Student Nurse Toronto 1973
Then there was the cardiac medical ward, where I came in contact with ‘supernurses‘… experienced professionals who obviously knew their stuff inside out! I swear more than once in my rotation on that ward I would pass a room and notice a nurse and a resident working on a patient who had arrested, without hearing all the bells and whistles on the PA announcing a ‘code’! My first time witnessing this impressed me like a scene from a movie: ….
the young attractive seasoned R.N. was straddled over a patient, giving him chest compressions with all her might, while a perhaps, (I cannot really remember) handsome young intern was bagging oxygen on the count of 2 to every 5 compressions ? (as it was in the day) into the patient’s airways …………. I was fascinated by the fact that her cap had fallen off her head, and somehow her long light brown hair had become loosened from hair clips and clasps with the physical effort of CPR, was flowing all over her shoulders – and needless to say over the patient too! of course the neophyte students (one or two of us) who were witnessing this surreal feat, were soon pushed out of the way as the crash cart team did come thundering through the corridor………….. Wow…….. cool I thought!! could I ever be like that??? Then there were about six ECG monitors at the nursing station that relayed the beats of the more seriously ill cardiac patients … amazing considering it was the early 70’s. These were monitored by nurses, who obviously knew how to read an ECG (me, never figured it out!!).
My main assignment on this rotation was to follow a newly admitted patient, Mr. Van Der Zam (Dutch roots). He had had rheumatic fever when he was a child. I learned that this condition could affect the mitral valve with scarring from the strep infection, causing it to become stiff and occluded through the years, most often unnoticed until the mitral valve stenosis diagnosis would be reached in adult years with the onset of heart arrhythmias and fatigue. I first had to do a ‘nursing history’ of Mr VDZ, finding out that he was 41 years old (God that seemed so old in those days) married with kids (?), well educated, moderate smoker and drinker and other than worsening periods of arrhythmia and a consequent cardiac consultation, he had no other health problems ………… and yes he did have rheumatic fever when he was 11 years old, nothing unusual along with all the other childhood diseases that everyone had in days of yore. [Rheumatic Fever is rare in the first world environment now].
I got to follow my patient, who was a really nice guy, to the cardiac catheterization lab, and observe the procedure which confirmed his mitral valve was moderately stenotic with scar tissue. I had to research thoroughly this condition and then ask my patient, after the cardiac surgeon had explained the necessary op that he would need, if he had any questions about the causative factor, -rheumatic fever, the sequelae of his cardiac disease- mitral valve stenosis… and the surgery that he was about to undergo – mitral valvotomy!! Awkward! – it felt that way, a student nurse trying to explain to a learned older man all about the heart problems he had …. the joys of being a student in a medical field…. I do hope it went okay … I have really no idea!!
So then I get to prep Mr. VDZ preoperatively. Preop prep was not too difficult to remember, but of course certain surgeries have specific elements related to body parts!!! I prepped my patient and then we got the call to go to the OR suite. So, along with a porter, I wheel my patient to the OR department into the waiting area hall where other scared, hopefully pre-operatively medicated souls are lying in their stretchers .. waiting their turn. I go through the important ID and chart information with the OR nurse, then I will get to go to the nurses’ change room and get into ……… what’s that you say?? ….SCRUBS!! Cool…………. but first a surgical resident is talking with Mr. VDZ, reassuring him, checking his hospital ID bracelet………. and then…………..”why hasn’t his chest been shaved”??? The resident is talking to me and not in a ‘reassuring’ tone any longer. Somehow, someway I had NOT SHAVED OFF HIS CHEST HAIR and he was having open heart surgery!!! To this day, I cannot recall how or why this had not been done, but it seemed to me and to everyone within ear shot that it was my fault!!! So one of the OR nurses hands me a disposable razor, swabs and a can of shave cream (I guess they are always prepared in the OR suite)! I apologize profusely to poor Mr. VDZ, who as far as I can recall is floating in a sea of euphoria from the demerol/atropine im pre-op I gave him, as ordered, an hour or so earlier. So in the waiting hall of the OR, with doctors, nurses, technicians, porters constantly passing by, I put the foam on my patient’s hairy chest and proceed to shave him with so much embarrassment, because, hell, this was a really stupid oversight, and everyone knew it.
You know, come to think of it, that would be the first, if not only time, I have shaved a man’s chest!! The deed done, Mr VDZ is wheeled into the OR, and I am directed to the change room.
So I am standing there scrubbed, paper over-shoed, masked and gowned, watching the surgeon cut into this man’s chest. Stupidly, my mind says: ‘are you going to faint now???’. No! no more embarrassing moments for me thank you very much. All I have to do is o.b.s.e.r.v.e!!! which I do and thankfully the surgery goes without a hitch. I next follow my patient into the patient recovery area and watch as he stabilizes and then I accompany him back to the ward and do post-op observations, add antibiotics to IV bags and give him im demerol for his pain…………. whew!! For some reason, I heard myself telling Mr. VDZ that he would be happy to know that his lungs both look nice and pink………. well, remember he was a smoker, and I did get a look at his lungs during the op…
Now I get to finish my assignment essay and p.r.e.s.e.n.t. the whole shabamm to my group……………. now that is worse than all I went through in the OR suite ………… Mr Van Der Zam soon was discharged with a cleared heart valve and I got a very decent mark…!