1. Cusmano, Alison DNP, FNP-BC


A post-childbirth emergency and a new understanding of the comforting presence of nurses.


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"Code purple" erupts over the loudspeaker. They can't possibly be talking about me, I think, as my room number is called out and chaos ensues around me. Nurses and corpsmen frantically move about, reciting a checklist for uterine inversion that clearly had to be dug out from within the code cart at the naval hospital. A large-bore IV is being placed and I can't help looking to confirm the flash of blood return. A tingling, cool sensation runs through my body. I do not feel pain, just numbness. I want to stay calm to offset the mounting anxiety in the room. My husband, an ICU physician equipped to care for patients in critical situations, crumbles and is escorted out of the room by a corpsman. The experienced nurses choreograph a dance of passing me medications via injection and sublingual forms. Even with masks covering the lower half of their faces, it's easy to see the adrenaline in their eyes as they spring into action.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

Within minutes we are en route to the OR, my newborn baby girl safely guarded by my husband and a corpsman. My heart aches that I am not able to hold her minutes after delivery, as I always imagined I would.


The team gets to the elevator and the gurney doesn't fit. This elevator is for visitors only, not patients on stretchers. In the heat of the moment at 0300, the assembly of on-call anesthesiologist, OB-GYN residents, and nurses clamor to find the closest way to the OR. The whole situation feels ironic. I thought labor was supposed to be the hard part, not the aftermath. We shuffle back out of the miniscule elevator, and I wish we would get to the part where I drift off into an anesthesia-induced sleep before waking up to learn that this was all a dream. I also make a mental note to pay more attention to the correct elevator locations in the hospital from now on.


What feels like minutes later, I wake up with an arterial line in my wrist and immediately check the waveform, as if I am the nurse caring for the patient. I move my wrist to see if the tracing truly correlates to me. The warming blanket draped over me is unbearably hot. That little green toothbrush in the small white Styrofoam cup of crushed ice on the bedside table is mocking me, as is the clock that says it hasn't been long enough to push the PCA button. The role reversal from ICU nurse to ICU patient is disorienting. I see familiar faces of friends in their hospital scrubs and badges starting to pass out morning medications. I know they are coming to round on me, and I just want the heating blanket to swallow me whole and let me disappear.


Just then, the nurse introduces himself. He has a professional demeanor, talking about things that don't involve medicine, and he shares personal stories about his own four kids. "It goes by so quickly," he says, a statement that I feel has become obligatory for veteran parents to tell rookie moms. I hear myself respond, but barely process the words as my own as I lie in a groggy state of pain and mixed emotions.


For years, I was the nurse patients woke up to after returning from the OR for open-heart surgery. After I gave birth, the roles were reversed, and I was looking at an ICU nurse caring for me instead. My experience of being so happy to have made it out of the OR was pitted against feelings of pain, thirst, confusion, and anxiety. I had a longing to see family, but a hesitancy for loved ones to see me in that vulnerable state.


My immense gratitude for that nurse did not sink in until I returned home safely a few days later and was caring for a newborn in the middle of the night. I'd never realized the impact nurses make as the first person a patient sees when waking up from a frightening OR experience. The emotions a patient feels in a postoperative state are varied and intense, and further complicated by the disorienting feelings from medications. As an ICU nurse, I have vivid impressions of the adrenaline-pumping moments of a code blue. Now, after being an ICU patient who experienced a code purple, I still more vividly remember the caring nurse who calmly made me feel like a human being after the happiest moment of my life spiraled into the scariest.