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I Am An Emergency Room Nurse

Live from Haiti blog by Karina Bethje

I am an emergency room nurse. I work on high adrenaline. I’m reactionary. I’m a Neanderthal. It may have been with these instincts that I immediately said ‘yes’ to the head of Hope For Haiti Foundation Surgery Shirley Winkler when she asked me to join her second surgical trip in February 2013. This trip marks trip number four for me on the surgical team.

For this week, pre- and post-op is my station. I start IVs, train Team Haiti nurses, assess wounds, tickle bellies, and soak up the warm ocean air. I love this job and the memorable connections I make with the Haitian patients and nurses. And while every job is important, we are, after all, here for the surgery. Surgery is not natural. A metal blade slicing through skin…muscles…organs. Tools and sutures finding their way into body cavities. The chemically induced sleep. The sterile drapes clinically covering a body.

But surgery is necessary. Whether it’s used to improve a life’s quality by removing a fibroid the size of a newborn infant, or to save a toddler from an incarcerated hernia, surgery is the only option. And this is what calls the team to Haiti. This morning, I asked the intra-op team if I could scrub in for a surgery and enter their world. “Of course” they chorus. “Let’s have you watch the hysterectomy.” I reminded them that I was a Neanderthal and they graciously accepted the challenge of walking me through today’s hysterectomy. The patient was a 44-year-old woman with a belly the size of a 16-week pregnant woman and labs revealing fairly significant blood loss.

As I walk into the cool, white operating room, I recognize order. Every nurse is set out performing her specific task as she floats and weaves about her fellow nurse in preparation for surgery. It’s anticipation. It’s pop music. It’s a comfortable laughter equivalent to the oldest of friends or brothers in arms. It’s rituals. It’s the seamless passing of energy, tools, and the transformation from clean to sterile. It’s April, Lela, Lanita, and our new friend LaShay. Each with patience and drive behind her smiling eyes.

It’s our anesthesia team: the best of their field. Amanda, Mark, and Shirley. Detail oriented and precise. Concerned with the minutiae. Doing much with little. Watching, adjusting, predicting, adding, subtracting, watching, adjusting, watching.

It’s our surgeons, Rob and Lisa. Masters of anatomy. Quick to identify a problem. Direct. Capable of balancing effortlessly the broad picture and the intricate task at hand. Learning from each other. Swiftly swapping their trade’s tool that challenged my reactionary mind. Clamp, clamp, needle driver, scissors. The surgery is lengthy. My weight shifts back and forth as I repeat to myself “My sterile area is at my chest. Keep your hands at your chest, Karina. My God, how do these people do this all day?” The procedure is tense. Then light. Then tense again. Priorities have changed and so has the team’s tasks. Yet again seamlessly, like they are putting on a show for me.

And finally it is over. And the 44-year-old patient loses her massive fibroma at last and her sterile drapes and has exhaled relief in a peaceful sleep. When she wakes, I will put my hands on her head and stroke her hair. She has a long road of recovery. She must fight the chaos that is Haiti and all of the obstacles she possesses. But today, this survivor can rest knowing she received order in the middle of disorder and hope in the middle of hopelessness.