On Saturday, I floated from my regular post-op cardiac surgery unit to labor and delivery, where a 28 week pregnant woman had come in for an irregular heart rhythm. The patient had her own L&D nurse, as well as myself. The purpose of my assignment was to monitor and document her rhythm, and take vital signs every fifteen minutes. As I got report from the previous nurse, I quickly realized that this patient’s irregular rhythm was not something that would resolve easily. Her heart rate ran between 150 and 180 beats per minute and the typical medications used to slow the rate down would not be good for the baby.
Cut to three hours later, when the cardiac team came through and announced, “We are going to shock her heart. Anesthesia is on its way, start getting ready.” I had seen this plan as possible from the start of my morning, but when it finally came to pass as the definitive treatment, I became uneasy. “The only patients I’ve ever shocked were intubated, sedated or dying,” I told the L&D resident. “I’m not comfortable,” I told my charge nurse.
At first, I felt weak and insecure that I didn’t want to be the only cardiac nurse in the room when the team went to shock this patient’s heart. But then I realized that if I didn’t want to be alone, maybe there was a reason, and that asking for help was going to make the whole challenge that much less stressful. So another cardiac nurse came from the critical care unit, we hooked the patient up, the team came through and sedated the patient and we delivered a single shock that restored her normal rhythm. The patient went home that afternoon. As she was leaving I told her, “You really need to think about naming this baby Valentine.”
Two years into this new profession, do I feel more confident in my abilities? I certainly feel more willing to admit what I don’t know, and to ask for help. I’m also aware of my limitations, mentally, physically and emotionally. Last year on Valentine’s Day, my patient coded and died. This year, I helped shock a pregnant woman. Next year, I think I’ll take the day off and spend it like a normal person, with candy and flowers.