National Nurses United

Continuing Promise_FNL with art 12/22/10 6:56 PM Page 14 Operating room RN Tim Thomas spent two weeks aboard the Navy hospital ship U.S.S. Comfort treating Haitian earthquake victims. He'll never forget what he saw and what he learned. BY TIM THOMAS , RN Ship of Life I was fortunate to be one of the volunteers that NNU's Registered Nurse Response Network, RNRN, was able to send to Haiti after the catastrophic earthquake in January. My mission was on board the U.S. Naval Ship Comfort, and I arrived two weeks into their relief effort. Our Day 1 began with reveille at 6:00 a.m., and then up the "famous" 81 stairs to the promised hot breakfast and down to the main operating room (OR) for the plan of the day meeting at 6:30 a.m. This was to be the pattern for most of the two weeks that we would be spending there. It was explained that the perioperative staff had initially spent the first several days working around the clock, transitioning gradually to sleep and meal breaks, and that they were looking forward to us adding to their ranks to allow for some badly needed rest breaks. It was also explained that they had a 200-patient backlog and were planning on adding additional working ORs with our help. With that said, room assignments and schedules were posted, and we got to work. The time flew by, and I was relieved for lunch. I found that I was fascinated with almost every aspect of the Navy ship. There was a maze of hallways and stairways (ladders) throughout the ship. In my search to find a place to smoke my pipe, I found one of the crew on deck using a pneumatic needle hammer to chip paint. Like almost everyone in the crew, he kindly lent me his goggles and ear protection, and I found myself exploring the deck, paint chips flying. My subsequent trips to the bridge and engine room were equally interesting. The engine room was the entire width and height of the ship in size with a giant oil-driven boiler and two huge turbines, each the size of a school bus. The bridge had an extensive view of the surroundings and was crammed full of colorful navigation and radar screens. I recall thinking that the small steering wheel seemed out of scale considering the size of the ship that it had to guide. Before I knew it, break was over, and I was back to my schedule in the OR. I was relieved to find the ORs on the ship to be very similar to my hospital's ORs. They had almost exactly the same equipment, from 14 N AT I O N A L N U R S E anesthesia machines to fracture tables. They did have a very "high-tech" standalone camera attached to the surgeon's headlight that was not standard issue in my civilian hospital. With a minimum of extra equipment, we could all see the surgical field and follow the procedure. Although the environment was familiar, there were reminders that we were still on a ship. Ring bolts on the floor were used to tie down the equipment when needed because of the motion. Moving equipment became a challenge because the ringbolts would often obstruct the path, especially for the C-arm. No one seemed the least bit surprised that I knew how to operate the C-arm, as that was expected of all of the OR nurses. I found all of the OR nurses to be extremely flexible in their approach and willing, if not eager, to adapt to new people and situations. Procedure was slightly different on the ship in that all of the patients were brought down to the OR before they were needed, and placed in the preoperative holding area directly outside of the OR suites. The surgeons would do a face-to-face history and physical examinations and write a note before any of the patients were brought into the room. This was especially helpful because of the language issues, and we had several interpreters available at all times. The anesthesia staff members performed their preoperative evaluation in the holding area as well. Paperwork was streamlined and although all of the important areas were covered, there were no extra papers. For example, there was one perioperative record for both the nursing staff and the surgeon. The majority of the 200 patients had secondary procedures during my rotation. My first patient previously sustained a complex pelvic fracture that had initially been stabilized with an external fixator. The surgery that we were to perform was an open reduction internal fixation surgery with plates and screws. This surgery, like most, was complicated by the fact that the pelvis had been in this position for two weeks, and needed further reduction as well as the internal fixation. Some of the other orthopedic revisions included taking out intramedullary nails, W W W. N A T I O N A L N U R S E S U N I T E D . O R G DECEMBER 2010

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