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Reflections

Nurses Know

Gerber, Lois MPH, BSN, RN

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AJN, American Journal of Nursing: January 2012 - Volume 112 - Issue 1 - p 72
doi: 10.1097/01.NAJ.0000410369.04427.35
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Illustration
Illustration:
by Annelisa Ochoa.

It happened back in 1976, but I still remember the sound of the distant ambulance. Why was I lying in the grass and the weeds? Hadn't I been in the car, driving home from the Visiting Nurse Association along the country road?

A woman stood over me, fear in her eyes. I sat up and flexed my legs and arms, fingers and toes. Only my right thumb tingled. It was hard to move my left arm, but it didn't hurt. Had I broken my left clavicle?

I smelled smoke. “How did I get here?” I asked the woman.

She pointed to the man standing beside her and said they'd pulled me from my car.

When the police arrived, they explained that a cement truck had lost control and hit me broadside. I was lifted onto a stretcher and transported to a nearby ED.

But the sense of unreality persisted. It wasn't really me who'd been injured.

In the ED, a nurse named Sheila helped move me to a gurney.

“Probably just some scrapes and bruises,” the physician said, as he calmly and gently examined me, “but I'm going to order a complete set of X-rays.”

I was X-rayed lying down, sitting on a stool, and standing. Just as I was asked to get up for the second time, and worrying whether I ought to, I heard Sheila's voice from the hallway. “She could have a spinal injury. Don't move her from the gurney.”

Thank God, I thought. Nurses know basic first aid guidelines.

Back in the ED, the physician reappeared. “Have you ever had a neck injury.”

“No, never.”

“The X-rays show a slight fracture of a cervical vertebra.” He gave a reassuring smile. “It can be easily treated.”

“Tell me more,” I said. “I'm a nurse.”

“The fracture is at C6 with a slight anterior subluxation. A week or 10 days in traction and then a neck brace for a couple of months should do it.”

After Sheila applied the stiff collar and used sandbags to stabilize my head, I was taken to the neurology unit.

I was met by a young resident. “I'm going to drill little holes in each side of your head to set up the traction.”

I gasped. “How many times have you done this before.”

He didn't answer, but kept setting things up.

I looked at Joanne, the nurse.

“Mike,” Joanne said kindly. “Let's page the senior resident.”

We waited for the senior resident, and then they got to work. I cringed at the sound of the drill boring through my skull, and as the weights were attached to the tongs, tears filled my eyes. But Joanne was there. “Try to relax,” she said. “You're doing very well.”

Nurses know how to act as advocates, how to reassure patients.

The next day a neurosurgeon examined me and suggested surgery to fuse the C6 vertebra with a bone graft from my hip. He would put me in a Minerva jacket—an upper body cast—for six weeks. “That's the best option,” he said, “but we'll need to wait a week and keep you in traction until the swelling subsides.”

My mind tumbled forward—infection, permanent paralysis, blood clot—but after talking it over with my family, I consented.

The morning of the surgery, a technician came to transport me, and began removing the weights from my head. “The weights have to stay on,” I said, and asked for the nurse. The nurse came in and insisted the weights stay in place for the transfer.

Nurses know how to keep patients safe.

After the surgery I had to lie flat in bed for another week. I was bored and discouraged, but the nurses were there. They included me in their chitchat. They even broke the rules and allowed my young children to visit.

A favorite nurse was Karen. “Another few days and you'll have your body cast,” she said. “Then you'll be able to get up and walk.”

Nurses know how to provide emotional support.

Finally my stitches were removed, and I was taken to the cast room for the application of the Minerva jacket. Afterward, back in my room—now without the traction—it was strange and comforting to feel the wet, warm plaster that extended from my chest up and around my neck and head. But as the plaster cooled, I shivered with a chill no blanket could ease. I ran my fingers over an oily braid sticking up from the opening in the top of the cast. My hair hadn't been washed for two weeks.

Karen came and asked if I wanted a shampoo.

“I'd love that,” I said, and so I was wheeled to the utility room. Karen covered my cast with a plastic bag, loosened the braids, and washed my hair. When she was finished she braided it again into a single, clean plait.

“That feels wonderful,” I said.

Nurses know how important personal comfort is.

© 2012 Lippincott Williams & Wilkins, Inc.