Wednesday, October 15, 2008

Veteran ED nurses have seen it all

At right, Dr. Joseph Servideo and Dr. Tom Myers enjoy the celebration of the opening of the new Fauquier Health Emergency Department waiting room. (Patients were welcomed this morning, October 15.) Both doctors worked in the Fauquier Hospital ED 30 years ago.

Lisa Mountjoy, a nurse in the Fauquier Hospital Outpatient Procedures Department and Lois Sutphin, a nurse in the Fauquier Hospital Infusion Center, gathered in the staff lounge and pored over old news clippings from the last 33 years. One article, cut out and stapled into a scrapbook, was torn and faded. The date on the page showed it was from September of 1978, three years after Mountjoy graduated from nursing school and joined Fauquier Hospital.
Both women remembered the story well.

Mountjoy said, “That was when we were still in the ‘old ED’ (a six-bed unit). Only that week we had been approved for helicopter transport.”

The newspaper article told of a serious car accident. A 22-year-old man had been pierced with an 8-foot-long board. “It was unbelievable,” said Mountjoy, who was head nurse of the ER at the time. “It went right through him. They had to cut both ends of the board away in order to get him in the ambulance.”

Attending the victim was Dr. Joseph Servideo, the current chairman of the Fauquier Hospital Emergency Department. He was then 34 and in his first year with Fauquier Hospital. He said, “The board had collapsed his lung, went behind his heart, behind his abdomen and through his bowel. I had never seen anything like it, and I was scared to death.”
Dr. Servideo and one of the hospital surgeons got the patient stabilized and he was airlifted to the Washington Hospital Center, where he was operated on successfully.

Former ED nurses Bernice Pearson and Janice Foley, now both retired, were on the scene that night too. Foley said, “It was a small community back then. If something big happened, you heard about it and just went in to help.”
In those early days of helicopter transport, Foley was called on several times to travel with patients on what she called “the MASH helicopters.” She said, “I’d be in the helicopter holding the IV and the patient would be in this big tube, attached to the outside of the helicopter. Sometimes when they didn’t have a medic, they’d ask the nurses to help with transport.”

The good old days
Sutphin, who began working at Fauquier Hospital in 1973, says that the hospital was a very different place back then. “We didn’t have a doctor in the ER all the time. I’d be in the OR and the bell would ring when there was a patient waiting at the ER door.”

Foley remembered, “One night a man arrived with a wire sticking three inches out of his eye. I had trouble finding a doctor and when I got one on the phone, he asked, ‘Can you see the wire?’

“I said ‘Yes,’ so he said, ‘Well, pull it out then!’ ”

Because of the frequent absence of an ER doctor, then nurses were often required to use their own judgment. Pearson told the story of a night when she was making her rounds and Foley was in the ER. “We heard this small voice say ‘Help.’ We checked the parking lot. No car. No rescue squad. So we went on with our conversation. We heard it again. ‘Help. Someone please help me.’

“We went outside and found a man hanging on to the wall in the parking lot. He had been shot in the leg and was AWOL from the service. We brought him in.”

Foley added, “We didn’t have any security back then. We figured if they can make it as far as the parking lot, that’s good enough for us.”

Foley remembered, “We had someone come in who had been shot in the chest and wasn’t going to make it. A motorcycle gang had been involved in a shootout. About 30 of his friends showed up and said, ‘We want his jacket,’ so I gave it to them.” Later, Foley realized she had given away evidence in the shooting. “I would have given them anything they asked for. They were scary.”

Sutphin said, “We made our own saline, distilled our own water, and prepared our own medicines that we got from Rhodes Drug Store. We used glass bottles for IVs instead of plastic bags.”

Mountjoy added, “We didn’t wear gloves back then. I remember one man came in who had been hit in the head with an ax. There was a lot of blood, but he was still talking. I held his head together with my bare hands while he was taken to Fairfax. HIV and Hepatitis were unknown back then.”

Thirty years ago, the most common emergencies handled in the ER happened on farms and in car accidents, according to the veteran nurses. Sutphin remembered, “Hay pickers, corn pickers, mower accidents. I remember when five people in one family were killed in a car accident. That’s how we got the traffic signal in Remington. One time someone came in whose whole bottom lip had been bitten off by a horse. They sewed it back on.”

She said, “I remember one little girl who lost her arm in some machinery. I was scrubbing that little girl’s arm, and I was crying like a baby the whole time.”

Dr. Servideo pointed out that emergency room physicians have so many more tools than they did 30 years ago. “Back then, we had X-rays, EKGs and some limited blood work. Now we’ve got CT scanners, MRIs, Dopplar ultrasound and multiple lab tests that can tell us so much more.”

The range of medicines has expanded tremendously too. “Back in the 1970s, if someone came in with a heart attack, we didn’t have much to offer – some pain relief, oxygen and nitroglycerin. Now, we can give them clot busters that within 20-30 minutes can dissolve the clot that is causing the heart attack.”

Clinicians’ training has changed, too. “Back then,” said Dr. Servideo said, “We didn’t have the specialty backup that we do now. Acute care specialties were just coming into being back then. Emergency room doctors were just family doctors who worked in the ER.

“And nurses, although they came out of nursing school very well trained and experienced in hands-on care, didn’t have to have the same skills they do now. In 2008, they need to be able to read heart monitors and work IV pumps, things that didn’t exist back then. We have an extensive program for new nurses that includes lots of lectures and hands-on experience, as well as working alongside experienced nurses.”

A close-knit group
Mountjoy and Sutphin remember the early days of the Fauquier ER as a time when the medical staff worked very closely together. “It was a much smaller group,” said Mountjoy. “We had six nurses who worked together for years. And the wonderful doctors… Dr. Servideo, Dr. (Eric) Maybach, Dr. (Steven) von Elten worked in the ED back then.”
Mountjoy remembered, “A child came in who had run her bike down her driveway into traffic. They thought they would have to amputate her leg. Dr. Benjamin Allen was the perfect doctor to help her. He had an artificial leg himself. He was able to offer encouragement and tell the family that their child’s life was not over. He told them how he played tennis and became a ski instructor.”

Foley and Pearson agreed that Fauquier Hospital has been able to attract wonderful doctors. Foley said, “When I first started here, we only had general practitioners, no pediatricians, no OB/GYNs. I remember when Dr. (Tom) Meyers (an OB/GYN doctor) first came here to look at Warrenton. He and Dr. (Bob) Young said they walked up and down Main Street and talked to people. They found that people were friendly and that there was a real sense of community. They wanted to start their practices and raise their families here. I’ve heard that kind of story a lot over the years.”
Of all the wonderful people the nurses remember from their early days in the ER, one they speak of most fondly is “Grandma” Ruth Krusie. Krusie was a legendary nurse whose memory is honored with the hospital’s Ruth Krusie award, given annually to an outstanding Fauquier Hospital nurse.

Mountjoy, Sutphin, Foley and Pearson all were honored with the Ruth Krusie award.

Mountjoy said, “Ruth Krusie was 72 when she passed away, and worked here up until 9 months before she died. She was so much fun, and a wonderful nurse. Before she went home every night, she’d tell us, ‘Watch out for the fools.’ ”

The women also remember the hospital’s snack bar wistfully. Sutphin said, “There was one long counter with some stools, and three or four tables for two people each. And there was the famous chicken salad. Volunteers – the chicken pickers -- would pull the chicken off the bone. It was wonderful.”

Mountjoy broke in, “And they made the best milk shakes. I liked mine chocolaty, but not too chocolaty. They knew just how many squirts of syrup to use for me.”

Mountjoy recalled that one night, visitors to the hospital cafeteria got a surprise. It seems that a jail inmate set his own mattress on fire and was brought into the ER with burns. Mountjoy said, “He escaped and ran buck naked through the hospital -- it was a shorter run back then. He ran into the cafeteria looking for something cool to put on his burns.

“He scared the cafeteria ladies, but one of the nurses ordered him into the shower.”

The nurses maintain that health care was much more of a hands-on proposition years ago. “Because the staffs were so much smaller, the head nurse was not only overseeing and supervising, she was another nurse on the floor.”
Sutphin remembered one day when the nurses would have preferred not to be so “hands-on.”

“There was a bomb scare at the hospital in 1969. Bernice (Pearson), then head nurse of the medical surgery unit, called us in and told us, ‘The bomb is supposed to go off at 7:00. So until five to seven, we’re going to search for the bomb.’

“I was only 17 and said, ‘I’m too young to be doing that. I’m going home.’

“Bernice said, ‘No, you’re not.’

“So we all looked for the bomb.”

Nurses did what needed to be done, agreed all four veteran nurses. Foley remembered a time when there was a shootout at a big country music concert in town. “I saw someone was shot, so I started to jump down and help. Bullets were flying. My husband pulled me back and said, ‘You can’t do that!’ ”

Pearson said with a smile, “Yes, Janice was one of those ‘eager’ nurses.”

All four nurses have deep ties to Warrenton. Pearson’s mother, Inez Gray, was also a Fauquier Hospital nurse, when the hospital was located in a house on Waterloo Street. “ ‘Lady Gray,’ everyone called her,” Pearson said. Pearson has been married for 40 years to Raye Pearson, a police officer she met in the ER.

Foley married Charles Foley, who was a prosecutor for the county, then a judge.

Foley said, “One night, when I was pregnant, a drunk gave me a hard time. He was chasing me around the exam room and I had to call for help.

“The next day he told Charles that a nurse beat him up the night before in the ER.

“Charles told him, ‘I heard about you at about 2 in the morning from that very nurse.’ ”

That was then, this is now

How do the nurses compare today’s brand-spanking new 33-room ED to the six-bed ER of 35 years ago?

“I love the fact that there are all private rooms,” said Sutphin. “We used to have all the patients in one room separated by curtains. And we have all state-of-the-art equipment. The new ED is just beautiful.”

When asked what he thinks of the new ED, Dr. Servideo grins broadly. “It’s fantastic. Having our own CT scanner is a dream come true. We have everything we need to provide the best possible care. You won’t find another ED anywhere that is better equipped.”

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