And I would do it again, but set down
This set down
This: were we led all that way for
Birth or Death? There was a Birth, certainly,
We had evidence and no doubt. I had seen birth and death . . .
—Excerpt from “The Journey of the Magi,” by T. S. Eliot
Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.
There is a nurse who loves running for exercise through a downtown park. And lo, it came to pass, one very cold day last year in December, that she came upon a host of people gathered around an unconscious man as he lay in the cold, wet grass.
Among them, three Wise Men were on their cell phones, calling 911.
These are my criteria for lending nursing skills to strangers:
▪ I witness the accident
▪ I’m the first one on the scene of an accident
▪ Others are first on the scene of the accident, but they don’t know what to do or are doing it wrong
This unfortunate man’s situation clearly fell into the third category, so I stopped and offered help. Receiving only vague answers to my question about what had happened, I got down on my knees in the cold, wet grass beside the man. He wasn’t breathing.
He was less than 20 feet from a public restroom. His pupils were pinpoints, but equal. Opening his airway, I could have set the alcohol content of his breath on fire with a match, if I’d had pockets to carry matches (or one of those pocket airway protectors, which would be handy right now).
I shook him. I straightened his airway so his tongue would not block it—an approach that had always worked before, but did not now.
Does any nurse not have an aversion to mouth-to-mouth rescue breathing?
You may be thinking, “The new American Heart Association guidelines say that rescue breathing is unnecessary in CPR.” This is true if the victim is pulseless. However, if the victim is in respiratory arrest from a drug overdose, as was this unconscious man lying in the cold wet grass, there is a pulse—in this case, a bounding one. But of course that would soon change if he did not breathe.
“Dammit,” I said out loud.
I dreaded what I must do. I cursed again, opened his mouth, and breathed into him. His chest rose, surprisingly easily in comparison to those of the mannequins in CPR training. However, this did not prevent queasiness from nearly overcoming me when I placed my mouth over his. I am not proud of this: I prayed I wouldn’t gag or retch. Of the half dozen people watching, only one offered to help, but when her rescue breaths did not make his chest rise, I was forced to resume.
Then something kind of special happened. While breathing for him, I accidentally clicked my teeth against his. This sounds gross, but it caused me to glance at his teeth. They were nearly perfect: straight, and white. It occurred to me that someone had loved this person enough to pay for orthodontia at some time in his life. In that very moment, I wondered, “Whose child is this?” and the thought was powerful enough to change my perspective. I wasn’t giving breaths to an overdose in the park anymore. I was saving the life of someone’s child.
It felt like 20 minutes before the paramedics arrived. As they approached, the man sat up suddenly and slurred, “I’m awake!” I commanded him to breathe deeply, and he did, coughing. His color changed dramatically from grey to pink. A pulse ox was placed on his finger with the oxygen saturation reading of 78%.
Before I left, a young man I hadn’t noticed earlier stepped forward, offering his hand. “I want to shake your hand. He’s my friend,” he explained. “I went to get help. Thank you for helping him.”
I shook it.
I left as the paramedics loaded him on a stretcher into the ambulance.
It’s taken a year for me to process this event. Despite my fears, I didn’t come down with any diseases, not so much as a cold. Nurses often put themselves in harm’s way to save others: I was true to my kind. In time, I appreciated the fact that I’d saved someone’s life.
But recently, I’ve come to see it in a different light. What if, what if, this overdose victim saved me from the cynicism that contaminates a heart into judging whose life is worth saving? Hadn’t I judged? But somehow, in the face of fear, there was grace, and judgment was transformed into action. I saved his life. He saved my humanity.
Nurses provide care, sometimes suspending judgment, and often putting ourselves in harm’s way—not because we’re angels of mercy, but because we are responsive to grace. We don’t wait for help to arrive. We help, albeit sometimes cursing the demands made on us.