The acutely ill patients UCLA nurse Mei Lani Renger takes care of need all the help they can get. Some are in comas, their families huddled around them, hoping they will wake up. All of her patients have suffered serious neurosurgical and neurological trauma leading to brain damage.
“Our patients are people who have fallen off of cliffs or been stabbed 20 times or paralyzed in a surfing accident,” said Renger, senior nurse in the Neurointensive Care Unit (NeuroICU) of Ronald Reagan UCLA Medical Center. “A lot of it is car accidents — usually people not wearing seat belts — and motorcycle accidents where the driver wasn’t wearing a helmet.” Brain-impairing strokes, pulmonary embolisms or cerebral hemmorhages also land patients in Renger’s unit, which draws patients from the emergency room as well as airlifted from other hospitals.
UCLA Hospital Hero Mei Lani Renger helps patients and their families through critical times.
“The job is very specialized,” she said. “You’re paying constant attention. Quieting the patient’s brain to prevent a seizure. Watching for brain swelling, a bleed. Keeping their blood pressure high to make sure the brain gets oxygen. You’re watching closely for changes, a change in the patient’s hand grip, for example — any little signal that something is going on.”
In acknowledgement of her work to provide “outstanding direct patient care above and beyond the call of duty,” Renger was named UCLA’s 2009 Hospital Hero, an award presented by the National Health Foundation. She also received the hospital’s Humanism Award last year, and the Best Nurse Award in 2006.
She serves on a team of 18 NeuroICU nurses who care for as many as 24 patients at a time. Having worked in the unit for 15 years, Renger has evolved into a mentor to student nurses and new graduates as well as a resource for more experienced colleagues.
Yet Renger almost didn’t become a nurse. She’d been excited about the field ever since the fourth grade, when she and her mother used to watch the soap opera, “All My Children,” every lunch hour at their home in Redondo Beach.
“They had candy stripers on the show,” Renger said of the hospital volunteers. “I thought, ‘I want to do that, help people in the hospital.’”
During her senior year of high school, she volunteered at a local hospital and found that she really did enjoy that environment. But with college around the corner, her father pressed his math-savvy daughter to study computers instead.
“I told him, ‘Let me take one nurse’s aide class and see if I like it,’” Renger recalled. “I loved it. I didn’t mind the bedpans or any of it, because I loved being with patients. And I convinced my dad to let me go the nursing route.”
Renger went on to work at Torrance Memorial and L.A. County hospitals, then crisscrossed the country as a traveling nurse, landing at places like Stanford University Hospital and The Johns Hopkins Hospital and developing expertise as a nurse in cardio-thoracic intensive care units.
Fifteen years ago, homesick, she returned to L.A., called UCLA to apply for a nursing job — and got the brush-off.
“They said they weren’t interviewing — they didn’t have any openings,” Renger recalled. “I said, ‘Oh no, you want to interview me. I have so much experience that you’re crazy if you don’t hire me.’”
UCLA interviewed her after all, and four months later, a position opened up in the NeuroICU. She has worked there ever since, except for a brief period when tragedy struck just weeks into her new job: Renger’s mother was diagnosed with pancreatic cancer. At the urging of her supervisor, Renger took leave to care for her mother for the last two months of her life — an experience that she said profoundly changed her.
“I think it is because of my mom’s death that I nurse in a very different way now — with more compassion, caring, empathy and understanding,” she said.
A nurse’s work in the NeuroICU can be very sad and hard, Renger said, “but we see miracles in our unit every day — a patient wakes up from a coma or is ready to go home. I believe in miracles because our doctors are so great, and we’re all doing 100 percent.”
She cited the case of a young man hit by a car while riding his bike. He came to UCLA’s emergency room with a head injury, crush injuries to his lungs and other internal organs, open wounds and multiple broken bones. Transferred to the NeuroICU, where he remained for six months, he couldn’t walk or talk — and didn’t want to, Renger recalled. “He was miserable, extremely sick and depressed.”
Determined to lift his spirits, the nursing team moved him to the best room in the unit, decorated it with cycling posters and told him, “We’re rooting for you. We’re going to be in here every day to see how you’re doing.” Not long after, he progressed to rehab and after a few more rough spots, finally made it home. Recently he visited the NeuroICU. “It was surreal,” Renger recalled. “He was walking, joking … and planning his wedding.”
Renger also works closely with patients’ families, who are often deeply involved in their loved one’s hospital experience. “I’m always trying to find ways to make their experience better, to be there for the families, to find out what they need to help them cope,” she said.
One particularly sensitive area in which Renger has developed expertise in is helping families make informed end-of-life decisions. “If a patient is in a coma with a devastating brain injury, dependent on a ventilator and a feeding tube, unable to speak or act, with no comprehension of who he is and no chance of regaining cognitive function,” Renger said, “does the patient’s family really want this for him?”
She pulls together the patient’s doctors, nurses, and members of the hospital’s ethics, social work and spiritual care teams to work with the family. “I want to make sure they have all the information they need” to make a choice to maintain or remove life support.
Not that helping families make this choice takes away their pain, but with resources and support, she tells families, “You can make a horrible situation tolerable.”
“One of the best days and hardest days of my life was when a family decided to withdraw care for one of our patients and asked me to be their nurse during his last days,” Renger said.
Doctors had determined that the patient, in a coma and kept alive with a breathing tube, would eventually die from pneumonia or a similarly painful condition.
Renger steadfastly remained with the family while they moved him to a quiet, private room, performed a spiritual ceremony and spent their final hours with him.
Among those nominating her for the Hospital Hero award was Dr. David Feinberg, associate vice chancellor and CEO for the UCLA Hospital System, who had heard about her work from colleagues and met her during hospital rounds. Cathy Ward, director of UCLA In-Patient Nursing, concurs. “Mei Lani is a model of inspiration and compassion in our hospital,” Ward wrote in an e-mail announcing the award. “Her deep commitment ... is evident in the care of her patients.”
Being named Hospital Hero, Renger said, “was a complete surprise and a true honor.” But the bigger honor, she said, is “to be there for our patients and families. That’s why I love my job.”