I love cardiac intensive care nursing. But I fear the system itself will collapse

This first-person column is written by Calgary-based Heather Häberli. For more information on CBC’s First Person Stories, please see the FAQ.

Ventricular fibrillation — this is a heart rhythm incompatible with life. One I know too well.

I am a nurse in a cardiac intensive care unit. Just minutes ago I started cardiopulmonary resuscitation (CPR) for the man in front of me, and now my top team is dancing around our patient, a ballet of skill trying to defy the plan of mother nature.

Working alongside this team made me feel like I was part of something bigger than myself.

So far, that was enough.

But for the past two years, I felt like the system was collapsing around me. So did my normal stress coping mechanisms – so I sit down to write about that instead.

This dance metaphor is an apt description for a day in intensive care. It’s not always graceful.

Sweat burns in the space where my N95 mask pinches my face and my abs hurt. I continue CPR, putting a large portion of my body weight behind each compression. I feel the familiar sensation of ribs fracturing under my fingertips. I step back, but I need enough strength for the heart to compress.

Strange, the thoughts that drift through my mind as I work. Like it’s been a while since I’ve had the time or energy to exercise. This CPR will (morbidly?) count as my workout today.

I count aloud while compressing… 25, 26, 27… a metronome to rhythm our ballerinas.

I hope someone else will take care of the patients for whom I am the main nurse. They are just as sick, but with the staffing shortages, it seems life or death has become our triage system.

My mind drifts to the human beneath me during compressions.

I went into his room to replace his norepinephrine bag and change the flow rates of his medication infusions. He wasn’t responding because of the sedation, but I talked to him anyway.

Then, as I was arranging the IV tubing (as any neurotic nurse does), her heart erupted into ventricular fibrillation in a single mistimed beat.

I started CPR by calling for help. Time slowed as I watched the team through the isolation ward window, delayed by the putting on of personal protective equipment.

I was hoping someone was looking for respiratory therapy, but today there was a group of new employees. They won’t understand the non-verbal cues that I normally use. I swore several times under my mask while waiting.

If only his heart was beating like I felt mine – pounding, flooded with adrenaline… 27, 28, 29, 30… My colleagues were now with me at the bedside. We watched the monitor – the asystole, or as pop culture television would show it, the flatline.

In a grisly game of keywords, a colleague took over to ensure the continued high-quality compressions. He starts counting again.

As I caught my breath, I glanced at a family photo we had hung on the wall. This man loved old cars and family gatherings. Her daughter calls regularly for updates.

I wasn’t this man’s primary nurse. She was called to accompany another patient to the MRI. If that hadn’t happened, would she have noticed sooner his clammy skin, his pale color, his decreased urine output, these signs of impending decline?

… 27, 28, 29, 30

I started working in health care in 2007 as a health care aide and studied to become a licensed practical nurse and later a registered nurse. Working with unstable heart patients and having this kind of unique knowledge is a privilege, and the reassuring lub-dub of a healthy heartbeat is comforting. Plus, I work alongside people I still consider heroic.

But this man’s heartbeat was not improving. Our team leader reviewed his patient’s history aloud and asked for ideas – a strategy that improves team dynamics and decreases mortality rates. Why does this only seem to happen in life or death situations?

A synth of electronic alarms surrounds us. It’s a muffled noise in the back of my brain.

Thousands of dollars worth of supplies litter the room, stains of blood and bodily fluids stain the snowflake print dress torn down the side.

But this patient’s alarms signal uselessness. That day, we escorted another soul into the afterlife – in what might seem like the slightest graceful attempt not to.

Deep inside, I feel a sense of worthlessness that crushes my optimism and perseverance. During sleepless hours, I worry about the person it has made me. Have I become passive while my patients are suffering?

I am a tired mother and wife, who too often bring their frustrations from work home. Now I’m taking fewer shifts on this unit, because sometimes you can’t pay me enough to feel so inadequate, to risk my license and jeopardize the level of care I’m used to giving.

I lay awake thinking about the solutions being ignored and the « what ifs » at 2 a.m.

Some of these heroes I work with have passed away – on stress leave, altered career paths, away from academics or cosmetics, while some have gone to other countries and provinces to become nurses.

If I had enough familiar faces, walking into this alarming chaos of a struggling patient wouldn’t be so daunting. I interrupted my work in intensive care to preserve my own adrenaline. I’ll hold on, work slightly away from the intensive care unit, and wait for the alarms in my head to subside.

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