Heart Attack Snow

self-compassion Apr 20, 2019

Heading into work that snowy, cold Chicago morning back in 2004, I was excited.“Heart Attack Snow” was falling, and I knew that meant patients. It might sound awful, but I was a new Cardiac ICU nurse with new skills begging to be practiced.

In case you aren’t sure what I mean by heart attack snow, imagine shoveling something crazy wet and heavy and the toll it might take on your heart.
When I got to work, there he was - MY dream cardiac patient. He had been found by his neighbor slumped over their fence with shovel still in hand. He was barely breathing and the neighbor had immediately called 911. I expected him to be in BAD shape, but he was talking to me and seemed in great spirits. Perhaps he would be fine. Good for him!

His monitor on the other hand would NOT stop alarming. He was having a ton of ectopy despite being on a lidocaine drip. I remember paging the doctor for orders as the increasing number of ventricular beats was making my relatively new to CCU heart have it’s own ectopic beats. The cardiologist seemed unconcerned about the ectopy and ordered him a food tray. Ok I thought - I trusted the cardiologist. If he’s going to let him eat, he must be fine.

At approximately 8:15am while my patient was talking to me about his breakfast choices, he suddenly turned his head away from me and lost consciousness. I looked up at the monitor as it started to alarm. Holy Crap! He was in VFib.

I hit the code button, moved the overbed table out of the way, flattened the bed, and started CPR. My colleagues grabbed the crash cart and the room seemed to fill endlessly with people.

I practiced many of those new skills I had been so eager to perform, but it did not make my heart happy. Sadly, we never got him back.

Shortly after the Code, the cardiologist came to the unit. I asked him what went wrong. He just stared at me and shook his head, “What do you mean? Of course, he died. He lost most of his left wall function before he ever came to the hospital. There was never anything we were going to be able to do.”

I had no words - how had this not been mentioned when we were talking about his lidocaine and food tray? Why didn’t he tell me that my patient was expected to die? Why did I have to be standing next to him having a conversation and then just nothing? I walked away from the doctor and locked myself in the bathroom. I cried for what felt like an eternity, but was likely more like 90 seconds max. I mean I knew I had another patient and tasks to perform. I knew there wasn’t time for crying.

I was so angry, frustrated, and broken hearted. How had I been so ill-prepared and uninformed? I remember being really mad at myself like I was stupid for not knowing what to expect. I changed after that. I made sure to ask more questions. I even went into Clinical Education a few years later to pay it forward to other nurses. I even taught advocacy and the importance of having clear expectations to aspiring nurses. I didn’t want anyone else to feel ill prepared and unsure.

And where am I today? Perhaps surprisingly, I have traveled back to the bedside after working in higher education for many years. I work per diem as an Emergency Response Nurse in a small community hospital in Southern California in addition to coaching. I respond to and manage all manner of Code situations including strokes, STEMIs, and general rapid response calls throughout the house.

I am no longer surprised when bad things happen, but I also recognize that I deserved self-compassion that day. I was really hard on myself and as much as I thought I was a good advocate, I am only now realizing that I did NOT advocate for ME at all that day or most days for that matter.

This is what my passion for Burn Brighter is about - learning to advocate for ourselves as much as we advocate for everyone else. I was a new nurse when this happened, and I do NOT remember anyone asking me if I was okay that day. I do remember feeling ashamed and fearful of showing my feelings.

This is what we cannot have. This is what we MUST stop. We need to take care of ourselves and each other better. We need to stop acting like deaths are normal and just a part of the day. We need to acknowledge the awful thing that has happened and connect with the painful part and process through it rather than tucking it down deep and pretending like it isn’t there.

What do you say friends? Are you open to this? Can we be vulnerable with each other? Can we connect openly when horrible situations happen and learn to better heal? I know it isn’t easy, but I do believe that the only way to feel better without risking unhealthy coping mechanisms is to process it in the present moment when it occurs.

I am committed to this process. I am dedicated to helping myself and you  learn to Burn Brighter. We cannot afford to lose any more of us to the heartache of stuffing things down and not speaking our minds.

Much love and compassion

~ Sherpa Erica 💖✨

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