The Guardian Angel

snowline_jill1As my alarm clock went off at 5 a.m., I couldn’t help thinking that I would rather stay in bed. I actually contemplated it for a little while as I closed my eyes after hitting snooze. As I lay in bed with my eyes closed, a sudden feeling of guilt flooded my mind. I snapped up out of bed, got ready and headed out the door. I had been a critical care nurse for a good four or five years at this point, and I felt I did not really need to go to advanced cardiac life support (ACLS) recertification so in early in the morning when I had to work that same night. I figured I better go and check off the box and go through the motions.

The four-hour class was the usual I had been through, however, my final code drill dealt with switching cardiac arrhythmias and really challenged me. I recall going home and going thru my notes to make sure I really understood the different algorithms for treating ventricular tachycardia, wide and narrow, with re-entry issues. I sat home and felt very tired. I should take a nap before headed in for the night shift. As I lay sitting up in bed looking over my ACLS notes, I dozed off. The ringing of the alarm pulled me out of the strangest dream. I felt strange as I was getting prepared to head into work. It was not a completely different feeling, as I usually felt strange as I tipped toed around the house at 10 p.m. not to wake up anyone who was snuggled into bed for the night.

I arrived at the hospital and received my assignment. A couple of co-workers commented on how my ACLS went and that they didn’t think I was coming in. “Me neither!” I thought as I began looking up the patients I had in my care. I remember there were two other nurses on that night. I was working on a small, 25 bed telemetry unit. After report I typically triage my patients to determine who I should go see first. This particular night I did not do this. I went into the room of a younger woman simply because the light was on in her room and the television was blaring. I said my hello and how are you feeling as I turned down the television and tidied up the room. The lady was nice and told me she was doing well. It was one of those, why is this patient even here stories. I left the room and heard the telemetry monitor ringing. I looked up at it and noticed the very patient was in ventricular tachycardia. I looked over to a nurse entering the kitchen and said I need help in here and headed back into the room.

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The patient was awake and quickly began to turn grey in color. Her respirations became fast and labored as she began to sweat. I will never forget the look in her eyes as she looked up at me and said, “I am going to die.” I quickly began performing chest compressions while the other nurse ran in the code cart. I knew this algorithm. I was re-reading it in my sleep and my strange dream was now a reality. I was coding this patient with no physician support at this time. You see small community hospitals typically have a couple physicians on staff who are in the emergency room seeing patients. I ran the code, went through the motions, and brought the patient back. Within a minute she coded again. I sprang back into action and ran the code. She was stable when the hospitalist entered the room. We quickly moved her to the intensive care unit (ICU). I explained and reported off to both the ICU nurse and physician.

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cedars_patient_focusedI went back to the telemetry unit and rounded on my patients, gave a few medications, reviewed their telemetry strips, and then headed back to the ICU. I found the physician still there looking over the patient’s chart. I told him very confidently that this patient needed to be shipped out to a tertiary care center. We shared our different points, however after much persuasion I was listened to. The patient was airlifted out to a larger hospital an hour later. I felt great and relieved and went back to my unit.

I think two or three months had passed since that night. Shifts went by. I had scenario after scenario with patients and their families. Things can sometimes blend together as you lose track of one situation to encounter another. As I walked out of the unit and down the hallway I was greeted by a large family. I tried to walk past them, when I heard “Hey it is my angel.” To my astonishment it was my patient who I had coded and talked the physician into flying out. She walked over to me, grabbed me, hugged me, tears streaming down her face. Her husband did the same, then her daughters, then her granddaughters. All of these people were here to see me.

I have been in man codes and participated in many patient situations. This is one of those situations that I will carry with me for the rest of my life. The internal feelings when this family thanked me for simply doing my job are hard to describe. I understood why I needed to work that night.

I would like to say this story ends here, however, there is one more section to go over. It involves me a few years later working as the evening supervisor. I was called to a room to assist in placing an intravenous line in a patient on maternity who was doing well. I entered the room to find many people, nurses, and physicians in attendance. As I made my way over to the patient I was quickly greeted with, “Oh don’t worry, my angel is here and everything will be ok.” To my surprise there was my patient. She explained that the new patient was her daughter and that she was going bad very quickly. The physicians and nurses needed access to her veins to give her fluids, magnesium, and other treatments. For some strange reason I knew I would get this task done simply because, well I was called here and this was more than coincidence. I prepared my supplies and closed my eyes. I looked up and went to work. I immediately placed an intravenous. “See everyone, I told you he is our angel.”

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This story sticks with me every day. I was at work for a reason and the power of what nurses do every day is enormous. This is why I get up every day when I just want to close my eyes.

John Green

John Green, RN, MSN is a Masters-prepared, registered nurse who has worked in healthcare for 20 years. He currently works as a nurse manager for a 46-bed medical unit in upstate New York. Read More

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