My Nursing Career
I worked at night 11p-7a in the Coronary Care unit. Initially, I started out on a general medical surgical unit and was the only RN with a LPN and two nursing assistants to take care of 34 patients. The LPN passed the medicines and I supervised the staff and had to make the assignments and monitor all the IV's and chart. Back then there were no IV pumps and I had to make sure the drips stayed on time by counting the drops per minute and do all the additives. IV containers were glass and we placed adhesive tape on the side and made hourly markings to help us keep the infusion on time. We had a variety of patients who were admitted the evening before a surgery and needed lab work or X-rays done. Then afterwards we had to care for their incisions, tubes and give medicines to keep them comfortable. Often a patient was admitted for 3-5 days even for a procedure that is now done as an outpatient in a few hours.
I remember having a patient to suction who had just had a tracheostomy done. I had to use a red rubber catheter which was soaking in Zypherine solution and then had to be rinsed with saline . The gloves were packaged separately. Now the gloves and catheter are sterile in the same package.
One night I was making my initial patient rounds and at the end of the hall found an elderly
man struggling to breathe and having chest pain. I called for help and he went into cardiac arrest. That was my first code and death. It was haunting and I'll never forget that look on his face and the feel of his cold clammy skin. We had to bathe his body and prepare him for going to the funeral home by tagging his large toe with his name, birthdate and Dr name.
Next he was wrapped in a shroud. The body was lifted onto a stainless steel table with a bin which had a table top cover. This was done in order to wheel the body out through the hospital without anyone seeing a dead body under a sheet. In the morgue we had to lift the body into the refrigerator for the funeral home to pick up and log the information in a book.
My supervisor made her rounds at about 2-4 am and got an update on our patients.
We all wore nurses caps and white uniforms, hose and clinical shoes. I learned how to insert IV's under her supervision. She could always find a vein and had a technique I use today and don't deviate from. She taught me a lot and I appreciated her expertise.
Three months after starting to work she came to me and said I needed to go work in the Coronary Care Unit. I was scared to death! She said it would be ok and the other RN would help me learn what I needed to know. I arrived and was put to work right away.
The unit held three patients and there was a monitor bank at the desk where we watched the heartbeat tracings of 6 more patients across the hall. It sounded like a frog pond in there. Each patients heart beat was beeping at a different rate. I thought it would drive me crazy at first. Then my ears became accustomed to the rhythms and I was able to hear things that were skipped or were abnormal.
Night after night they asked me to work there and eventually I was enrolled in a EKG class to learn all the different rhythms. But as luck would have it, the teacher ended up leaving the hospital and I was on my own to learn along with the other nurses who worked with me.
Thank God for them! Mrs Brackin RN, Addie McLea LPN and another girl that I can't remember right now taught me how to read the monitors and run the codes.
Occasionally I helped in the 4 bed ICU area. I remember a stripper who was badly bitten by a rattle snake, a guy who had been thrown from his car and had landed on a fence post. There were photos of it sticking out of his stomach taken in the OR and an immobile 400 lb lady who had a large bedsore big enough to put 1/2 a basketball in it!
When a code was called all hell broke loose! We took the code cart which had all the drugs we needed and the defibrillator on the top. We went all over the hospital and ran the code along with the nursing supervisor and the patients doctor over the phone! Back then only the emergency room, coronary care unit and OR had a defibrillator.
I had to run a code one night on a doctor's mother. She was across the hall at the time from the unit and went into VTach then VFib. I about shit! I got over there in seconds with the cart and shot lidocaine into her IV and shocked her. First I remember throwing about 6-8 pillows out of the way to get to her! She survived and I sure felt proud but exhausted.
One quiet night Addie and I were talking and I remember telling her that my father-in-law Wayne Windham would someday be in there with a heart attack. She told me not to worry but I knew his lifestyle put him at a big risk. He smoked, drank and ate all the fried foods he could. He was stressed all the time and was angry frequently. Hard guy to be around when drunk.
We left Alabama in Sept 1976 when Jimmy rejoined the Navy. On Jan 14, 1977 Wayne had a heart attack and we were called to come home. I drove 11 hrs with Lauren and found out when I got there that Jimmy was granted emergency leave and flew in a few hours before we arrived! I knew Wayne would end up in coronary care! He had a massive heart attack. But he was fortunate. He lived until 2010. Several heart attacks along the way happened but he eventually stopped smoking and drinking as much and was a kinder man as a result.
In the meantime, Olga enrolled in nursing school and graduated with her LPN license and went to work to support them. Since then my nephew Keith and brother-in-law Mike have become RN's. Both of them have excelled in their fields of Anesthesia and Administration. I'm so proud of them.
One of the most shocking things I have ever seen was on my first day of work in Newport RI. I was on orientation with the IV team nurse and we were called to the ER. When we arrived there were many people surrounding the stretcher working frantically. When I got a glimpse of the patient it was an infant boy approx 4-5 mos old who had a huge knife in his tiny belly.
There was hardly any blood but he was as blue as if dipped in grape juice.
I really struggled with handling the shock of what I saw and knew right then and there pediatric care would not be something I would ever want to do.
That poor darling has always profoundly haunted me.
Nursing has been a great career path for me. I ended up in Jacksonville, Fl
working at Memorial Hospital in 1980. The new Critical Care Center( CCC) just opened there and it was really state of the art for the time. I met so many friends that I continue to know and work with. We were a great team. We got to wear scrubs and could opt out of having to wear our cap. I opted out! I hated wearing it and my scalp hurt from the bobby pins I had to use to keep it on. It seems it was always in the way of doing something.
The unit was triangular in shape with 8 rooms on each side. There was an elevated observation nursing station and in the center of it was a monitor bank pit were the techs were seated who kept an eye on all the monitors.
The patient rooms had sliding glass doors and were large and roomy for the bed and all the equipment. All the things we needed were within easy reach or just outside our rooms in cabinets. Each side was stocked the same with a cart for changing or inserting various special lines like arterial lines for blood pressure or swan-ganz catheters for monitoring pressures in the heart and lungs. Usually we had 2-3 patients assigned or were the code nurse. If there was a code called, you had to go and if the patient survived you had them in the CCC afterwards. We had to chart on flow sheets which were large and fan folded so they could fit in the chart. They had a graph for charting the pulse, resp, BP every hour and temp, ventilator settings and lab results. Off to the side we charted the assessment.
At the bottom we entered the medications or treatments given and times.
It kept you very busy along with everything else that had to be done like wound care, catheter emptying, suctioning, restraining and medicating. Not to mention the endless new orders from the doctors changing what they wanted done. We ran our asses off all night.
But we laughed a lot, too and it actually was fun to work that hard with friends who you respected and knew they had your back when needed. We helped each other always.
For instance, when we had to weigh a patient who was on a ventilator we had to get the lift pad under them hook it to the apparatus and pump it up all the while making sure nothing got pulled out of place. While they were suspended in air, we quickly changed the bed linens and lowered them and got the pad out from under them.
Burn patients were kept in strict isolation. We had to stay in the room with them all gowned, gloved and masked for hours and tend to them. It was hot and uncomfortable.
They had it worse. Many did not survive and it was pitiful to witness their pain.
I went to the OR and watched open heart bypass surgery. It was fascinating! Then I took care of the patient afterwards and the following day. I loved it!
Next I learned to do hemodialysis. Putting a patient on and off the machine was so complex. We did all the controls and blood clotting testing. So cool.
I also learned the balloon pump. This machine was used to help bridge the gap for a patient in need of heart bypass surgery. A large catheter with a long inflatable balloon was inserted into their artery in the groin and fed up to just under their heart inside the aorta.
The timing for the balloon to inflate was between their hear beats and had to be exact.
It was amazing how much it helped get perfusion to their hearts and increase their chance of survival. Wow!
Our Intensivists, Dr Mathru and Dr Venus and cardio thoracic surgeon Dr Wingard were the best there is! I learned so much from them.
A septic infection invades the whole body and causes a chain reaction of events that usually lead to cardiac and respiratory arrest if not handled swiftly. The body swells and can hold on to fluids. The patient is unrecognizable sometimes. I rarely saw someone survive back then from this happening. Now we have sepsis protocol that helps us determine a patients risk for sepsis and can often prevent it from occurring. Our hospital is the first in the nation the be recognized for our sepsis prevention program!
Obese patients have many health risks. Many can die from these conditions such as
sleep apnea, hypertension, diabetes, coronary artery disease, peripheral vascular disease,etc. Once lap band surgery was introduced as a treatment option for these patients, we started a program to treat them. Our hospital was the first in NE Florida to have a Certified Bariatric Program!
I continued to work in CCC until 1987 when we moved to Norfolk, VA. At the time I changed and began working in the Emergency Room. It was new and I liked the fast pace and could use all my skills from critical care. I even delivered a baby in the back seat of a police car in a pouring rain storm. I saw trauma patients, heart attacks, asthma attacks,
gun shot wounds, suicide attempts and rape victims. After five years, I went into administrative nursing.
I applied for a position at Portsmouth Naval Hospital as a civilian Division Officer.
My department was one of three units that civilian nurses ran when Gulf War I started and many of the personnel were deployed to Iraq. I ran the women's surgical oncology department. It was a big responsibility. I was not used to the role and found it hard to be in charge of others who I did not know well since we all started at the same time.
I had to adhere to all the a Navy regulations as well as the nursing company that employed us. I decided administration was not my cup of tea and was glad when we were stationed to come back to Jacksonville when a Jimmy retired from the Navy.
I went back to work at Memorial, reconnected with many of my friends from the 80's and started in a new area of Outpatient Recovery. My friend Mary McElroy was the director and Frida Sitchon and Linda Lee, Katherine Brown, Sylvia Tablada were there, too. It was great.
The anesthesia MD's were all great and we had a busy department. So many things had changed over the years in surgery. Now patients came in as outpatients for most procedures and only the big cases like open heart, neuro or big vascular or abdominal cases were kept as inpatients afterwards. Everyone else went home that day.
Mary came to me one day in Jan 2000 and asked if I would take over as Recovery Room Director because she was going to become the CNO (Chief Nursing Officer).
At the time, I really was not sure if I ever wanted a job in administration again.
I went home that night and talked to Jimmy about it. He has always been very supportive of my decisions. On that Friday I was on call and had gone to visit Casey's brother Danny who was recovering from his near fatal accident. Jimmy and I were returning and a beer truck pulled out in front of us. I do not know how we escaped from being killed that night.
I remember screaming and how shaky I was.
On Monday I told Mary what had happened and that I was no longer afraid to take the job.
It was a big job and I ran three departments the Main Recovery, Outpatient Recovery and the Short Stay Unit. I had 60 employees to keep track of.
We had JCAHO inspections that were grueling but we passed them with no infractions.
The training with the Navy had helped me prepare for them!
We underwent a huge expansion of our areas and had no disruption of patient care and never had to close. We managed to do our work around all the construction and commotion. After five years I decided that was enough and went back to direct patient care. At the same time mom's health was failing and I was having to dedicate a lot of time to her care. It was the best decision ever. I was happy that her last ten years were with us and that I could care for her at the end.
Today I work part time two 12 hr shifts a week. In the morning from 6a-12 work in the PreOp area getting patients ready for their surgery that day. In the afternoon from 12:30-6p I work in Pre Admission Testing area. We do all the anesthesia interviews and testing work up. We ensure that all clearances for surgery are done and that all lab testing is completed. It's an area I can put all my clinical skills and teaching to practice to make sure my patients needs are met while they are in our care.
A lot has changed since 1973 in the way we handle certain medical conditions and the type of medications and treatments and equipment to make the job easier. I have learned many new things. But most importantly I have learned to never forget there is a person in my care. To always treat them with respect and dignity no matter what.
I have enjoyed nursing and find it hard to believe I've been nursing 40 years!
Catherine M. Windham R.N.
1973 - 2013
