I could hear the tremble in the paramedic’s voice as he called in report to the ER medical command phone line. It was late February, we were in the middle of an ice storm, and he had a resuscitated code. As the emergency department charge nurse, I mobilized the troops, including ED and ICU physicians and we were ready when the medic arrived with our new patient. I can remember so many details from that night – I can see my hands untangling a mass of wires attached to the patient, I can feel the buttons beneath my fingers as I set her up on the vent, and I can still see the look on the face of her medical-phobic husband, Larry. He was alone here and would have preferred the distance of the waiting room, but I needed him near us in case anyone had questions. I posted him in a chair right outside of the room where we could keep an eye on him too. The memories are so vivid from that case – charting on the pale lavender T-sheet, pulling her IO before I put the hypothermia pads on her, and checking her pupils. In my mind’s eye I can see the moment when she started posturing, and the detour we took to CT, so we could scan her head on our way to the cardiac catheterization lab. Of all the details I remember from that night, there is one missing piece: I cannot recall her face.
Our trip to the cardiac catheterization lab was the typical trip – numerous pieces of equipment all hooked to one slight-framed human, barely recognizable under all of it, with staff surrounding the moving island of the stretcher, squeezing the ambu-bag, keeping the lines protected as we turned corners, and arriving to the waiting cath lab staff. All the while, Larry trailed behind us, and I let him know that it was safe to lean over and kiss her forehead, one of the few places where her skin was still exposed. Depositing him in the waiting area – so alone – felt like a betrayal, but I had to take his beloved wife into the lab and give report. Familiar faces greeted me in the cath lab, and I discussed with the receiving nurse Jill, how I was concerned for the patient’s neurological outcomes, and how we left the cooling mechanisms
Walking out of that cath lab, my stretcher topped only with equipment, we approached the Heart Center waiting room where I left Larry. I couldn’t just leave him there, all alone! I sat with him while we arranged for someone to join him, and the nursing supervisor came and stayed with him, so I could return to our busy emergency department. As I departed, I remember Larry hugging me quickly and whispering, “Thank you for staying.”
That shift progressed toward its end, like all shifts do, and I heard some updates about our patient. Life in the emergency department means that you move to the next thing when needed, and rarely do you find out how cases finish, how the story ends, and the final outcomes. I put this patient from my mind on my drive home, wishing her well, but knowing that I was unlikely to find out how the story ended.
Fast forward a few days, I picked up a shift in my other role, on the IV Team, and I did a PICC dressing check in ICU10. It was an unremarkable stop, where I spent time with a pleasant but confused lady who was perseverating about finding the book that she brought to the hospital. She was sure someone had stolen it and wanted help finding her book. I told her I would keep an eye out and I packed up my things and walked out of the ICU. There was something familiar about her, but I couldn’t put my finger on it – until I passed Larry – sitting in the glass-walled waiting room. He jumped up to hug me and I had my “A-HA” moment. I had just been in his wife’s room and she was alert, awake, and doing well. I asked Larry if I could inform the ED staff from that night how she was doing, and of course he agreed. Knowing that she was awake and expected to make a full recovery, was more closure than I usually get with my ED patients, but our story was not yet complete!
In March of that year I was invited to collaborate on a case presentation about Sue. It was an honor to present information about her care in our ED, the therapeutic hypothermia protocol, and the chain of survival. I only saw Sue briefly that night, as there were so many people eager to meet her and engage in conversation, and I knew it would be an overwhelming night for her in many ways. Instead, I made sure that Larry knew I was there, and that I would always remember them.
In May, my whole family attended the annual EMS awards banquet where my paramedic husband would be receiving county-wide recognition for clinical saves. We went every year and this year was no exception, with our daughters all dressed up and family in attendance. It was no different until
I saw Larry. He was being recognized for his citizen-save, for the CPR he performed on his own wife. While I was talking to Larry, and introducing him to my own family, Sue Davis walked over and introduced herself to me. We were very emotional as we told her the story of that night in the ED and trip to the cath lab, of me sitting with Larry, and of how much effort so many people had poured into the case to protect her and save her life. My six-year-old daughter was astonished to realize that it wasn’t just Daddy
who saved lives every day.
I heard the pre-hospital story of Sue and Larry
that night, and the amazing things that happened to them. How the ice storm had knocked out power, and Larry had used a cell phone to call 911. In the dark of the house, when Sue collapsed, how he had performed CPR on his beloved wife, then had to decide to stop and run outside when he heard the sirens get close enough. He used a flashlight – waved it in the air – to show them where to go, because they couldn’t read the house numbers with all the power knocked out. I got to hear how the paramedic (Matt E.) worked with a flashlight in his mouth to put in her IV, and intubate her, while running her code. I was so glad that I got to hear from the first-hand participants about this case and felt that a bond between our families had somehow started that night.
No surprise then when in June, watching the tracking board from my ED nurse charge desk, I saw her name pop up and I went immediately out to the waiting room to find her. She was pale, diaphoretic and hugged me as I directed her into a wheel chair. Back in a room, we seated Larry outside the curtain as he was still uneasy with all things medical. Inside the room, I worked quickly to get her situated on the monitor, started an IV, and grabbed a 12-lead EKG, as a colleague called my ED physician into the room. Dr. Clark opened the curtain, pulled Larry into the room and said, “Hey Jess, look at his shirt! He’s wearing Star Island gear!” Star Island is a tiny Unitarian retreat island off the coast of New Hampshire, near where Dr. Clark grew up. Generations of my family have vacationed there for over 50 years, and it is a very special place to us, as Dr. Clark knows. At this moment, we discovered even more connections between our two families, and that Sue and Larry have been going there since 1985 and knew my in-laws and my extended family. Sue and I lamented how we would not be visiting Star Island, our spirit’s home, that summer for different reasons. She could not go anywhere with her current recurrent SVT situation, and I was due in two weeks to have our third child, not time for either of us to take big road trips! As they were preparing to take her from the ED up to her monitored bed for admission, I could hear her saying that she would not leave until she saw me one more time. She wished me well, especially with the new baby, and said that she would see me soon.
To complete that year, I received a Christmas card from them, and the best gift anyone could give me. They donated to the hospital foundation on my behalf. The letter I get each year from the foundation is a prized reminder of the impact we have on our patients. The Christmas card from Sue and Larry is the one that stays up well into the warm months of the year.
I am still ashamed to say that I did not remember Sue’s face that first night I met her. But now, when out walking my dog, or at the hospital, or around town, all I have to do is catch a glimpse of her and I know her instantly. We shout greetings of joy and embrace whenever we are lucky enough to meet. I am glad that now, I remember her face, along my part of their story with warmth and gratitude.
In terms of the time that nurses give to their patients, she was one small part of one shift, that had a lasting impact on her and her family, along with everyone that she has touched and inspired since. She is an advocate for community CPR and teaches lay people CPR so that they too can be a critical link in preserving life.
I urge the nursing community to celebrate the successes we promote, both large and small. Share your stories, help renew your passion for our profession, and inspire others to recognize the impact we have on those we touch.