 I don’t know what it was called, but underneath the wound was what appeared to be new, fresh skin. It was the weirdest thing; I was so intrigued by this discovery. Anyway, we cut the new sponge to fit the wound and placed it on top of the wound. Then the doctor placed the special VAC film over the top of the wound and hooked it up to suction, packing the sponge securely into the wound in this method. After that the lift team came in and assisted the patient into a weird contraption of bed/lift equipment/chair, and put it into the chair position for the patient to sit in. 

At 10:00, we hooked up a PCA on Mr. S.C. filled with Dilaudid and had a good conversation about Oktoberfest. Afterwards, his girlfriend showed up and told me all about how he fell out of the tree. After a little while, Mr. S.C. needed to have a bowel movement and did not want to go in the bed.  This is when I realized how difficult it would be to move the patient with three lines attached and running, an arterial line attached, and continuous pulse oximetry. It required three people to do it when normally I could have handled a non-ICU patient by myself. After that, it was pretty much business as usual.  The nurse gave meds and I observed her routine closely, which consisted of a lot of charting and medication administration. During this time, the nurse and I discussed her definition of the role of a critical care nurse. She described it as “flying by the seat of your pants” and “getting the work done”. She said that she loved being an ICU nurse because of how exciting it is to her and how there is never a dull moment. 

The nurse and I also discussed the death of a girl she had had as a patient the week before. She was only eighteen and had been involved in a motor vehicle accident. One legal and ethical issue concerning the patient was the decision of the family to remove the young woman from life support and donate her organs. This decision was a heavy one, one that was not taken lightly and one that has permanent repercussions on the family, the nurses involved, and the patient. The nurse told me that sometimes it isn’t always clear what the right decision is, that emotions sometimes can cloud your feelings, but that you have to check your emotions for the betterment of the patient and the patient’s family in order to assist them to the best of your ability. 
	Today I had the pleasure of meeting Mr. D.W., who was born in Jacksonville, Florida in the year 1948.  Mr. D.W. is a white male, who grew up with his mother, a step-father, and his younger brother.  His parents were working class citizens who labored very hard in order to provide for their family. 