I am a proud to be a Liver Transplant Nurse!

Arnol Nylcy1,*, Parimala2

1Staff Nurse, Kauvery Hospital, Chennai, Tamilnadu, India

2Clinical Instructor, Kauvery Hospital, Chennai, Tamilnadu, India.

*Correspondence: Tel No: +91 94435 68280; email ID: [email protected]

I am proud to be a nurse because nothing is more gratifying than gifting my patient the simple power of my touch, the calm tone of my voice, a moment of silence when required, but always a kind word.

All these things shall provide peace, comfort and healing to our patients. The best way to find yourself is to lose yourself in the service of others.

Hi everyone, have a good day. I am Arnol Nylcy. I am working as a liver transplant nurse at Chennai Kauvery hospital.

In this article, I am going to share my journey in the liver transplant unit and say why I feel proud of being as liver transplant nurse.

Giving is the master key to win, in all applications of human life.

If you can motivate yourself, you shall always burst into an abundance of energy that will drive you to the pinnacle of success that you dream of.

Some weeks ago, I was waiting near ER, prior to proceeding to a medical camp. Suddenly I observed one person; I had sensed that he was looking at me since quite some time and I was thinking “why is he looking at me like this” and finally I recognized “who was he?”.

He was my first patient, Mr. M, from the time I started my journey in liver transplant unit.

He came near me and started crying, holding my hands. I tried to stop him, but I was not able to. His wife was with him, and she thanked me.

She shared that, at that time, they were not even clear whether he would live through or not. “Because of you guys,” she said “today he is standing here, without your care and treatment, he would not have got new life.”

It was the best moment of my life. I remembered that, on Day Zero, the postoperative day, he was fighting with us for water and he used very harsh words to us. But, at that time, we handled him very nicely, and now he was feeling sorry for that and conveying thanks to me and to whole transplant team, with tears.

My experience, as liver transplant nurse

Scrub and PPE:- The day in LICU starts with changing our scrubs. It is the best thing to change our mind set, and also it is refreshing. Why I am saying this because, even if I am upset or not in the mood to work, whenever I am wearing that yellow scrub, every time it changes my mood! It makes me more confident. After wearing that always one thought comes to my mind that my patients are waiting for my care.

We are not allowed without scrub in the unit. We are trained to wear cap, mask, and other PPE items because its sterile area and we have to prevent infection in patients.

Hand hygiene

  1. Hand washing is the best way to prevent the spread of harmful bacteria and other organisms
  2. Before entering the unit, we need to wash our hand
  3. Next, every 4 hourly, we are trained to wash our hand
  4. Hand hygiene play a major role in prevention of infection
  5. Use of sterilium before and after touching the patient is a must
  6. We are trained to wear the gown which is also very important to prevent infection

Invasive catheter handing

  1. While handling the sterile lines such as CVC, HD cath. PICCO, we need to use gloves to prevent infection with proper hand hygiene
  2. Use of alcohol swab for cleaning the iv catheter ports is a must in my ICU

Investigations

  1. Order given by doctor must be followed within 30 minutes of time
  2. We are instructed to collect all the reports within 2hrs of time periods and then we have update the results of the reports in the group

Medication

  1. All IV drugs to be diluted in 5% dextrose only
  2. Antibiotic should be diluted in 20ml syringe only, and we have to administer over 1 hour of time

Immunosuppressants-

  1. Surgeons give order regarding immunosuppressants
  2. PPI should administered 2hrs before steroids
  3. Immunosuppression chart is maintained separately in the ICU
  4. Complications may occur to the patients, such as infection, increase in total blood cell count, GI disturbances etc. So, we work conscientiously to observe this

General points-

  1. Complications may occur to the patients, such as infection, increase in total blood cell count, GI disturbances etc. So, we work conscientiously to observe this
  2. ECG leads to be placed appropriately, not in zig zag manner
  3. All the useful forms should be placed appropriately to reduce the search time
  4. Flushing of every invasive line is must
  5. PICCO flushing must be done every 4 hourly, that photo we have update in group
  6. No heparin is used for flush bags in liver ICU
  7. No IM injection to be administered in LICU
  8. Fluid bolus to be given with in 20mintues (monitor for HR, CVP and BP)
  9. Every day, we have to check spo2 and try to decrease fio2, if patients condition allows
  10. Chest x-ray should be taken in sitting position
  11. During blood transfusion albumin should be withheld
  12. While mobilizing the patient we must give the gowns to the patient
  13. Daily checking of the patient’s weight is must
  14. All the charts to be maintained properly and that too according to color differentiation
  15. Every 4 hourly drain total should be mentioned if it is above 400. Need to start drain replacement process
  16. Encouragement patient for use of spirometer, we must inform to doctor about volume of incentive spirometer
  17. Files should be arranged according to checklist
  18. All nurses, in unit need to know about the unit protocols

As a nurse, we have the opportunity to heal the mind, soul and body of our patient, their families and ourselves.

I feel proud; whenever I think about all the patients and their loved one, I have worked with over the years. I know that most of them may not remember me, nor I remember them, but I know that I gave a piece of joy to them and they gave a piece of joy to me. I sewed a thread into a tapestry that comforted them while in pain.

This kind of experience has honed me into becoming a better nurse. I can proudly say I have built a good foundation of skills and knowledge through my clinical experience over the years.

Being a liver transplant ICU nurse provided me a roadmap to a successful nursing career.

Ms.-Arnol-Nylcy

Ms. Arnol Nylcy

Staff Nurse

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