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Tales From an ED Nurse

All in This Together

Published December 15, 2008 12:44 PM by Lorettajo Kapinos
In the Emergency Department, I frequently interact with EMTs and paramedics. I receive report from them and assume care of the patient that they have started. Sometimes a lot of things have been done. I know I feel grateful for their assessment and interventions, but I don't think I say it as often as I could. It was few weeks ago that I was able to have a bird's eye view into exactly what happens inside an ambulance. It was this experience that taught me how valuable pre-hospital EMS care can be.

My family gathered together a few days after Thanksgiving. We were laughing, talking and celebrating. The atmosphere was light, playful. The time had come for all of us to say good-bye. My mother was making the rounds, plopping kisses on her offspring when my grandmother, Nana, started to not feel well. In a few seconds, she was pale and unconscious on my kitchen floor.

I had been summoned to her side just before she passed out. My nurse mode kicked in, allowing me to maintain control over the situation. Each and every family member present assumed a role and helped out. Even before my Nana regained consciousness, an ambulance was on its way, my brothers had caught her and removed her jacket, and I started a full assessment on her.

It's at times like these that I am thankful I am an ER nurse, but at the same time feel cursed with too much knowledge. In a split second, ten different diagnoses crossed my mind; none of which were very positive. While I waited for the ambulance, my Nana slowly woke up. She began to follow commands, move all extremities and speak. What my family (and I assume most families) didn't know, was that I was able to rule out so many different diagnoses just from interacting with her. I was feeling calmer by the second, while they waited anxiously for answers.

Westfield Fire arrived, carrying their gear and acting confident. I recognized the paramedic, but didn't know his name. I felt immediately grateful for their presence and backed off to let them do their thing. For the first time, I allowed myself to hope that everything would be ok.

In the ambulance, the medic started an IV, did a twelve lead EKG, full set of vitals and a head to toe assessment on my Nana, all before we left my driveway. I was amazed at how much he accomplished in so little time; I had never been inside an ambulance. This experience confirmed what I had always said about calling 911: care starts at the door, not when you arrive at the hospital.

Paramedics can do so much more than the average person realizes. I think they do more than many ER nurses realize, too. They function under direct scrutiny of an anxious family in almost any setting. And yet, they are so frequently overlooked as an essential part of emergency care.

Well, after this experience, I want to make it a point to value them, no matter what. A good paramedic makes my job as an ER nurse easier. As a family member, they took the burden of care off me. I was able to return to being a concerned granddaughter with someone else in control of the situation.

My Nana ended up being ok. She spent a few days in the hospital, receiving stellar care from everyone, from the ER to the telemetry floor. I don't think there is anyway to express the gratitude I feel to everyone that was involved. I know she feels the same way. So, I'd like to take this time to thank everyone who helped. You are remembered and appreciated.

It is said that experiences change us and evolve us into who we are today. I hope that as this event moves further back into my memory, I can continue to appreciate all the skill sets that each level of hospitalized care provides. After all, as the song from High School Musical says, we are all in this together.

posted by Lorettajo Kapinos

7 comments

Lorettajo,

Thank you for mentioning the EMT/Paramedics and their part in health crisis situations.  We don't thank them enough.  Even though we have these programs here at LCC along with Nursing, I don't think people give credit to the training and people skills the EMTs and Paramedics utilize during emergency situations.  As usual -- your blog enlightens us.  Pat Curry's suggestion to have nursing students ride in an ambulance is an excellent idea and I will pass it on to our Nuring Director.

As a family member I can't tell you how grateful I am to you and your family as you took charge and made sure Nana was taken care of during her medical emergency.  Each time I related the incident to my friends here, I was thankful she was there with you -- the best place to be in a medical crisis.

Keep up the great nursing -- in the hospital and on line!

Love,

Aunt Tat

Loretta Osborn, health education - admin. sec, Lans. Comm. College January 5, 2009 9:01 AM
Lansing MI

Loretta,

I am so pleased to hear that your grandmother is well now. We went through a similar event with our mother in Jackson. Please continue writing.  You do it so well!

Love,

Aunt Carole

Carole Curry-Warren December 27, 2008 10:51 PM

Ditto..I hope she is recovering well.. RNJericho at <a href="http://www.qualitypointservices.com/nsr/">The Nurse Resource</a>

RNJericho December 25, 2008 5:33 PM

Thanks Loretta for saying what many of us forget to say in the few seconds we have to interact with the EMTs of all levels. How easy it is for those of us who have many people and resources at our hands to overlook the EMTs who have only their knowledge and the back of a bus to deal with often a very ill patient.  Keep up the good writing!

Carly, RN December 21, 2008 4:57 PM
Hartford CT

Hi, I am so glad to hear Nana is doing well.  What a good thing she was there with the family.  You know, she could've been back here in Mich. alone!!!!

Once again, you have done a great job on the blog, passing on your experiences.

A trip in an ambulance should be a requirement in a nurse's training!!! Especially an ER nurse.

Love, Aunt Pat

Pat Curry December 21, 2008 9:31 AM
Livonia MI

My Nana spent two days on the telemetry unit and discharged with the diagnosis of Syncope.  That is a fancy word for the statement, "We don't know why you passed out."  Through this experience though, I have come to see the value of follow up with a Primary Care Physician.  She is being followed to rule out any chronic issues.  

My diagnosis.....dehydration and a resulting vasovagal respnose.

She is doing well, thank you.  Recovery has been slow but steady.  Today, she is out and about Christmas shopping!

Thanks for asking....

Lorettajo Kapinos December 18, 2008 10:02 AM
Springfield MA

What did your Nana have? I hope she's recovering well.

Abbey Scott December 16, 2008 11:55 AM

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About this Blog


    Lorettajo Kapinos, BSN, RN
    Occupation: Registered Nurse
    Setting: Western Massachusetts
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