Today I felt like a nurse

It was somebody's birthday on the unit today which means this was the sight that greeted me when I went into the nurse's lounge during my break (apologies to my leftover spaghetti, still in the fridge).

I learned the food is from a place called Maramara Istanbul Restaurant, really close to our apartment. Maybe the girls will be up for some take-out on our last night?

Quite a bit of blood mentioned in this post so if you're one of those who feels queasy with the thought of it, you've been warned! Back in the CCU for an evening shift today after almost a week off (except for a day in the cath lab). I think I actually missed it a bit; the nurses, the patients, the fear/excitement of the unknown. The patient assigned to Soumya and I was a stable, post-angioplasty, middle-aged man awaiting a bed in the ward upstairs. There was a new patient being admitted down the hall that Souyma was asked to help out with so naturally I followed close behind.

The partially-conscious patient was intubated, had a very fast heart beat and was very agitated. He wasn't fully awake but his arms and legs were so the nurses were putting on restraints as a small group of doctors gathered at the doorway. His heart was pounding, fast and loud. Then I noticed the man had two wound dressings, one on each side of his groin (over his femoral artery) and both were oozing quite a bit of blood. One of the nurses (there were about 4 of them in there), with some gauze, starts putting firm pressure over the wound site on the left side, which was bleeding a little more than the right. You can imagine how much your hand starts to hurt after a few minutes of this and how uncomfortable this can be to a patient. It's a good thing he wasn't awake. I stood next to the nurse and eventually asked to relieve her when her hand started hurting. She was hesitant to let me (bleeding from the femoral can be very serious) but one of the doctors chimed in.

"Let her do it so she will learn," he said.
I pulled the gauze away to take a peek quite a bit. Yep, still bleeding. I pressed my two gloved hands firmly down and waited.
By now the doctor had begun to assess/ stop the bleeding from the other side. To tell if I was correctly over the artery, he told me, I should be able to feel the pulse, even through the gauze. I couldn't feel it. He pulled the gauze away and put three fingers firmly down on the man's skin, where blood was slowly pooling around his fingers.
 "Here," he said, indicating the correct place to apply pressure. I put my hand down again, a little harder this time, to stop the bleeding.
"If you are in the correct place, his pedal pulses (on his feet) should feel weak," he added.
With one free hand and while still applying pressure to the site, I reached all the way down to the man's foot and felt for a pulse. It was weak, good. I continued to apply firm pressure to the left side while the doctor applied pressure to the right side. He told me that in order to stop the bleeding, we had to press down on the site for 10-15 minutes. So there we stood, both putting pressure down on either side of this patient, who was now completely sedated, watching to see if more blood would pool when we removed the gauze. I learned the doctor was from Oman and had recently returned from two weeks in Canada. He hoped to get a job in Vancouver.

After about five minutes my fingers were numb but on the plus side it felt great to be given such a big responsibility and to being doing something useful (besides throwing away empty gauze packages and opening syringe containers which, while important, isn't quite as rewarding). There was a moment during all of this when I did start to feel a little warm, the first step in the road to lightheaded-ness (a road I've traveled a few times now).  It wasn't because of the blood, oh no, but likely because I had forgotten how to inhale air. Thankfully I still remembered how to put one foot in front of the other. So I asked one of the nurses to take over, telling her, "I just need to go and check of MY patient." Out the door I went, did a quick lap around the nurses station, took a deep breath and back in I went. I guess you could say I jumped in with both feet. I did check in on my other patient: he was walking around the unit talking on his cell phone. I think he's doing alright, I thought.
Things learned tonight: if it's bleeding, apply firm pressure. This experience also helped alleviate some of the fear I had initially felt about the CCU. Before coming here I thought it was downright terrifying and now, not quite as terrifying. I'm learning!