In A Heartbeat

I had a wonderful exchange with Facebook friend and fellow author, Raymond Alexander Kukkee, which he posted to his blog, The following is an essay mentioned in that discussion, which also happens to be the my first published piece from 1993.

In a Heartbeat; A Special Thank You to Forgotten Heroes

If a survey were conducted throughout the hospital questioning what brought employees to Mercy San Juan, their answers would be as diverse as the backgrounds they come from. Each brings with them different experiences and personalities that when combined, form a potpourri of strengths and weaknesses. The enormous task each unit must endure on a continual basis is that of melding the best of everyone to achieve the highest of standards, often in spite of their differences.

Within the whirlwind of increased patient loads, budget restraints, added legal requirements, and reduced resources, it is no wonder that every now and then we must remind ourselves — and each other — of our mission and philosophy and our personal obligations to health care. Sometimes – when we least expect it – that reminder appears much like a rainbow after an intense shower …a new birth of spirit that warms our soul and revives our sense of purpose. Often such a rainbow brings a reminder of the dedication others around us possess that we overlook on a day-to-day basis. Together and individually, we have the ability to make a difference in the lives of those we care for.

As health care becomes more challenging with each passing day, nowhere are the heartstrings of patients and those who diligently care for them more readily visible than in our emergency room. Each passing shift hurtles staff through a vast array of emotions, pushing them to the limits of compassion and frustration.

To each patient who enters the ER registration area, his or her need is urgent. The patient’s emotional condition is often as unstable as the injury or illness, adding to the stressful environment. For truly critical patients, their physical and emotional needs must be addressed immediately despite the status of the unit at that moment. Concerned family members await information and personal contact from staff, placing additional demands on the department. Yet, through it all, the staff manages to provide for everyone because of their ability to depend on the strength of each other.

As shifts come and go, training and instinct command a first-rate performance. From the clerks to the techs, the nurses to the doctors, patients are bandaged, admitted, and referred. The ER frequently seems to be the human “pit stop” in the Medical 500. The pace is fast and time is of the essence.

And then it happens. A patient arrives who will ultimately affect all who participate in the patient’s care and the unit as a whole. The patient requires the best of those who are on duty, extracting from them the lessons of their training and finally, their deepest emotions, normally suppressed into control to survive within our environment.

The downpour before the rainbow begins.

Perhaps it’s the courage of a patient facing the pain and fear of an aneurysm that feeds the strength of the staff in the trauma room – a dedicated team bonding skill with time, sealed with prayer. As the patient is transferred to ICU, the staff takes a moment to acknowledge each other’s professional contribution and share in the reality of an uncertain tomorrow. Together, they realize they made a difference today.

Oddly enough however, our greatest strength as a team occurs during those times when skill, experience, and even prayer is not enough.

This was an overwhelming realization for me during a recent shift in the ER. We were addressing our third “code III” in less than 45 minutes when a fireman (still in the ER from a previous code) carried an unconscious youth from a car into the unit. The boy’s face was blue and his body seemed lifeless. The staff, seriously taxed from the three previous codes, rushed into what can only be described as supreme action to administer resuscitation.

My job as the unit clerk was to transcribe each aspect of care as it occurred, to watch and record the actions of all who would struggle to achieve what ultimately proved to be impossible for this young boy.

For those present, the words of the ER physician to “stop the code” were heavy, sending a numbing sensation racing through the department much like electricity following the path of least resistance. Staff members and other patients were unable to escape the devastation.

I watched as the physician defied the words himself, and I realized for him this was especially painful. We all knew that the best of the best was given, and yet it was not enough.

The following hours brought continued stress and reminders of the loss as family members were admitted into the examination room. We found comfort in knowing that for another, life would be made possible through the donation of organs so generously offered by the boy’s parents. Many of us have children the same age as this boy, making his life all the more precious to us.

We would all go home and kiss our children that night.

On this sad morning, I recorded more than the vitals and status of patients or the motions of an incredible team doing what they do best. I was witness the strength of the human spirit, the skill of a finely orchestrated team, the endurance of emotion, and the compassion that would revel itself as our most valuable tool.

It was a day in which staff members would prove themselves not only dedicated to their work, but also dedicated to each other.

Hand in hand, they guided each other through the pain and created a rainbow of caring and support. I was never more proud to be a part of our ER and grateful for the tenderness extended to me by my co-workers so that I too could survive the suffering.

Without a doubt, the management support and personal gifts offered each day by staff members represent the success of those standards we work so hard to achieve; everyone giving their all… in a heartbeat.