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