THEN HE SAWED OPEN HIS CHEST!

I was in the surgery changing room digging through a rack of scrubs to find my size. Nervous and excited I quickly changed and met the RN who would escort me to operating room 18. It was my day in the OR. I had wondered all night how it would go. What surgery would I be watching? Who would be the surgeon? Was he going to ask me questions I didn't have an answer to, leaving me feeling inadequate? What if the worst happened...I'd see the blood and guts, get dizzy , throw up and pass out. They would probably just drag me outside the room and carry on. And I would be the inspiration of all their jokes for the next few months, blushing every time I saw them in the halls.
"Oh, I'll put you in the OR with Dr.P, he's doing a coronary bypass , you'll love him." I was listening to the nurse while trying to put on my surgical mask like I had done it a thousand times. The OR room was bright and clean. Several sterilized staff members were busy filling basins, opening sterile instrument trays and dropping sutures onto their work fields. They were very kind and explained that the Physicians Assistant was harvesting the vein and I could stand by and watch. But if I broke their sterile field they would have to kill me and if I felt flush or dizzy to "back up to the wall and sit down". I took it all in as I watched him by video digging through yellow fat and tissue, finding just the right place to remove this vein. Once the vein was out, it was way smaller than I had imagined in my head. Smaller than the diameter of a pencil, pink, and rubbery. Glad I made it through that part, not so bad. The surgeon was paged and we began.

Anesthesia let me stand on a stool at the head of the bed, overlooking this 200+ pound white man with a freshly shaved chest. As the surgeon grabbed the scalpel and cut strait down the center of his chest I could feel my heart pounding. That part wasn't bad at all, then he asked for "the saw". I tried to mentally prepare myself for what I was about to witness but that's really hard when you've never seen a human body sawed open before. How else are they supposed to get through the sternum? I guess I hadn't ever really thought about it. Next he sawed through the sternum and applied a sort of crank to hold open the chest. I detached from the reality of it,and it became strictly medical.
Now this chest was open and there it was, A BEATING HUMAN HEART. Right in front of my eyes! I couldn't believe what I was watching. It was truly amazing! In order to quiet the heart down to a "quivering" organ they could work on...they poured a bucket of ice over it, they also hooked him up to the bypass machine and then began looking for bypass sites. I watched in awe. Inspired by the fact that this kind of thing is possible, I contemplated if I was capable of becoming a surgeon. Then the thought of 10+ more years of school flashed across my brain and my surgical aspirations quickly disappeared.
Magnifying goggles were required to utilize sutures so small that I could barely see them. Once it was all over , the two sides of the sternum were wired back together. It took a ton of strength to jam a needle through the bone on both sides,and run wire through to tie it up tight.4 chest tubes were placed, 1 on either side of the heart and 1 by each lung, and some pacing wires were attatched to the heart and threaded through the front of his chest. Now, it was basically over.

I made it without embarrassing myself! I wanted so bad to take a photo with my phone of my view, looking over the drape at an open chest, a beating human heart and the surgeon performing a potentially life saving procedure.

My life was changed by my experience that day in the OR. I love my role as caretaker of these people even more and can truly understand why they hurt so bad afterwards. Lesson learned: eat your veggies and exercise so you wont have to get your chest sawed open, and that is one lesson I'm saving for my kids. - THE ROOKIE

The Power of a Little Man

I became an Aunt for the first time this year. I am in my mid twenties and it's a great time to practice my baby skills and prepare for the great challenge that lies ahead. On my first day of babysitting I was ready to handle it all . My first poopy diaper...I put him in the crib on his changing cloth and began to wipe away. As I was wiping he started to go some more, and more and more and more. I was wiping as fast as he was going. I thought it would stop but apparently he wasn't finished. I used up a whole box of wipes and then got hosed when he decided to pee and I didn't have his little man covered up. Wow what a job!

So then day two of babysitting comes along. This time I had learned to let him finish. He's a man and men need time to do their thing. Why didn't I know this?
I grew up with an older brother in a house with one bathroom. I spent hours banging on the door, pleading with him that I HAD to shower and he could finish his novel somewhere else. That is why I let little "Caleb" go and go and go.

I set him in his swing and left him alone. When I was sure he was done we went into the baby room. As I removed his little pants I saw it! His little stink bomb had been squished all up his side, out of his onesey and up his back. Great! I stripped him down and started wiping. It was everywhere! The crib sheet, my hands, his arms, back, legs, clothes! The whole time I'm thinking "I need gloves. Where are the gloves? This cant be sanitary. He's going to get Ecoli, I'm going to get Ecoli! No sink, no cavi-wipes no gloves, this is bad." His mom is going to kill me when she gets home and finds some little spot I've missed on his neck or something. I zip lock bagged everything and gave the boy a bath! When my sister-in- law asked how he was, I gave her the full report. She laughed and said " he's been working on that one all day".

The next day I pondered my experience as I cleaned up an explosion from a man I had just given an enema to. I thought, how can I come in here and clean up adult butts everyday with out a problem. Give laxatives, deal with antibiotic induced diarrhea, enemas and fecal management systems and this tiny 3 month old and his bottom the size of my hand can drop a bomb I can barely handle? I leave the nursery a defeated soldier. And yet I conquer the bowel mountain at work everyday.

The great lesson I've learned is this: My nursery will be stainless steel, equipped with sanitary wipes, gloves, towels, sink and a decontamination shower........

The Rookie

We're not God...thank God

Nursing reminds me who I am, who I'm not, and what is better left in God's hands.

Level I Medical has arrived. EMS is coding a pencil thin, naked old man who is covered in dried feces and hypothermic. It took a while for the police to locate his 75 yr old brother. His brother walked into the room, confirmed the mans identity, then walked out shaking his head. I stepped out in the hall to talk with him. According to the brother "He used to be a drinker but his last wife had the rope on him. Made him go to church, fed him good and drove him everywhere. Didn't leave him alone for a minute. She died 11 yrs ago and the family really hasn't seen him since". The EMS run sheet said the patient lived in a one room cabin in the woods. The grounds keeper found him outside the cabin on the ground. He was unresponsive, covered in urine and s____. The groundskeeper figured him for dead. EMS arrives on scene and damn..he had a heart rate of 175. So the fun begins... Intubated and vented, 7 bags of fluids over 2 hours, still ZERO urine output from foley. The ER Doc says to us "That's the highest Na, K and Cr and the lowest Ph I've ever seen". The hot-line"s running saline at top speed, bear hugger in play going strong but I still didn't see a core temp above 92. His racing heart wins him a bed in ICU. I wanted to just hurry and get him up there knowing it was just a waiting game now and he could continue his passing over up there. I had work to do.

But wait, the Doc says "on the way to ICU take him to radiology so we can put a dialysis catheter in him". I guess we will run his kidney through the cleaner and make him better? I start thinking "There is just no dignity for this guy. He's going to wake up covered in s___ in the ICU with 1/2 a brain and lots of debt". There are moments in nursing when the most I can do is return a little dignity. The other nurse and I are literally washing his feet when I start saying "Why are we doing all this. for what reason? CT showed his brain is now the size of a walnut, he's on his way out for God's sake! Why do we get in the way of people dying just to keep them here in their messy lives"? The other nurse speaks up and reminds me "We don't get to choose. He has a heart rate, he gets it all". OK, I'll work on that. The next day I came in curious to look him up on the computer and see what happened. "I'll be damned" I said as I read the ICU nurses charting.

He woke up, started pulling tubes, seizured and by morning all his lab values were normal and he was taking oral fluids and following simple directions. Granted he won't be functioning independently for a while but I remind myself that this had more to do with God's plan than any of us. Maybe now he'll be able to reconnect with his family and leave this earth in a more dignified, loving way. Maybe holding his brother's hand..... I learn again.

GRAB THE CODE CART!!!!

I work on a post cardiovascular and thoracic step down unit so I had to get my Advanced Cardiac Life Support certification 6 months after beginning work. The class was amazing. We were in a university simulation lab running codes on computerized dummies. The instructors sat outside the room and control them, made them stop breathing,go into change rhythms and even talk to us. We ran code scenarios until we were blue in the face. I felt sooooo much better about the whole thing when I left. I was pumped. Up until then I was really scared that someone would code and I would not handle it well because I really didn't have a clear picture of what to do. I had pumped chests and bagged people while working as a tech in an emergency department but never functioned as the nurse. The next week after my class I told my managers how much I enjoyed it and how great I felt. Shortly after that the monitor room called me and said "go look at room....... He just had 4 beats of V-Tach" as I rounded the corner I glanced at the monitor and saw sustained V-Tach. My charge nurse was right there and I yelled " grab the code cart" . Mean while I'm thinking " this is it.. okay, V-Tach, think, think,, check a pulse.." and BAM.. 5 of us go bursting into his room, blazing glory, code cart and all. The man's eyes were as big as baseballs , sitting there asymptomatic as could be, watching t.v. looking at us like " what the hell?". We asked him if he felt okay, he said yes, we told him we had to check his vital signs and hook him up to the monitor. As we are doing all this he starts asking what is happening,gets really scared, and starts to cry. We look at the monitor and its reading sinus rhythm. " Sir I say, your heart looked like it was having some irregular beats which can be dangerous and we had to hook you up for your safety, it looks like everything is okay but I'm going to review your rhythm strips and see what happened. Turned out to be really wierd artifact that from a distance on the monitor looked like V-Tach. My manager looked at me and said "I know you liked the ACLS class, but don't be bringing it back with you." We all laughed. Finally my patient laughed. I told him " well at least you know if something did go wrong we would be all over it!" Glad it was a false alarm.......that time....
-THE ROOKIE

JUST THE BEGINNING.....

Nine months into this gig and I am just beginning to come to work without butterflies in my stomach, although they do come and go as they day passes by. The first 6 months were hard to say the least. I rethought my decision to choose such a demanding and challenging career many times. I thought I may not be cut out for this and I definitely thought nursing school was hard, but nothing like the real thing. NURSING.... what was a dream of mine for so long had now become my life. It was real now, the long hours, the heartfelt moments, the fear,the joy and the satisfaction of going home at night knowing I made a difference. I can say I came into this green, scared and questioning myself. I pushed on , learned my stuff , became part of this amazing team and I have been earning my "battle scars" ever since. TO ALL THE NURSES OUT THERE, WE ARE A TEAM, WE ARE AMAZING AND WE ARE MAKING LIVES BETTER EVERY SINGLE DAY....... JOIN WITH ME ON MY JOURNEY..... ITS ONLY JUST BEGUN....
-THE ROOKIE

33 Years, Still Going Strong

Little did I know 33 years ago that I would now proudly refer to my nursing career as "Life in the Trenches" It's not for the weak of stomach, heart, or spiritually maladjusted. Well, you may enter spiritually maladjusted but dealing with the tragedy, humor, miracles, frustrations and stupidity of humans will change all that. The names and places are forgotten. The stories stay with me.

Like the very prim and proper, perfectly coiffed middle aged mother who anxiously answered the "why did you come in" question with this: When my college age daughters came home for Thanksgiving I was absolutely appalled at dinner when I realized they had both pierced their nose. I was furious. They looked like...I can't even go there. Today i was walking through the mall and I saw these things for sale. It's a small magnet that you put on the inside of a nare then a diamond looking stone that you put on the outside out here (she's got her finger in her nose demonstrating). I was going to wear it to Christmas dinner just to show them how ridiculous they looked. It tickled and I sniffed in. I think the magnet is in my lungs". .

I'm not sure how the billing department coded this one, or what her final out-of-pocket cost was. But an ER room charge, MD evaluation and chin to pelvis x-rays can't be cheap. The end result was she was OK and would just poop the magnet. During discharge I said "You must tell this story to your girls". She threw her nose up in the air and indignantly proclaimed "I WILL NOT!" I hope she changed her mind as her ruffled feathers settled. It would make for a great family story at Christmas dinner.