When I was a very young licensed practical nurse in the mid 1970s, a patient — Mr. X — had been admitted with chest pain to the cardiac unit.
Our cardiac unit was set up in two semi-private rooms at one end of a medical/surgical wing with four cardiac monitors. Our hospital did not have an intensive care unit at this time. There was a central monitor at the nurse’s station and one registered nurse was assigned to these four patients. I was one of the nursing staff assigned to the wing that provided care to these patients.
Mr. X had been diagnosed with an acute MI, but had not demonstrated any problems during his first few days of hospitalization. A few days into his recovery, he experienced recurrent chest pain and an ECG indicated his MI was extending. Over the next hour, the RN assigned to the cardiac unit, was having difficulty managing his chest pain.
Mr. X’s BP was low, and his cardiac monitor showed frequent premature ventricular contractions. Subsequently, Mr. X went into ventricular tachycardia and cardiac arrest. The code team responded very quickly. I happened to be the closest nurse to the room when this occurred, and I was assisting with CPR and recording the event.
After approximately 20 minutes of treatment and interventions, Mr. X survived the arrest. He remained in the cardiac unit for another three days and was then transferred to another room on the medical/surgical unit, where he continued to recover without further chest pain or cardiac problems.
Several days later, I was taking care of Mr. X and we talked about his cardiac arrest. I was very surprised to find that Mr. X was able to describe almost everything that had occurred during the incident. He explained that it was like looking down on everyone from the ceiling.
Mr. X said that his chest pain was suddenly gone. He identified several of the nurses and physicians that he knew from the unit that responded and were in the room. He gave details about receiving CPR and how many times he was defibrillated. He even commented about the physician in charge yelling at one of the nurses because she could not get an IV restarted.
Mr. X described how bright the room was and that he felt himself being drawn away. He said he heard the doctor say that he needed to be shocked again. And then suddenly, his chest pain was back, and he was waking up. I was dumbfounded and not sure how to respond.
I do not remember the entirety of my conversation with Mr. X, but I do remember he was so happy to be alive and thankful for the staff that responded to his crisis. I was proud to be a small part of that team, and very proud to be a nurse.
I remember Mr. X so vividly because that was the day I decided I would return to school for my RN, so I could be more effective as a nurse. Looking back over the years since caring for Mr. X, I have pursued opportunities to improve on my nursing skills. I now have an MSN in Nursing Education and work as a Learning Specialist in the same facility.
Almost every nurse can remember a special patient or incident that influenced their nursing career. Mr. X was that special patient that influenced mine.
Rosemary Hilvert, MSN, RN, BC, is a Learning Specialist at Cape Regional Medical Center in Cape May Court House, New Jersey.
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