Cool nursing stories from Tabby

Here a few stories that some of you will enjoy and some of you might not. So if you don't read I won't be offended. :)

#1 - organ donation
By far the coolest nursing experience I've had was in my last semester. I got to observe an organ donor harvest from a girl who was brain dead. It was sad, of course, but absolutely amazing. Her heart was still beating, but she had absolutely zero brain function. (For those of you concerned about ethics, this was different then a case where someone would be taken off life support because they had no higher brain function or no quality of life. That person would be considered alive until their heart stops beating. This is when someone has lost even their involuntary brain function, and is legally considered to be dead. Their heart and vital organs can be kept functioning with drugs and machines and stuff, but they are dead. There are really strict guidelines and a lot of tests and stuff that have to to done to determine this.)

So anyway, I got to go into the operating room and watch them cut open her chest and abdomen and rinse everything out with saline. While this is going on a guy from Midwest Transplant Network is on the phone with doctors from all over the U.S. offering them the available organs for their patients who are on the donor list. One surgeon and his team were flying in from California to get the heart. Other teams were flying in from a few other states to get the kidneys and liver. I don't remember what else was donated, but those were the major ones.

So in the operating room it was really hot, because they were trying to keep the body warm and everything functioning. The donors chest was completely open and we could just watch her heart beating and see her lungs expanding and relaxing with the ventilator. The heart surgeon lied about when he would be there, so she was sitting on the operating table like that for over an hour. The surgical teams flew into the downtown airport and were brought to the hospital in ambulances. they brought their own ice chests and everything. It was so interesting.

Once the heart surgeon came and got started everything in the room completely changed. He clamped the vessels going to and from the heart and it stopped. Then all of the sudden the room was freezing cold, because now they were trying to preserve the body instead of trying to make the environment as if it were alive. They flushed some special fluid through all the major organs so that blood wouldn't sit there and clot. Then the other teams came and got the other organs. One interesting thing the guy from the transplant network told me was that both of the kidney's would be transplanted into the same person. The donor was only 3 years old, and the blood vessels going to the kidneys are small and hard to work with. So instead they cut them off from a larger vessel that both kidneys are attached to, and put both kidneys in place of one adult kidney.


#2 - cool heart drug
Also in my last semester of school I got to observe someone getting a really cool heart drug called adenosine. This girl had a heart arrhythmia, which was making her heart beat at over 200 beats per minute. It had been going on for several hours, and they had her on a continuous infusion of one drug, but it wasn't working. Because her heart was beating so fast it wasn't working that efficiently. She was very tired and sweaty, and if had gone on for too long it could wear her heart out. So we tried this "cool" drug called adensoine, that actually stops the heart for 3 to 5 seconds, with the hope that it will start again in a normal rhythm. So to give it we had to have her on a heart monitor and have a defibrillator right next to the bed in case it didn't work. The nurse I was working with actually gave it. It didn't really work for her - her heart just slowed way down for a few seconds and then went straight back to the 200s. But it was neat to see, because it's something I had heard about in school but that is used to rarely I didn't know if I'd ever actually get to see it.

A few hours later the girl sat up in bed, yawned, and laid back down, with a perfectly normal heart rate.

#3 - embarrassing story
So, this one isn't all that cool or interesting, but it's funny so I might as well share. This week one of my patients was a 16 year old girl who was recovering from septic shock. She was well enought to get up and use the bedside commode, but she also had diarrhea. Well, she calls me into her room and tells me that she has to go to the bathroom. This is while a couple of drugs are running into her IV. I move the pumps closer to the bed, and I was just sure the IV tubing would be long enough that they would reach to the commode. I was wrong. I help this girl stand up and turn half way, but they she can't go anymore. I tell her to sit back down on the bed so I can move the pumps, but she starts yelling, "No, I have to GO, I have to GO!!!!" And she does. Gross green diarrhea. \ All over the bed, all over the floor...and then of course she won't sit on the bed becuase it's dirty, but I can't go get help because she's not really strong enough to stand there by herself. So I'm standing there yelling "Help!" but no one hears me for a little while because there was a lot of commotion going on in the room across from us. Finally my preceptor comes in and helps me get her moved and cleaned up.

That's all the stories I have for now. Hope they were enjoyable, or at least bearable. Don't hate me for thinking it's cool so see people cut open or to try to stop their hearts with drugs. :)