An Unbeating Heart

General E. Speaking, RN, RN

"The monitor tech is sick. We are in a bind. You will be the monitor tech today," the house supervisor casually told me as I was searching for my assignment on the white dry erase board on my Telemetry Unit.

I have only been an official RN since June 2008- a mere 3 months. I say "official" because although I am newly licensed as a registered nurse, the term nurse has been with me for a long time- licensed vocational nurse.

"Crikey!" (as the Crocodile Hunter would say) I muttered to myself.

For a moment my fight or flight response took over. I tried to calm myself. I am ACLS certified and I have taken EKG classes. I know can recognize the dangerous rhythms but I had never been oriented to the monitor tech position. I sat in the chair and stared at the numerous squiggly lines on the sleek flat screens in front of me. I got a brief report from the night monitor tech and then I was on my own. Just me and 43 rhythms. Okay, I'm being dramatic. I wasn't totally on my own. My charge nurse was there and the ICU charge nurse is always available. How else can I pull in an audience unless I have some drama? I pulled out my trusty readers. Yes, I said readers. You know- the ugly glasses you buy at the dollar store that make your eyeballs too big for your face? How else was I suppose to count those incredibly tiny blocks to decipher what rhythm these patients were in? Seems after the age of 40, Mother Nature thinks you will look better with a bit of plastic in front of your seasoned eyes. Who was I to argue?

I settled into my new role and managed to march out my P waves, count my PR intervals, and measure the ORS complexes. I muddled through some trigeminy, Afib and lots of alarm bells notifying me of artifact resembling V-tach. Thankfully, there were no junctional rhythms. I still have trouble with those. Four hours had passed.

"Only a measly eight hours to go," I wearily thought looking at the clock for the umpteenth time.

When one of the monitor techs showed up to relieve me I was elated.

"I guess we can take you down to the Cath Lab so you can practice pulling some sheaths," my supervisor suggested. Better than being the monitor tech, I thought.

"Or... would you rather watch open heart surgery?" she said with a smile.

I am gowned up and standing in the operating room. The circulating nurse reminds me of a lizard. She had those rotating eyeballs that independently move in opposite directions. I quickly decided that this must be a requirement for circulating nurses so they can watch the surgical goings on while assuring observers do not break the sterile field. My supervisor gently nudged me towards the 2 feet green drape that essentially divided the patients head from his body. I moved closer. Closer. I slowly peered over the drape with eyes as wide as a child. I couldn't believe it. I was staring into the chest of a man. I thought of LVN school 18 years before when we toured UTMB in Galveston and I saw my very first human organ in a jar. If memory serves, I believe it was a kidney. Whatever it was I was fascinated. None of the stories, diagrams or even pictures in books can compare. This is the real thing. I had this type of moment again. There it is. This is the real thing. The human heart. It was so close. I had to resist the urge to reach my unsterilized gloved hand over the drape and touch it. It was so still, this small unbeating heart. I watched the huge EKG monitor to my right which showed an ominous flat line.

"Fill it up," the surgeon said softly.

The blood flowed and heart began to swell. It was bloated but motionless. Then it started quivering erratically. I looked back on the monitor screen and immediately recognized ventricular fibrillation. I was looking at an actual heart in V-fib! The chaotic trembling seemed to go on for an eternity. The tiny while paddles were placed on the sides of the heart. They were so small and resembled kitchen utensils instead of life-saving medical equipment. For a moment the room was dead quiet.

"Clear!"

The monitor proudly displayed a beautiful normal sinus rhythm. An unbeating heart no more...

An Unbeating Heart

About General E. Speaking, RN, RN

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