nostalgia

back when i started on my unit, we took care of a lot of ENT patients.  as a new nurse, this was terrifying because most of the patients had jacked up airways....new trachs, fresh laryngectomies, all sorts of weird stuff.  i'll never forget some of the things i saw, like the bivona trach that stuck out of the side of this guy's neck, or the patient i had who had such bad stridor that he had a tank of helium in his room that he was supposed to be breathing.  but my best ENT story of all was J.  

J must have had some sort of head and neck cancer, i really don't remember.  all i know is that he scared the crap out of me.  he had a laryngectomy, so basically he was breathing through an open hole in his neck.  he had a huge incision down the side of his neck, with a couple drains and a bunch of swelling.  i remember that there was this little larry tube that i was supposed to be sticking in his stoma to help keep it open, and i remember that i was supposed to clean it with a tiny bottle brush.  being new then, and obsessive always, i cleaned that larry tube religiously, probably at least every couple of hours.    i took it out, scrubbed scrubbed scrubbed, and put it back in.  then J started to complain about shortness of breath.  i took vitals, and he was fine.  his pulse ox was good, and i wasn't concerned.  but his wife was a worrier, and she was freaking out.  this went on for awhile, probably close to an hour.  during one of my many trips into that room trying to calm J's frantic spouse, i saw him cough, and noticed something strange.  it looked like something was coming up out of his stoma.  so i did what any good nurse would do, and promptly stuck my pinkie finger down the hole in his neck that was also his airway and fished it out.  come to find out that the ENT doctors had packed his tunneling neck wound with gauze stripping, and that the packing had come loose and one end had fallen down his airway.  i had no idea that the packing was there, and had probably been pushing it farther down each time i took out and replaced his larry tube.  so i called the ENTs, and they came running (literally) down the hall with scopes in hand.  they determined that i had gotten all the packing out when i reached down there and grabbed it, and congratulated me on the pickup.  i wasn't feeling as celebratory as they were, however, just horrified by the whole experience.  doctors weren't always going to tell me important facts about my patient...what?  would i be frequently expected to shove my hand down people's throats?  it was one of the first moments that i realized that this new job of mine might be a little more than i bargained for, that my sunshine and sugar nursing school education may not have quite prepared me for the real world.  

so what brought on this wave of nostalgia, you ask?  you'll never guess who walked on to my floor today.  

j.  

three and a half years after the gauze/pinkie incident, J is alive and well.  he's living, breathing, walking proof that the weird, random things that i do every single day make a difference.  and THAT is an accomplishment.