One ordinary Monday morning, a colleague asked for my support while she presented a lecture to the caregiver class, an important part of her new role as educator. She was addressing the Stem Cell Caregiver Class for autologous and allogeneic transplant patients and their family members. However, the class was not being held at its usual location; because of a scheduling conflict, it was moved to a new building. Perhaps I should have taken that as a sign that this would not be an ordinary Monday.
I quietly entered the room and opted to sit in the back, in the last chair, in order to maintain a nonintrusive presence for both the speaker as well as the learners. The educator was doing a lovely job, and positive energy filled the room. The lecture was progressing along nicely, and she announced it was time for any questions. Suddenly Mr. T., who was sitting in the third row, became unresponsive and slumped forward in his chair. His wife screamed loudly, “HELP! … HELP! My husband just fell over!” Her scream still rings in my ear.
Instinctively, I bolted to the front of the room. My initial assessment was that Mr. T. was at least 6 feet tall and weighed approximately 200 pounds or more. He was unresponsive, diaphoretic, cyanotic in color, and had no palpable carotid pulse. I could not believe this was happening; I felt like I was in a movie. The educator, Mr. T.’s wife, and I lowered him to the floor, and I immediately started CPR. As this was happening, an inpatient staff nurse who was auditing the class initiated a Code Blue and evacuated the other patients and family members to a nearby sitting room. Thankfully she was able to spend time with them because they were visibly frightened.
As I was counting chest compressions, I could hear Mr. T.’s wife say that she was a nurse and explain that her husband had just been released from the hospital, status post high-dose chemotherapy for aggressive lymphoma.
All I could think was, “This man must make it out of this classroom alive!” During the ordeal, Mr. T.’s wife would rub his arm calling his name, and I just kept thinking, “Please answer her. Would you please just answer?”
We had completed one cycle of chest compressions when the code cart arrived with a group of physicians and emergency room (ER) nurses. I was never so glad to see a code cart! As the patient started to arouse, the code team placed an oxygen mask on him, and a faint pulse could be detected. The ER nurses took over, placing him on a cardiac monitor. I was extremely grateful and thrilled to see a heart rhythm on the screen. I am not an expert on rhythm strips, but I knew that this was a good a sign. Mr. T. finally opened his eyes, and in a low, raspy voice, asked, “What happened?” The ER team lifted him onto a stretcher and transported him to the emergency room.
I accompanied Mr. T.’s wife to the ER; providing emotional support, active listening, and allowing her the opportunity to talk about the unfortunate event. When we reached the ER, Mr. T. was evaluated immediately by his primary oncologist. He was admitted for further testing and observation. Once labs were drawn and IV hydration administered, I gave both of them a big hug and headed back to the cancer center. I promised to visit at the end of the day.
This event had an obvious impact on my life. The experience was an opportunity for me to test my traditional nursing skills. Because I practice in a nontraditional nursing role, I do not have the opportunity to regularly perform CPR, which evoked some self-doubt in my skill level. The fact that I knew what needed to be done immediately and was able to take charge of the situation made me realize that CPR is like riding a bicycle. You never forget what to do, and performing chest compression becomes an innate skill. In addition, my awareness of how fragile oncology patients can be and how even a preplanned event could entail danger was heightened.
This episode served to remind me that nurses should assess environments at all times and always be prepared to implement nursing care. It reinforced the foundation of my nursing skills, and how they can apply to each and every situation on any given day. In addition, the experience acknowledged the fundamental reason why I became a nurse: to assist patients and their families during times of illness.
Some people might say there was an ulterior reason for me to be in that class on that Monday morning; some might say, “It was fate,” some might say “This is life” or “This is nursing.” I say, “I’m grateful for the nursing opportunity and delighted that a positive outcome was achieved.” My ordinary Monday turned out to be quite an extraordinary day. That Monday morning was a nursing moment I will never forget. ONA
Denise Quinn is a nurse transplant insurance coordinator at John Theurer Cancer Center at Hackensack University Medical Center in Hackensack, New Jersey.