Open Heart Experiences

Clinicals this week were once in a life-time. I remember back to when I was just beginning the program. I was the typical Sophomore; a wise fool as Mr. Webster would define it. Wet behind the ears, I entered the wonderful world of nursing. Mocked for my enthusiasm, I jumped in with both feet. I soon learned that not only were we required to learn patient care and perform learned skills, but we were also assigned a number of O.R. observations. Just the thought made me all tingly inside!

My first O.R. experience proved to be less than eventful. Abdominal surgery has it perks, and although I have a uterus of my own, and was wholly enthalled to actaully see someone else's, once was enough for me. My second experience was not so much a lesson in medicine as it was a lesson in O.R. decorum. It quickly learned that most of the conversation circulating between the surgeon and his assistants was just plain vulgar. "What does oral sex have to do with a knee replacement sir?" I felt like asking. But since he had already scolded me about sterile fields I felt it best to keep my mouth shut.

Regardless of past experiences, it was this past week that was going to take the cake. Sunday, I was presented with the opportunity of a lifetime. Wanda, my faithful steed, transported me safely to Memorial Hospital in downtown Chattanooga on Sunday afternoon to pick up my clinical assignment for Monday morning. Posted in the SICU (surgical intensive care unit) were the assignments of choice and my name highlighted with a memo branching off the paper. "Call me before you pick a patient." I promptly beeped Kelly Hagan, my instructor, and waited for her reply. Startled by my cell phone and more than likely waking all the patients on the unit, I scrambled to answer her call. "Would you like to go see a CABG (coronary artery bypass graft) tomorrow?" (As nurses we just call this a cabbage for the obvious reasons.) Flabbergastered I followed Kelly's instructions and found the paperwork she had set aside for me. Since Fundamentals of Nursing I had dreamed of this moment. Open heart! The opportunity of a lifetime.

That night I could hardly contain myself. Sleep was hard to come by, but somehow I made myself slip into unconsciousness and before I knew it the alarm went off. 4:30 AM. Dragging myself out of bed I slipped on my gay apparel. You must understand why I call it this. We have to wear all white, all the time. I have even been rudely called the virgin Southern nursing student because of such attire. Anyway, I digress. I arrived at the hospital at 6:00 AM. Immediately we paged the O.R. and they said they were ready for me. I scrubbed in and was given the usual O.R. head gear and face mask. All set! Now it was time to meet the patient. This is where I can't say much, you know, HIPPA and all, but I met them none the less and followed them here and there. First a swan-ganz cathether was put in and an A-line. If you want to know about these things call me later! In a nut shell the swan-ganz is is something that is threaded into the heart to measure blood pressure and cardiac output. We'll leave it at that. Then the doctor came to see the patient and told us that we would be ready in about an hour. It was the longest hour of my life.

Rolling at 8:00 AM. The patient was wheeled into the O.R. and the prep was to begin. Here is where I experienced some difficulty. They wanted to know my name for medical records. Of course reading is not a prerequisite to be in the medical field, for I was clearly wearing a name tag, but nevertheless they asked me to write my full name on a white board across the room. Proceeding to do so I was questioned by the nurse if I touched a sterile field along the crowded path to the white board. I was tempted to say, "Lady, despite your apparant inability to learn to read, I did. I also learned my colors, and I know that blue indicates a sterile field!" But I bit down hard on my tongue and smiled politely replying, "No." This woman then proceeded to take me by the shoulders and physically walked me across the room and stuffed me in a corner. I had a few choice words for her, but again, kept them to myself. 2 months shy of graduating and they still manage to treat you like a complete imbicile!

The developing conversation did not surprise me either as the physicians filed into the O.R. All I caught was something about "boobs" and suddenly became grateful for the face mask to cover my blushing and even for the fact that I was stuffed in the corner. After 1 hour of prep they opened the patient's leg to harvest the saphenous vein which would become the new coronary bypass grafts. This done laproscopically was interesting despite the fact that it was a lap procedure. Finally it was out and the cardiologist came in. I was placed at the head of the patient and given yet more face gear. Sporting some vascular googles I was told the importance of having then on. Vascular surgery = blood spattering and such!

The surgeon opened the patient's chest and sawed (yes sawed!) through the sterum to get to the heart. I could see the pink lungs moving up and down in synch with the ventilator. Rib spreader. Scalpel. Incision. The pericardium was opened (this is the sac that surrounds the heart). Retractors. And there is was. Glistening in the overhead lights. Beating. My heart stopped. For the next hour the patient was transferred to a bypass machine and the grafts were meticulously sutured into place. Ice was placed on the heart to prevent ischemia (tissue death), and the surgeons performed what I really consider a miracle. 5 bypasses later, I left the O.R. in a daze. I'd forgotten about the conversations and my treatment. For the rest of the day I walked around in an amazed stupor.

Normally I am known for my big mouth. In fact, there is a girl that I work with in the SAU cafeteria, Kamara, who calls me big mouth. I usually have a lot to say. Yet this is one of those occasions where I am left totally speakless. So to close this, my first blog, I leave you with these words, not from myself, but from the great Psalmist himself: "I will praise You, for I am fearfully and wonderfully made." Psalms 139:14