Thursday, May 4, 2017

I Need a Nap

by Angelia Pfortmiller

As a Licensed EMT I have many unique obligations in my daily life. The different roles that I play are keeper of the dead, counselor to the addicts, protector of the mentally unstable, extra hands of the Code Blues, and good Samaritan.

It all started with a beautiful lullaby played over the intercom for newborn babies when Henry promptly pulled me aside to go with him to tend to “Mr. Jones.” After someone's loved one passes, there is a part of you that must show the utmost and last respect to the deceased. I bathe the patients after they've passed. A week ago Mr. Jones came in as a Code Blue. The ER team resuscitated him and transported him to ICU. After 3 days the family was informed that Mr. Jones showed no brain activity and now it was the family's decision on what to do. They chose to let Mr. Jones go. He was given a dose of Roxinol, which is the humane way to put someone to sleep. Henry and I gathered the rest of the family to watch Mr. Jones take his last breath. Henry told Mr. Jones that we were to bathe him and Mrs. Jones stated “You know he's dead, right?” I looked over to Mrs. Jones and softly told her “It's a sign of respect and dignity, we will be telling Mr. Jones everything that we are going to do to him, if this bothers you, you are more than welcome to step out while we finish.”

Mrs. Jones stayed in the room as we bathed Mr. Jones from head to toe all the while still talking to him as if he were still alive. You have to be extremely careful when caring for the dead because they lose control of all bodily functions and extremities flop around like a fish out of water when rolling the patient from side to side. As Henry and I finish the bath, Mr. Jones has a fresh gown on and completely new bedding where he lay. His eyes are gently closed again as I lay his arms gently by his side. I turn to Mrs. Jones, who is still sitting in the room watching, “Henry and I are finished with Mr. Jones. You and the family can stay as long as you'd like.” As Henry and I proceed to walk out the door, Mrs. Jones and her family thank us for taking such amazing care and time for preparing their father.

As a counselor to the addicts, I have talked to several patients about alcohol addiction, but the one that sticks the most is a patient named “Corbin.” He voluntarily admitted himself into the hospital. As I was rounding on patients, Corbin was walking the hallways to ease the pain of withdrawals. I stopped him in the hallway and said “I understand what you're trying to accomplish by becoming sober. I myself have been sober for almost 8 years. It is possible to recover and regain what you once had. By the way, my sober birthday is May 15.” Corbin replied “In order for me to succeed, I will have to leave my wife and 18 month old daughter.”
In telling me his story, his eyes begin to fill with tears because at that moment in hearing himself, he knew that reality was setting in and this was going to be an incredible challenge, but at the same time it had to be done to become sober. At the end of our conversation I said “If you need to vent, listen, or help, you are more than welcome to come find me.” Corbin was discharged from the hospital 3 weeks ago and have yet to hear from him.

My next role is a protector of the mentally unstable. To get her fix, “Tonya” decided to snort Prozac. As Tonya came rolling into Room 3330, she looked coherent until she started talking. While Shane, Nikki, and I transferred Tonya from the ER bed to ours, she screams “I need pain killers! I want Oxycontin!” Shane explains ever so politely “You will not get narcotics because of your attempted overdose. You are only allowed Tylenol.” Tonya continues screaming for pain killers and mumbling random numbers, when out nowhere she looks at Nikki, and with a murderous voice says “I'm the Grim Reaper! I'll be coming for you bitch!”

As I begin to attach the EKG wires, she looks at me with dark lifeless eyes. I explain “The wires are to keep a watch on your heart since you decided to snort Prozac. There is a good chance you could have a heart attack and die.” Tonya replies “OK! You don't have to be so straight forward about it!” As I finish attaching the O2 sensor and blood pressure cuff, all I can think is “What a drama queen!”

As extra hands for Code Blues, we are required to be available. As I was sitting in the break room when the intercom announces “Code Blue! Room 3329!” I run to the room where Tessa, Rochelle, and Justin have started chest compressions. I positioned myself at the head of the bed, grab a BVM (bag valve mask) and hook it up to oxygen. I crank up the O2 to 15ml, fill the bag, drop an oralpharangeal down Steve's throat to begin bagging him. I squeeze the bag looking for chest expansion and O2 levels on the monitor. I am bagging at the perfect rate. Steve's O2 is at a beautiful 98%! After just 2 rounds of CPR I look down to see Steve's eyes open. I yell to Tessa “His eyes are open!” I kneel down next to Steve's face and ask “If you can hear me, blink once crew for yes.” Steve blinks! I tell Tessa “I have an eye response.” Tessa yells “I have a pulse!”

The ER crew comes running into the room because ER responds to all Code Blues. In the six minutes it took for them to arrive we had Steve back. He was alive and breathing. I knelt next to Steve again and explained “You are going to be intubated but you won't feel anything. Do you understand?” Again, Steve blinked once for yes. I then proceeded to assist with the next step in Steve's recovery. As Dr. Smith carefully put Steve into a medically induced sleep, he proceeded to insert a breathing tube down Steve's throat. The ventilation machine was set to his specifications per Dr. Smith's orders. We then prepped Steve for flight transport to NHI (Nebraska Heart Institute), which specializes in cardiac care.

Lastly, as a good Samaritan, I had stopped at car accident. I witnessed a pickup T-bone a full sized van and drive off. I pulled over to the side of the road, ran up to the van, where I discovered an 80 year old woman. She had been laying in the back sleeping when the accident occurred, causing her to fly forward, breaking her nose on the passenger seat. The break was so severe that it placed her nose on the side of her face. As I stood in the pouring rain comforting her and controlling the bleeding with my t-shirt, until EMS arrived on scene.

As the newborn lullaby of life rings throughout the halls of the hospital, as life begins, in one room the deafening sound of silence lingers as death ensues in the next.

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