I was methodically cracking open pills from their cartridge and putting them in a small clear cup. Overhead a calm woman’s voice says, “code blue room 468, code blue room 468”. I was in room 467. I dropped the pills along with the cup to the floor. My adrenaline kicks in and I am in a full-on sprint next door that I nearly ran out of my Dansko shoes. My fellow new grad coworker was standing next to the patient in total awe of their lifeless body. We locked eyes and I screamed out the door “grab the code cart”.
I swiftly kneeled on the patient bed along the patient’s lifeless body, put the heel of my one hand on the middle of the person’s chest and followed with my second hand just like I did in BLS class. I pushed softly at first and then pounded in a rhythmic motion with an immediate recoil of the chest. By this time, I have a full audience. Hospitalists, respiratory therapists, nurse’s aids, registered nurses, managers crowd the doorway.
I hear someone yell “roll” and we quickly put the stiff plastic backboard underneath the patient. The primary nurse was in the corner yelling out medical history, medications, and recent events. I kept pounding on the chest of this middle-aged man until I felt a tap on my back. Another nurse yells, “Rachel, switch!”. I stepped away off the bed with blood pumping through my veins, my face hot and my hands sweaty. After, I stepped back to understand what had happened. I finally realize that I just did CPR for the first time.
After Intubating the patient and return of spontaneous circulation (ROSC), me and the primary nurse helped wheel the patient to the ICU. One nurse was squeezing a liter normal saline with all her might as we drove the patient. A respiratory therapist bagged the patient. And like the new nurses we were, were just trying to figure out where heck the ICU even was.
I wheeled the patient into the room and five nurses and physicians swarmed like bees on honey. One with an IV start kit, one starting a pressure bag, one hooking the patient up to the monitor. Simultaneously, the respiratory therapist attaches the patient’s artificial airway to the ventilator. The movement was frantic but also calm. They all moved within perfect motion of each other and moved among each other like a choreographed dance.
The nurse closed the curtain leaving me and the primary nurse in the hall. We are left holding the defibrillator, the oxygen tank, and a confused look. As soon as the curtain was pulled, I knew I wasn’t ready to leave. It was at that moment I knew I wanted to be an ICU nurse.
In the next six years of nursing, I became the Oncology charge nurse, preceptor and then eventually an ICU nurse. BLS and ACLS have become a normal part of my routine. I have performed CPR and ACLS skills hundreds of times, I could probably do it in my sleep. BLS and ACLS are our backbones, our foundations. Without these skills, most of our patients would not have a chance.
I would consider myself to be in fairly decent physical shape. I work out about 3 times of week. But no one is ever in “CPR shape”. Maintaining good physical fitness is important for not only your own health, but for your patient’s wellbeing. In times of need, I had to perform CPR for over an hour with just two other people. A person’s life rests underneath your fingertips. Their memories, their children, their dreams are all resting on you. Make sure you have the endurance and energy each shift with food, water, and physical stamina.
I am currently an ICU nurse during the COVID-19 pandemic. COVID-19 has complicated BLS/ACLS but for some reason it has given me more passion and drive to save my patients. You never know how much you love and care for total strangers than during a pandemic. As medical professionals, we risk our lives every day to help them fight this virus. But when the patient needs BLS or ACLS, we put ourselves at an even higher risk. Breaking the seal of a ventilator, intubating and bagging patients causes aerosolization of the virus, making it more transmittable.
The biggest piece of advice I can give oncoming medical professionals, is to picture these people as your family member. These lifeless people under your fingertips have futures and dreams and your hands can give them life. Find that empowering as you enter a hospital room during a code or out on the streets during a car accident. The patient does not need a fancy medication or procedure. You are the person/machine/energy bringing people back to life and giving them a second chance.
That person I first had performed CPR on went on to live a long and healthy life. However, there are patients I have performed CPR on that did not make it. Regardless of the outcome, you have the skill to give them another chance. Don’t be afraid to jump in even if you’re afraid to fail. BLS and ACLS is the most empowering skill you can ever achieve, so put it to work. Use your medical judgement, your heart and soul into each BLS experience. I promise you there is nothing quite as special as reviving someone yourself and seeing them thrive. There is no greater gift. Stay safe, be strong, be courageous because you have the skill to save someone’s life.