Message from a Baghdad hospital

I got another email from our modern day Florence Nightingale direct from Baghdad:

Tonight as I write you this email, I am listening to booms from either mortar fire or now after looking at the news an ammo depot that caught fire. It is a bit humbling to hear munitions so close to the hospital. I'm in the International Zone ( AKA the green zone ), but we are no more safe in here behind the walls than outside. Although at least I am not out looking for insurgents or conducting sweeps of the local towns as the other soldiers are doing. I am in the hospital taking care of patients.

Tonight I am working in the SDU (step down unit). It is a little different from the ICU. The patients here are usually not intubated, or on ventilators. Their medical/surgical issue does not require one on one attention from a nurse or require certain medications to keep them alive. Basically they are doing fairly well on their own they just need frequent monitoring of their vital signs and of their issue to prevent further deterioration in their condition. Usually they stay for a short period of time before they are transferred to a ward. Tonight I have 4 patients. Not bad. :)

This last week was a rough week for me. It is hard to say a rough week without laughing at myself, because I have really only been here for 3 weeks thus far. Plus, the people who have been deployed before keep telling me that things really haven't gotten too crazy yet. I'm afraid of this!

The ICU is my new challenge as I think that I have expressed before. We take care of Iraqi nationals, Iraqi Army, Coalition forces, and US soldiers. Mostly we take care of the Iraqi people which includes suspected insurgents and prisoners. It is a real challenge to care for someone who may have killed, attempted to kill, or injured a fellow brother or sister in the military. It is a topic of discussion amongst my fellow nurses and poses many issues for us. It is my biggest ethical dilemma I have faced in the last 9 years of nursing. I do my best to take care of any patient that comes my way and I work just as hard to keep them alive regardless of who the are.

I took care of a Marine last week which became a difficult challenge for me. Not only was he very injured with an amputation being only one of his injuries, he was, what we call unstable. He had a hard time maintaining his blood pressure , which of course can lead to many other issues. I worked so hard that night from the moment he rolled up on my floor to the next night when I put him on the chopper to send him on his way back to the states. I just hope that all my efforts were enough. He has a difficult and long road ahead of him. After working at Walter Reed for the last 2 years I have seen the new challenges this soldier will face. A soldiers resilience to adapt and overcome the obstacles placed before him is one of the most amazing gifts I have been a witness to.

I get attached to my patients. It is so hard for me not to. As an Army nurse you share a common thread with those soldiers that you care for. They are your brothers and sisters in arms. They fight for freedom and i fight for their life. My battle buddy coined that phrase the other day and I almost broke into tears. It sums up how I feel, how I work, and why I am here.

I also learned about Angel flights this week. Angel fights are the flights where the American soldiers who have died are flown home to their families. I have not been a witness to the actual loading of these great American heroes because it hits a little too close to home for me. I'm not sure that I can quite handle that at this point. I was told about what happens though. The Army song or the Star Spangled banner is played while each soldier is removed from our morgue and hand carried and placed on the helicopter. A salute is rendered to the soldiers on that bird by the hospital staff standing at attention on the helipad. It is a solemn moment. The soldiers from what I understand are flown from us another base and a memorial ceremony is conducted there and then they make their final journey home. Maybe I will find the courage to witness this flight, but for now I will honor those fallen.

I have seen alot this week. I have been exposed to amputation, multiple fractured body parts, gun shot wounds, and a variety of other trauma that I couldn't comprehend until I got here. I am giving medications I have never given before and transfusing blood at a pace unsurpassed in my nursing career. I am working with monitors and equipment I haven't used before. I am using supplies that may not get replaced as quickly as I wish they would. I am making the best of what I have.

On a lighter note, I just want to say thank you for all of you that have been sending me packages. I appreciate them so much. My roomies do to. I love getting mail and you have made going to the mail room exciting for me. Thank you so very much.

Oh and I decided that I would save my little updates and use them in my scrapbook when I get home, so... if any one happened to save my very first email I would appreciate if you could forward me it so that i can print it off and save it.

I guess I will end this here. Let me know if you have any questions or want to know about certain things that I am doing or whatever so I can include them in my next email. I hope all is well with you! Missing everyone.