learning again. I am so thankful that my seniors were very helpful. They taught me everything they know. They oriented me on ACLS, basic ECG, monitors, and the use of every contraption in there.

The area is entirely different from the set-up I am used to at the ward. Since that day, I have realized why the ICU was termed a “Special Area.” It takes serious knowledge, skill, efficiency, speed, and common sense to be an ICU nurse. Days passed and I eventually got used to the ICU set-up, and then one day, it hit me: I love this area. This is the area I would like to work and specialize as a nurse. I want to become an Intensive Care Unit Nurse, permanently.

I was so amazed and thrilled by the constant challenge that the ICU offers. There is no day in the ICU that your alertness and your brain become lax. I love the day to day challenges that the ICU permits, especially when taking care of these critically ill patients where you must make decisions in terms of seconds, otherwise losing them to death’s sharp scythe. I love the ICU, but there is this one thing that particularly touches me, makes me wonder, and at the same time, pains me: the unconsciousness of the CVA clients we handle.

 Cerebrovascular Accident or Stroke is a disease condition wherein there is a disruption of blood flow to the brain, leading to cerebral ischemia and irreversible neuronal death. It is a condition that occurs suddenly, and it is one of the most common cases being encountered in the ICU.

Often, people who undergo a stroke get admitted to the ICU immediately to control further increases in ICP, reverse the pathology, monitor the patient, and, more often than not, directly transfer to the OR for surgery once a craniotomy is required based on the magnitude of the situation. Stroke patients that

I encounter at the ICU often get admitted with a GCS of 9-12, and then rapidly deteriorate to 3-5 in short periods. Medical management is initiated as early as possible, but some patients eventually proceed from ischemia infarcts to bleeds.

It is when these things happen that the client becomes unconscious and is disconnected from the outside world. I often encounter patients like this on duty. Unconsciousness is a thing that bothers and continues to impress me; after all, neurology is my favorite. It is always amazing how a person you are talking to a while ago, and who is being monitored, would suddenly deteriorate into unconsciousness and eventually would be intubated and mechanically ventilated. I sincerely feel sorry for these clients. 

I know CVA, and I know how CVA is one of the most challenging pathologies to reverse since neurons do not replicate. Hence when neurons die, they permanently die. I am a spectator to these events and when they occur, I do everything in my power to go along with medical management and try to help the client in the best way that I can. It pains me to see these people, who have lived lives of hope and love, to see them be rendered disabled by this condition.

   CVA is a despicable disease. It extinguishes one part of the body that is responsible for all the vital functions that our body performs. It is responsible for killing emotions and knowledge from the cerebrum and eventually rendering a person permanently disabled and unconscious, unable to hug those they love, nor speak to them at all. It is one of the diseases that gained so much focus on the field of neurology since it causes irreversible aberrations and it splits families apart.

It pains my heart to see families visit unconscious clients, holding their hands, whispering to them words of love and care. It breaks my heart to see wives, husbands, and children, hold the hands of patients, and sometimes see them cry. The words they speak bring tears to my eyes and break my heart. All I can do as a nurse on duty is to render the most effective and passionate care I can to these clients.

I am not providing people with false hopes, and false promises that everything will be okay. What I can promise them however is that, when they leave after visiting hours, I shall do the best that I can to care for the people that they love. I shall take a share at that piece of hope that they cater within their hearts.

As long as there is life, there is still hope, and no matter how medically challenging and irreversible CVA maybe I shall always hold on to that small bit of hope, though sometimes, as a person, you should know when to let go, and that is one of life’s ironies.

This article was submitted by JD Gopez RN


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