At 4 AM yesterday, I went off to babysit a child who was about to become a big brother. At 7 AM, his father sent me pictures of the latest addition to our population. Although the delivery itself had some complications requiring a C-section, the outcome was a healthy baby boy. My charge and I spent the rest of the day looking at pictures of his new sibling and celebrating the day of his birth.
At 6 PM the same day, I headed to the ED to start another 8 hour shift. Not even thirty minutes into the shift, we had two full arrests come in by paramedics. The physician whom I was scribing for took the 97 year old who was in respiratory distress. The other ER physician took the 4 year old pediatric cardiac arrest. As far as I know, our 97 year old is still thriving, albeit in critical condition in the ICU. The 4 year old, who was running in the park just an hour before, was pronounced dead shortly after her arrival. There are a lot of terrible sounds in the world. But the sound of a mother screaming out her daughter’s name is bone-chilling. It is a wonder how anyone – physician, nurse, respiratory technician, EMT – can continue on with their jobs after losing such a battle.
January 29th marks a witnessed birth and death. Life works in strange ways, doesn’t it?
Yesterday, during a scribe shift, I encountered two critical patients. There were so critically ill that my doctor stopped seeing new patients halfway through his shift so that he could move back and forth between the two and try to keep them from worsening.
Now for one of the patients, this doctor decided to place a central line in the femoral area. He invited me to come watch, but what seemed like a simple procedure turned into an Easter Egg Hunt. He pricked the patient numerous times in her left leg, in search for her femoral vein, but instead, nicking the femoral artery a few times. He then tried the subclavian, but once again, nicked the artery in his search for the vein. He tried the internal jugular vein once before deciding to put an end to his efforts. Now I understand that this isn’t an easy procedure, so I don’t believe the physician lacked any skill or knowledge for not being able to successfully place a central line. But as he continued to dig that needle in the patient, over and over, my eyes couldn’t help but drift to her face and empathize with the amount of fear and pain she was probably feeling. I wanted to hold her hand, comfort her – or at the very least, get the physician to snap out of his search so that he can acknowledge that there was an actual person attached to those veins and arteries.
Imagine my relief when the nurse, who was juggling both critical patients (as well as a few other patients), came in and began comforting the patient, requesting that he give doses of Ativan to ease the patient’s mind. Nurses are really the patient advocates, especially in an ER setting.
One profession is not subordinate to another – rather, the field of nursing vs doctoring are a dichotomy. Two completely different fields. And yet, nurses simply do not get the credit they deserve. A patient will wake up, and if saved from a life-threatening circumstance, will thank the doctor profusely. But he or she will not remember the nurse who spent hours ensuring that he or she were comfortable and well-cared for during his or her stay. We mustn’t forget, nurses are the heart of the ER.