Katy was assigned as the Scrub Nurse for a thoracoscopy procedure, small incisions and use of a scope to look into the plural cavity for the procedure. Normally, this is a position with no patient contact prior to the patient being given general anesthesia and intubated due to the technical aspects of the position and the challenges of setting up a large surgical case in the operating room. On this day, as she does often, Katy took the time to walk down to the pre-operative holding area and introduce herself to the patient and his family.
The start of the case was a typical thoracic case. The patient was positioned, incision was made and the scope and camera were used to visualize the lung and take a biopsy as planned. Then the unexpected occurred. The patent had a drop in blood pressure and a loss of his pulses. The patient was now in PEA (pulse less electrical activity). The procedure quickly turned from a thoracoscopy (with the scope) to a thoracotomy (larger incision between the ribs) to allow for open chest compressions. Katy was cool and calm and allowed a quick transition for the surgeon.
This case was unique in the fact the code was called, lifesaving measures ceased, yet the patient continued to spontaneously breathe, pulses returned and blood pressure came back up. But, this was not the end of the story for Katy. The patient was prepared for transfer to the ICU.
Rather than stay and clean up her room, as is the custom, Katy chose to accompany the patient to the ICU to be of assistance to the anesthesiologist and the circulating RN. While transitioning to the ICU the patient became very agitated. This is where compassionate caring and clinical excellence shined. Even though the patient was intubated and appeared unconscious, Katy leaned over the patient, took his hand, called him by name, reminded him who she was and they had met in pre-op, and reassured him they were taking the best care of him possible and he was going to be all right. The patient responded to Katy by calming down and not being as agitated while the team was able to get him settled into the ICU and starts his sedation management.
Katy took the few extra minutes before the start of her case to walk down the hall and introduce herself to her next patient. That connection, which seemed very routine to Katy at the time, played a major role in this patient's care at a time of crisis.