Critical Care Essay: Reflection & Research

Kaitlyn Mitchell

Critical Care Essay: Reflection & Research

April 13th, 2025

Part 1. 

The case from Critical Care that spoke to me the most was Theresa Brown’s second “Condition A”, in which Robert, an older man who had arrested and passed away in a different unit. In this case, the patient had gone to a different floor to receive radiation treatment. He was accompanied by his wife for the majority of his hospital stay but she had gone for a bit as he was receiving the radiation treatment. His wife, Marianne,  was seen as pushy by some nurses, trying her best to get food he would like or schedule tests so that he could get rest, but really she was just trying to make sure he received quality care. Brown did not go into much detail about what Robert was receiving radiation for, but it appears that Robert died of sudden cardiac arrest. 

Sudden cardiac arrest (SAC) affects somewhere from one hundred fifty thousand to four hundred fifty thousand Americans every year and is the leading cause of natural death (Einav). Even with medical intervention, like CPR and medication, only has a ten percent survival rate (Einav). However, this survival rate is even lower when there is decreased reaction time, like in this case where no one had checked on Robert for five minutes. It is hard to determine exactly why a patient suffers from sudden cardiac arrest as it is often a combination of many factors including prior sudden cardiac arrest, family history, structural heart disease, non-cardiac comorbidities, age, cardiac comorbidities, and much more (Einav). 

In Robert’s case, it probably had something to do with his cancer or the radiation treatments he was receiving as well as his age, history, and other factors. This answer could potentially be found in an autopsy, if that is what the patient’s family requested, but it might also never really be known (Einav). Ultimately Marianne decided she did not want an autopsy, so the reason will never truly be known. 

Part 2.

This case really stood out to me because of how real it seemed. It was also hard to read about how the nurses knew that the CPR was not going to bring him back but he could not yet be pronounced dead and had to inform the family about this. It must have been extremely difficult for Robert’s wife, Marianne, to make the decision to have the medical professionals stop what they were doing. I have never been in the position to make that kind of decision and I am honestly not sure of what I would do. It must be extremely difficult for a patient’s family to decide when their loved one will die. As a nurse, I know that I will have to consider this in my future practice, giving extra support and consideration for the family of the patient as well. 

Also, for Robert to have suffered from cardiac arrest must have been a surprise for his family, they might not have been expecting this risk as he was currently getting radiation treatment for cancer. This might have been part of the reason why Marianne had difficulty telling their daughter, as his death was so unexpected. Brown was asked to tell their daughter but she noted how their daughter seemed so overwhelmed with grief. 

Brown showed true professionalism and patient centered care in this response. I think her actions were exactly right for this case, she tried to best support her patient and his family, she provided information about Robert’s condition while also trying to support his family in their grief. Her response could also relate to the issue of nurse burnout, a rising issue in nursing practice (Van Bogaert). She talks about how, as a nurse, it can be difficult to deal with the death of patients, which is something that can lead to nurse burnout. 

Nurse burnout can be caused by many factors, including emotional exhaustion, depersonalization, and more, and can affect both individuals and entire units (Van Bogaert). In facilities with unit-level exhaustion, there was lower patient satisfaction and quality of care (Van Bogaert). Obviously, facilities would want to avoid this. However when you work in an oncology floor of a hospital like Brown, how avoidable is nurse burnout? When deciding where you want to work as a nurse, you should consider your personality. Are you the type of person that can deal with loss, with grieving families, and hard situations on a daily basis without getting too emotionally exhausted? Brown briefly discusses this and she talks about the community she has with her fellow nurses, her own family, how they support each other and help with difficult situations such as this. 

Citations:

Brown, T. (2010). Critical Care: A New Nurse Faces Death, Life, and Everything in Between. HarperCollins Publishers.

Einav, S. , Cortegiani, A. & Marcus, E. (2021). Cardiac arrest in older adult patients. Current Opinion in Anaesthesiology, 34 (1), 40-47. doi: 10.1097

Van Bogaert, P. et al. (2014). Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events—A cross-sectional survey. International Journal of Nursing Studies, 51(8), 1123–1134. doi: 10.1016