“Burr, its cold out” I whisper to myself as I leave my house for work. I crank the heat in my car as I head off into the darkness…not a soul around, because everyone else is still asleep. I’m due in to the hospital at 5:00 am.
As I enter the Emergency Department I almost collide with my night shift ER nurse, who looks like she can’t find a bed soon enough! “Here are last night’s reports,” she says as she hands me a stack of documents depicting everything from a broken arm to a rash that wouldn’t stop itching. “It must have been a full moon.”
I flip through the stacks as I enter each patient’s room, introduce myself and assess their condition. “How are you feeling, can I get you anything?”
Once I am certain that everyone currently admitted is stable and on the path to recovery, I check all of our other rooms to make certain everything is clean, stocked, and all life-saving supplies are ready for ANYTHING that may come our way today.
“Team, I’m going to make some coffee, I have a feeling this is going to be a long day!” I announce as I finally head to my office to check on the rest of my workload for the day.
Just as I sit down and log in to my workstation I hear it, the page that tells me it’s go time. I’m out the door in an instant and see a man, approximately 50 years old staggering towards me. His skin is gray and he is sweating profusely.
“It’s just some heart burn that’s kept me up all night,” he mumbles.
“You’d better let them decide that honey…” assures his wife.
“Let’s hope that’s all it is but we’re going to check everything to make sure,” I assure him. “You’re in the right place. We will take good care of you.”
In the back of my mind I know that this is worse than just heartburn but I must first rule out the worst possible causes for his symptoms.
“Sir, I’m going to check your heart rhythms and start an IV for you. Jenny here is going to draw some blood,” I say to him as I swab his chest and work feverishly to attach the electrodes for his 12 lead EKG. “Do you have any known drug allergies?”
Meanwhile, another emergency room RN is rapidly admitting our patient into the Electronic Health Record; which can be a wealth of information and simultaneously a maddening obstacle in providing rapid care.
Within five minutes we have given the patient aspirin, started the IV, drawn blood, performed the EKG and registered him into our system. All we can hope for at this point is that he has arrived soon enough to save his life.
“Doctor, our patient is showing signs of a STEMI (ST-elevation myocardial infarction – aka a bad heart attack),” I say to our ER MD as he enters the room. “I will get on the phone to arrange transport right away.”
“Sir, we need to get you transported to a cardiac catheter lab right away. The sooner we get you there the greater chance you have of a full recovery,” I explain to him and his wife as I work to control his pain, blood pressure and heart rate all at once.
As the emergency room MD calls the cardiologist I think about all of these moving pieces taking place at once and how nervous this patient and his wife must be. I have done my best to explain to them the severity of the situation while trying to remain calm enough not to scare them even more.
Once the ambulance arrives, we quickly give our reports to the EMTs and the patient is rushed to a cardiac catheter unit. With everything moving smoothly, he is in our department less than 30 minutes because this circumstance was a stable STEMI.
“We’ve done a good job this morning,” I say to my team. “I realize that this type of patient tests our teamwork and communication skills, and I appreciate when you can all try to put yourselves in our patient’s shoes.”
As I pour out my cold coffee I check the clock…It’s only 6:00 A.M.!
Amazing amounts of skill and team work went into that brief 30 minutes. The ability to balance the art of caring with the science of medicine is at the very core of an emergency room nurse. To comfort and lessen anxiety for our patient and their family is always on our minds.
Later in the day we receive a fax including pictures of our patient’s heart and the arteries that are no longer blocked. I breathe a sigh of relief and immediately high five the rest of the team on a job well done. It’s good to actually see the tangible difference we helped make in this patient’s heart…LIFE!
Terri Slapak-Fugate, RN
Director of Emergency Department/Urgent Care
SANE Program Manager
Direct (608) 342-4730
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