The workday started as any typical day on the Cardiac Intensive Care Unit. I arrived at the unit promptly at 6:30 am to gather all pertinent information on my two critical patients. I printed off my cardiac EKG strips, looked up my patients' history, physical and chief complaints and tried to plan my 12-hour shift accordingly.
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The workday started as any typical day on the Cardiac Intensive Care Unit. I arrived on the unit promptly at 6:30 am to gather all pertinent information on my two critical patients. I printed off my cardiac EKG strips, looked up my patients' history, physical and chief complaints and tried to plan my 12-hour shift accordingly. My preceptor walks over to me at 6:42 am and in a stern voice says "It is now time for report". Report consists of the off going nurse to give the oncoming nurse a brief synopsis of the patient and plan of care. As a new graduate registered nurse I always found report intimidating but exciting. Intimidating because most of what is said during report I have no clue what we are talking about. It's exciting because I get to learn new things even if it means I have to look up what certain terms mean at a later time.
"Karla, who do you plan to see first"? Hell if I know, I thought to myself. "I plan to see Mr. Smith first because he appears to be the most unstable. I want to make sure he is receiving adequate ventilation and is responding well to his cardiac medication". My preceptor nods her head in agreement and proceeds to the break room to retrieve her morning coffee. "Call me if you need anything", she says. I'm only on week 7 out of 12 of my orientation so at this point I realize what I know and more importantly what I don't know. My morning consists of assessments, rounding with the intensivist, administering medications, assisting with personal care, speaking with family members and of course the never ending documentation. Around 1 pm my stomach is starting to growl and I realized I haven't eaten anything since 5:15 am. I also feel a strong urge to urinate and realized I have not been to the bathroom since getting up at 4:30 am this morning. I spent all morning taking care of my patients and their family members that I have neglected myself. At this point, I decide it is time for a break and I quickly go to each of my patients' rooms to make sure there is nothing they need so that I can have an uninterrupted 30-minute lunch break. In room six is Mrs. Jones, 89-year-old female that suffered many complications from a hip replacement. She is lying in bed, alert and awake visiting with her daughter and son in- law. Mr. Smith is a 40-year-old male who is here because he had a massive heart attack. 2 days ago he had coronary bypass surgery and he'll remain in the Intensative care unit until he is stable enough to go on a general medical-surgical unit.
As I approached Mr. Smith's bed, my heart skipped a beat and I found it hard to swallow. I found him lying motionless on his bed and he had a bluish hue on his skin. He was dead. I felt for a pulse and didn't feel anything so I immediately called for help, pushed the code blue button and initiated CPR. I climbed on top of his bed and positioned myself over top of his chest. With my arms extended downward and hands placed in the center of his chest, I began pressing downward, hard and fast. Within seconds (which felt like forever) a whole swarm of physicians, nurses, and respiratory therapists were in the room. Everyone worked systematically to attempt to save this man's life. One person was at the head of the bed administering oxygen and breaths via an Ambu bag, another person was administering medication, the physician was directing everyone on what to do and when to do it, and here I was performing chest compressions. This was indeed the scariest moment of my life.
With each compression, I felt a grating sensation under my palms. I knew that I was breaking his ribs. Then I remembered a CPR instructor saying "If you feel ribs cracking then you're doing a great job. Better to live with broken ribs than to die with ribs intact". After 2 minutes, I felt completely exhausted. I felt beads of sweat form across my forehead and I was immensely short of breath. I yell" Can someone please take over"? A tall skinny, medical resident volunteered and resumed chest compressions. I then began to silently pray to myself for this patient. "Lord, please don't allow this man to die. Not now and not this way. Remember that he has a wife and a 13-year-old daughter who needs her daddy" After 10 minutes of CPR, I looked at the cardiac monitor and saw that he was in Sinus Rhythm. "Can we feel for a pulse" shouts the physician. "We have a pulse" a nurse responds. Finally, I breathed a sigh of relief.
The charge nurse walks over to me and clearly notices that I'm a bit shaken up. She tells me to take "five" and that a more experienced nurse will be resuming the care of Mr. Smith. I briskly walk over to the bathroom, shut the door and sob. I sobbed uncontrollably for 5 minutes as I tried to wrap my brain around what just happened. I wondered if it was my fault that Mr. Smith died, did I miss something critical? What if we didn't save him, would I have been the blame? Why did this happen, he was up talking just a few minutes prior to him coding. So many thoughts and questions ran through my mind. After my meltdown, I managed to dry my face, straighten out my scrub top and go back to the unit.
My preceptor approaches me and says "Good job in there". I was shocked, yet relieved. "Um, I really didn't do anything". "Yes you did" she replied. "You noticed that he was in trouble and you did not hesitate to jump right in and help". I guess she is right, I thought to myself. If I would have gone straight to lunch without checking on my patients then he would have been dead a lot longer and probably would not have been able to bring back to life.
Three days later, I arrive at the unit and prepare to take on another shift as usual. As I walk past Mr. Smith's room I see his wife and daughter by his side. Mr. Smith looks at me, with tears in his eyes and says "Thank you". With tears in my eyes, I replied:" You are most welcome". At that moment I realized that being a nurse is exactly what I was put on this earth to do. I walked away with joy in my heart and a smile on my face.
