I’m writing to you after my second day of clinical in the ICU. Right now I’m high. High off my body’s catecholamines: the fight-or-flight system, the hormones in our body that, when activated by certain events, prepare us for action. Heart races, blood vessels constrict shunting blood to vital organs, blood pressure increases, the heart pumps as much blood to the body as possible: our body is in survival mode. You know the feeling… a near miss auto accident, a noise in the night, even a scary movie. You feel you heart bounding in your chest, all of your senses are heightened, tunnel vision focuses on the matter at hand. Your body has a physical reaction, even though nothing physically stimulates it.
I had a few minutes of down time this afternoon, and since I’m totally enamored with the ICU, I told my nurse I was going to the other ICU wing down the hall to see if anything was going on that I could learn from. I got there, not much was happening. I said hi to a classmate, then noticed a little bit of tension in one of the rooms. I hustled over. Within five minutes, a code was called and I found myself performing chest compressions on a man with no pulse. 2 minutes of compressions seems like an hour. You’re sweating, tired, but could actually go on for an hour thanks to those catecholamines. Soon there were 20 people in the room and outside, and I found myself in the middle, because that’s where I wanted to be. Throughout compressions the leader was calling out meds to be given… calcium, bicarb, epi, atropine, amiodarone.
-“Stop compressions, check for pulse.”
-“I have a femoral!” EKG is stable, but then he goes into V-tach… a shockable rhythm.
-“Charge the defib….CLEAR!” Silence. Shock.
Stat blood test have come back by this time and the nurse is yelling out pH, O2, CO2, BiCarb, K, Ca, Na and Cl levels among others… respiratory acidosis, I think to myself as I’m taking a break from compressions, they need to blow off his CO2… Then the lead call out:
“Hyperventilate him, let’s get some albuterol, continue compressions!” Whoa….I was right!?
After 35 minutes the man had a pulse. He was by no means out of the woods, and I don’t know how he fared the rest of the afternoon. I tried to be one of the last to leave, soak up every ounce of the experience as I can. The leadership, teamwork, and organization were incredible.
Regis teaches us to always have a pair of gloves in our pocket. Silly I used to think. But I found myself gloved and ready to work while others were fumbling around trying to prepare. It’s important in situation like this to mindful. If you’re not doing anything, get out of the way. I didn’t want to leave, so I made myself a part of the team. A very small part, but enough to justify taking up space!
I went back to my side of the hospital. Talking to my nurse, I tell her what she already knows… only as a nurse can you be in the midst of chaos, doing chest compressions, standing on the fence between life and death…and the next minute be changing a pillow case, trying to make a sedated patient more comfortable. This is the right career for me.