First Dive

Ruby Vee, BSN · Mar 21, 2014

Well, you've got about six months to figure it out, since you've only been in your current job for six months. And ER is actually pretty good experience for a hyperbaric nurse. My husband was a hyperbaric nurse for years, but did it per diem. In fact, at that chamber, all of the nurses were either per diem or floats -- they didn't do enough dives to justify full time RNs. Another chamber used ICU nurses for their dives, and floated a nurse over when they had a dive. Some of the ICU nurses were dive-certified, and did call for the chamber. That chamber was a military chamber, at a military hospital.

Are there any chambers in your area? Perhaps you can shadow there and find out what they do and what a dive is like.

313RN, BSN, RN · Mar 22, 2014

Depending where you work the pace might not be as slow as you hope.

I'm an ICU nurse who works in a clinic with a multiplace chamber. I dive all the critical emergent patients plus work in the attached wound care clinic. Techs do most of the diving with our out patients, but if staffing requires it I'll occasionally dive then as well. We have 2 scheduled dives per day and are sometimes close to capacity.

There are two to three RNs in wound care depending on the day including me. We're fairly busy and can see upwards of 50 wound patients a day.

Techs take dressings off and take vitals. RNs round with the physician and dress all wounds. We also chart on every wound we dress. Some patients have more than 10 wounds. Charting can take 2-3 hours a day after clinic hours end.

Some days I'm the only nurse present. My personal best is seeing 28 patients myself in 3 hours. I think I saw around 36 patients that day total.

Keep in mind that most of these patients suffer from one or usually more than one chronic illness that we have to continually address in our plans of care and efforts at patient education. We have to have a lot of patience with some folks who have to be told the same things over and over, like always take your anti hypertensives as prescribed. You'll be surprised how often this occurs.

Additionally I'm on call 24/7 and have been for more than 2 years. I've had a total of maybe 15 days off in those 2 years. I take call because I'm the only RN in the trauma hospital where I work who wants to dive. I also get call pay which I feel is worth it.

I've worked a full shift only to be called back a few hours later, dove critical patients all night, slept in the chamber for 2 hours and then started my shift again. It's happened a few times.

if you dive in a multiplayer chamber and you take intubated patients it can get pretty stressful. Managing an ICU patient while you're effectively in a submarine as much as 165 feet below the ocean means that even if there's a whole support team outside there's not much they can do to help you in an emergency. In my facility we keep our vent and meds inside with us, so we're running the whole show. The MD on the outside might as well just be giving phone orders.

Also, because I'm inside during the dive I'm at risk for the bends if we have to ascend in an emergency. We have plans in place to minimize the risk but it would be foolish of me to ignore the fact that the risk exists.

Theres also the ever present risk of a fire in the chamber which could be catastrophic.

It takes a certain amount of experience and self confidence (in my opinion) to be comfortable in those situations.

I do it because I love my job and enjoy the challenges it provides. But I don't do it for the nice relaxing pace.

If it sounds like something you want to do, then go for it.

Ruby Vee, BSN · Mar 22, 2014

Depending where you work the pace might not be as slow as you hope.
I'm an ICU nurse who works in a clinic with a multiplace chamber. I dive all the critical emergent patients plus work in the attached wound care clinic. Techs do most of the diving with our out patients, but if staffing requires it I'll occasionally dive then as well. We have 2 scheduled dives per day and are sometimes close to capacity.
There are two to three RNs in wound care depending on the day including me. We're fairly busy and can see upwards of 50 wound patients a day.
Techs take dressings off and take vitals. RNs round with the physician and dress all wounds. We also chart on every wound we dress. Some patients have more than 10 wounds. Charting can take 2-3 hours a day after clinic hours end.
Some days I'm the only nurse present. My personal best is seeing 28 patients myself in 3 hours. I think I saw around 36 patients that day total.
Keep in mind that most of these patients suffer from one or usually more than one chronic illness that we have to continually address in our plans of care and efforts at patient education. We have to have a lot of patience with some folks who have to be told the same things over and over, like always take your anti hypertensives as prescribed. You'll be surprised how often this occurs.
Additionally I'm on call 24/7 and have been for more than 2 years. I've had a total of maybe 15 days off in those 2 years. I take call because I'm the only RN in the trauma hospital where I work who wants to dive. I also get call pay which I feel is worth it.
I've worked a full shift only to be called back a few hours later, dove critical patients all night, slept in the chamber for 2 hours and then started my shift again. It's happened a few times.
if you dive in a multiplayer chamber and you take intubated patients it can get pretty stressful. Managing an ICU patient while you're effectively in a submarine as much as 165 feet below the ocean means that even if there's a whole support team outside there's not much they can do to help you in an emergency. In my facility we keep our vent and meds inside with us, so we're running the whole show. The MD on the outside might as well just be giving phone orders.
Also, because I'm inside during the dive I'm at risk for the bends if we have to ascend in an emergency. We have plans in place to minimize the risk but it would be foolish of me to ignore the fact that the risk exists.
Theres also the ever present risk of a fire in the chamber which could be catastrophic.
It takes a certain amount of experience and self confidence (in my opinion) to be comfortable in those situations.
I do it because I love my job and enjoy the challenges it provides. But I don't do it for the nice relaxing pace.
If it sounds like something you want to do, then go for it.

WOW! It's changed a lot in the years since DH dove, but when I think about it, it's been over 25 years, so I guess that makes sense.

CaliBoy760 · Mar 26, 2014

The reality is that most HBOT units are no longer multi-place. Today it's much more common to see between two and six monoplace chambers in any given clinic. And, while not nearly as labor intensive as an ICU or ED based multi-place chamber, things can get quite hectic if patients start stacking up on each other. As an RN, it's a good idea to have some Wound Care experience, because that's what your primary job will be in a HBOT/Wound Care clinic. Normally, it will be the techs that actually operate the chambers. There is a certification for nurses, though. It's called Certified Hyperbaric Registered Nurse (CHRN). Certification is through th National Board of Diving and Hyperbaric Medical Technology (NBDHMT). Another good resource is th Baromedical Nurse Association (BNA).

toomuchbaloney · Mar 31, 2014

I think I will stick to casual and recreational "diving" where I can enjoy the submersion and depth with fishes and crabs and turtles. LOL