Every new nurse imagines the experiences that lay ahead in his or her future, including the caregiver's excited dream of saving a life. Every experienced nurse knows that the reality of the job is much less glamorous than the dream. But I want to tell you about a nurse in our Emergency Department who truly single-handedly saved a life.
It was just another night in the Emergency Department. Rene Bautista was Charge Nurse and calling in patients from the waiting room when his nurse at the check-in desk alerted him that someone had driven up to the hospital and ran in yelling for help. As the other nurse went outside, Rene found a wheelchair and was close behind her. When Rene reached the car where the patient was in the backseat, he assessed the patient and immediately discovered that the man was not breathing and had no pulse. As Rene instructed the other nurse to bring out a gurney, he immediately pushed the patient down to lay across the car's backseat, crawled into the car himself, and started performing chest compressions on the patient.
Now, everyone who has heard about CPR knows that the usual cycle for each set of compressions is two minutes, and then another rescuer is to take over because compressions are tiring and it is vital that compressions are of the right depth and rate to be effective. But, only a person who has performed CPR before knows that one minute of compressions feels like ten, and when one is doing compressions by himself, not knowing when or if assistance is coming any time soon, those minutes feel like an agonizing eternity. In the time Rene spent inside that car performing life-saving cardiac compressions, it was at least five minutes before a gurney was finally brought outside. And as the staff members pulled the patient's lifeless body from the car onto the gurney and started pushing towards the hospital, Rene attempted to continue compressions walking alongside but soon realized it was impossible to establish effective pump and recoil from that angle; and, with no hesitation, he climbed up onto the gurney to continue CPR.
This night, I was a nurse working the Trauma Bay in the ED. I heard one of the other first responder nurses alert us that a cardiac arrest was being brought to us now, and immediately ran to the open room to prepare. Words cannot describe the scene I saw as the commotion came around the corner. Nurses and doctors rushing the gurney into the room with the lifeless patient on it, and Rene, exhausted but persevering, straddling the patient and still performing chest compressions. As the gurney skidded into position and the receiving staff took over care, Rene was finally relieved as another staff member took over compressions. Rene, having endorsed care of his patient to the receiving staff, then returned to his work area, exhausted and drained both physically and emotionally, and resumed his job assignment.
As fascinating as the story of this patient's journey between the planes of life and death in our hospital is, the point of this story is about what an amazing nurse Rene is, so I will be brief about the patient's condition. The man had gone into ventricular fibrillation arrest en route to the hospital in his friend's car, and ultimately required medications, multiple defibrillations, and a transvenous pacer insertion in the ED before he was stable enough to go up to the cardiac catheterization lab. Rene set us up for success in saving the patient's life because his hard work and diligence in continuing compressions on the patient in the five to ten minutes before he was brought to definitive care kept the man's brain and vital organs perfused, giving him the best chance for survival and recovery.
Ninety-nine percent of the time, an emergency room nurse will never know the outcome of the patients he or she took care of last shift, because after they are stabilized, they are sent upstairs and it is time to move on to the fifty other patients in the waiting room or in the ambulances pulling up to the hospital. This nursing story, however, has a happy ending. A week later, Rene was walking down the hallway past the CT scanner and stopped in his tracks as a patient was pushed past him in a bed by inpatient staff. In shock and disbelief, Rene recognized the face that he had loomed over for those ten plus minutes, sweating and struggling to continue life-saving compressions on just one week before; only that face had been pale and lifeless, but this face was bright, full of life, and talking! Rene is a nurse whom I look up to and have the utmost respect for due to his kindness and wisdom, but he looked like a little boy on Christmas morning when he came up to me that night to tell me that he met our patient from that stressful Code Blue, alive, talking, and very well-appearing. I could not imagine a better outcome for a team member as hard-working and deserving as Rene. He truly saved that man's life, and the entire department is proud to know he is one of ours and a representation of who we are as emergency care providers.
This story is just the cherry on top of the ice cream sundae of Rene's skills and assets to nursing and our hospital as a whole. He is a leader and teacher that all the newer nurses look up to and feel comfortable approaching. He pulls us aside to give us advice on how to stay safe in the workplace and reminds us to be strong patient advocates and to demonstrate strong pillars of nursing care. Whenever a nurse is training for a new role in the unit, they are blessed to be taken under Rene's wing. He is the nurse every new nurse dreams to eventually be: skilled, smart, kind, and inspiring!