The Cycle Of Life; In One Hour Of An ER Shift

One takes his first breaths just as another takes their last.

One family is all smiles, joy and delight; celebrating a new life born. Another's spirits are broken from the sudden loss of a life.

I imagined work in an ER as a place floating with the endorphins and adrenalin, running around trying to keep hearts beating in the barely living and to bring the hearts of the unborn into the living world.  I didn't imagine it all happening on my first day off orientation, in the first hour, as a ripe novice ER nurse.

I was working the 11 am to 11 pm shift that day. After a quick workout and a jumbo coffee, as most people are counting the minutes till their lunch break, my heart twitters nervously for my first day off orientation in the ER.  The cord snipped, and I am free bird in the wildlife of the forever, chaotic ER. With no expert ER nurse to hold my hand, I take hold of the reigns, ready to face the constant turbulence of my workplace.

I barely find a spot to hide my coffee, when a stretcher pulls in with an exhausted  mom, a tired and worried dad, and a slightly shocked aunt. In comes a newly birthed baby who had taken his very first breaths inside the musty, back seat of a New York City yellow, taxi cab. The newborn, 8 lb 4 oz., still covered in afterbirth announces his presence into the world and in the ER with his piercing shrills. The cord is barely disconnected as I assume care for a double patient load; mother and baby. Luckily it was only a few months prior that I had been delivering babies under candlelight in Africa, so cleaning off the mom and baby in an ER that has lights and electricity is just a menial task to overcome at this moment.

I am just getting the new mom and baby set to go up to the mother and baby unit, when in rides an EMS group pumping a patient's heart. "Pulseless Activity", sent to team 2, my team, assigned to the little nurse with curly hair and glasses.

My team immediately jumps into action, we put in lines, push meds, take turns performing chest compressions, and we hang some fluids. I am still fumbling to find all the supplies; I find them all with some help from my peers.

The patient is a Jane Doe, so one nurse plays detective with her purse, finds a name and calls her family.

Amidst the chaos in the room, I notice her pale  feet with their perfectly pedicured toes, and elegantly manicured nails. Remnants of her make up are still on, painting the being laying out in front of us, as we attempt to pump life inside of her,  with an image of the life that once resided in its now almost lifeless form. The room is crowded, and each person with a task. The attending leads the code, yelling out orders, and we keep going at it; more compressions, more meds... still no pulse. At some point, a resident uses an ultrasound. Free fluid on the left side, and a chest tube is set up and is ready to be placed. The skin is quickly cleaned and the scalpel slits a small vertical line into her skin. The body, turns into hose of blood, spraying liters out of her body. We call the blood bank, and we get some blood, we squeeze the O negative blood into her veins. It is like we are fighting the tipping scale to level the volume of blood lost with the volume we are pushing in.

Her family comes, tears dripping into the already slippery puddles of red. We tell her to talk to her mother, to tell her she loves her. We suspect/know it's the end, but for her, in the mind of a daughter to a mother, there is hope as long as we are working on her. We hug her and tell her we are doing all we can. We squeeze some more blood, as the compressions are paused again, and the pulse is still not palpable. The cardiothoracic team, comes in, they open up her chest; the room gets sprinkled with a bit more shades of red. They think it is a ruptured aorta, they think we did all we can, and we hope that we did. The attending calls it; time of death, 1225. We cover her, and we give her family some time to process their loss.

The room’s equipment is splattered with blood. The liters of lost blood created islands of maroon, bloody puddles across the floor. Garbage, wrappers and tubes scattered all over the room. In the center of the room, a newly lifeless, pale body is lying in a peaceful permanent sleep, oblivious to the loss she is to the loved ones at her side.

The day continues, I still have 10.5 hours left of my first shift as a lone soldier, fighting the wars of the ill in a bustling New York City emergency room. Two more patients come in; one is septic, my Adrenalin increases, my heart rate rises,  I gulp some caffeine, I put in lines, collect some lab work and continue my day.

And so it was; within in the first hour as a newly born ER nurse, I watched one life come into the world and another depart. The two diametrically opposed aspects of my career; to bring life into a new being born and to care for a life leaving the world of the living.

All in a day's work.

#ProjectERNurseD

From Subways to Cycling; A Nurse Crosses Bridges To Work

Outside big cities, commuter options are limited, simple and mostly odor free. Unless you are walking distance from your area of work, commuters will drive to work. They may take different highways, listen to different music stations, and experience varying intensities of road rage and traffic issues; but they are similar in that they are all shielded from odors, train delays and non ventilated, rat infested train stations.

Living in NYC, and commuting daily across the bridge that connects Brooklyn to Manhattan, to the land of traffic and overpriced parking garages; I along with many others take the train to work. For some of us, such as myself, it takes 3 trains plus a walk to reach my workplace. Over the past few years, I grew accustomed to the stenches, the heat in the summer, the cold in the winter, the train arguments, and delays. It all became part of the New York City living experience and I just accepted it with my NYC pride.

Commute time for many New Yorkers, are hours counted in their regular work day.  For me, my train rides extended my sleep cycle. My 5am wake up, jump into clothing, then quick dash for my lunch bag, and a flustered run to catch the 5:27 train, are all a mere interruption of my nighttime sleep cycle. Once I have my seat, often in the same train car, next to the same people, I rest by bag, don my hood and drift right back into my train sleep. My own version of the sleep cycle. I relied on those precious bits of train REM, that was distinctive by virtue of real life dreams consisting of the various train stops and the closing car door messages. Occasionally my sleep is interrupted by an unwelcome jostle or by loud preaching with verses of a bible I do not follow. In my deepest train REM, I have never missed my stop where I change my train across the platform. Even on my connecting train I often see the same people, and often they too are snoozing and dreaming in the same NYC train dreams as I. When the odors of the train station are slightly more bearable, and the weather does not turn on a faucet of sweat on my skin, I even manage a quick power nap in a standing position until the local train jostles me out of my stupor and props my eyes open for the new day.

On the way back from work, my body, winded by 12 hours laboring as bedside nurse, it itches for a seat to rest my overworked legs.  I occasionally take a light nap, read a book/ or textbook, and even attempt at blog writing about an interesting event from my work day.  Occasionally I am granted some train entertainment; whether singing, dancing, poetry, and the many other talents so gracefully shared by the diverse populations who frequent the New York City subways cars in their attempts to eat food, share wisdom, or as means of shelter from extremes in weather.

While chilling on a train seat has become my host for my commuter naps, exercise has always been an important part of my schedule, whether on workdays or days off. I truly see it as treatment for my mind body and spirit. Now that my work life has migrated into the night world, I was seeking a means of enjoying a few extra hours of vitamin D, since many daytime hours will be spent hiding behind blackout shades and attempting catch rest in a short daytime coma. I figured that I can either spend my commute time napping on the 4 train and attempting to achieve some daytime REM to fulfill my body's sleep requirements,or I can cath sun and a workout in one go; and so I chose to live life and seek out some sun each day as I bike ride to work. Now instead of rushing to the train to make my spin class, my bike skips the train and spins me to work. This saves me commuting time, and get me to work whilst exercising and enjoying New York City views; a triple win. Gone are the train naps and subway entertainment, and on are strong calves and a vitamin D enriched #NurseD.

I have only been biking a number of times and I only slightly miss my train experiences, which i will be saving for days that the weather is not so bike-ride accommodating. I can now add #cyclist nurse to my forever lengthening hashtag; #AuntyRunnerCyclistNurse with curly hair and big glasses, Holler, if you see that green clad description on a blue bike and neon helmet, racing the yellow cabs across the bridge on her way to work, bracing her self with physical strength to save some lives!