Florence Nightengale Spring 2007 update

This posting is one of a series of updates from the Green Zone in Baghdad, Iraq. Our Florence Nightengale has been in Iraq since September 2006 and has had her tour extended, so will not be returning in September, as she was told, but will come home to a warm welcome in November 2007.
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(13 May 07)
Hello All!
I found some inspiration to write an early May update. Today is Mother’s day. I’m wishing you a, HAPPY MOTHER’S DAY to all my family and friends. I wish I could be home to give you all a great big hug and tell you how much I appreciate all of you. It is on the holidays that you realize how important your family is. It doesn’t matter if you get along well with everyone in your family or not, when you are over here in Iraq you start to learn how to appreciate certain things in your life and the importance of family and friends.
I was very lucky this past week. I was able to go over to my younger brother’s FOB and reenlist him. Luckily with the help of my Head Nurse, we were able to make the visit possible. I was able to spend 3 days with him and I have to say I had the best time. My brother and I are very close. You could say it is because we are so much alike.
I took a helicopter over to his FOB which was all of five minutes away. The catch is that it is in the Red Zone. My hospital Commander has a policy that no one will convoy into the Red Zone so permission to leave the FOB must be obtained through both the company commander and him. My brother’s unit was aware that I was coming over, but when I arrived there was no sign of anyone from his unit. Luckily the SPC that is in charge of the LZ gave me a ride over to an area where he said that some 504th guys usually were. Well, of course when I arrived no one is there. Someone was able to call the unit and a SGT came over and took me to Matt’s unit CP (command post). They were then able to get in touch with Matthew and he came to pick me up.

Matthew and I spent the next three days watching movies, playing pool, walking around the FOB, and talking. I swear Matt and I can go on and on forever with conversation. It was funny because we went to lunch when I arrived and as soon as I walked inside the DFAC it was like everyone stopped eating and stared at me. It was creepy. There are females on this FOB, so I was like what are they staring at. Matt said it was because there are not that many female officers around so I was a rare sight. The staring continued for the next three days. We were also approached my several of Matthew’s NCOs along with the chaplain that did his marriage counseling. Yeah, they were all checking out who he was talking to and why he was sitting alone with a female soldier at chow. He quickly introduced me as his sister and the look of relief washed over their faces. Too funny. Apparently they are really big on fraternization especially male female type. So they were basically checking up on him.

(17 Jun 07) So, with good intentions I started my May update on Mother’s day, however, as you can tell I didn’t finish it. Let’s just say from that day forward was a whirlwind month. The number of patients and sadly the number of soldiers we care for in the month of May surpassed our numbers in October which was our busiest month thus far. It was sad because this is the month of Memorial Day where we should take time to remember all those who have served and made the ultimate sacrifice for our freedom. It is also the day in which, 3 years ago my boyfriend, Ken was killed. I was upset that I could not join my California family and visit him in Arlington to celebrate his life as we have for the last 3 years. I was upset that I was here in Iraq fighting in a war I just can’t see an end to. I was upset because I was taking care of wounded soldiers and knowing that some of their buddies had died beside them. I was upset that they were getting hurt and killed in this country for some unknown reason that escapes my mind. "

On the 30th, the 3rd year anniversary of Ken’s death, I took care of an American soldier that came in with massive head trauma and a large open wound from his hip around to his butt. The plan was to receive this patient from the OR and then immediately air evac him out to Balad since he had a head injury. This kid arrived on a litter because I figured if we are immediately evacuating him out, it would be better to package him on a litter already and save us an extra step. I like the philosophy of work smart not hard. When the soldier arrived he was accompanied by the anesthesiologist and the surgeons. Our ICU doc was also right at the bedside too. This poor kid had extensive swelling in his face and head, black and blue eyes, and a head wound. He also had a chest tube, foley catheter, a large wound from his hip to his butt with a large dressing on it and all dressings were already bloody.

This kid needed blood and he needed blood right away. My fellow co workers helped me get the monitor on him and we connected him to the ventilator. We were getting vital signs and I was assessing the patient from head to toe as someone else was running downstairs to get the blood. We rapidly infused this kid with over 16 units of red blood cells, 10 units of fresh frozen plasma, 3 units of platelets and gave him two rounds of factor 7. His blood pressure at times dipped down low and we would have to give him fluid boluses to bring it back up. On top of that we were trying to keep him pain free and somewhat sedated so he could tolerate the endotracheal tube helping him breathe. Once we infused a number of these blood products into this kid and the pace was starting to slow, I took a step back away from his side and looked down. I was covered in blood as well as standing in a puddle of it. I had it all over my shoes and pants. I looked under the litter and found that this soldier was bleeding from his wounds on his hip and from his head.

We redressed his head wound and applied a pressure dressing to the bleeding area. We also reinforced and created a pressure dressing on his hip wound. The two round of factor 7 that we gave him is supposed to help stop bleeding. It was a structured chaos as I tried to manage this patient. Oh, and let’s not forget that I also had another patient that was intubated and vented and had to maintain a blood pressure map in the 60’s to prevent him from bleeding because a gun shot wound he sustained shredded his liver. Sounds like fun doesn’t it? I hated being me that night. I am a good nurse and my standards are high so if things don’t get done, I tend to beat myself up for them.

The next issue we faced was the weather and the sky/flight conditions. There are certain weather conditions that our helicopters can and cannot fly in. There is green status which is a perfect weather condition. Amber is cautionary flight conditions. The wind may be moving too fast or there may be a lower level of visibility. Red is usually when the visibility is nil and it would be too dangerous to fly with out jeopardizing the lives of the flight crew and patients. The colors also pertain to enemy contact potential as well. The problem with being stuck at our CSH is that we do not have any neurosurgeons. The patient was potentially going to need a craniotomy to relieve the pressure and swelling on his brain and Balad is the best place for him to have that type of procedure done.

I have to thank God for my battle buddy Kim. She is the best. She really helped me out with everything going on. She keeps me calm and focused and we work as a tag team to give the best care possible.

I also had some much needed help from “Papa Bear”, a Captain with 30 years of Army experience. He jumped right on in after he stopped by to check in on us on his day off. There were no questions, no complaints, he just jumped on in and helped. Without these two awesome people, I would not have been able to handle my overwhelming assignment.

I think I will close this update for now. I need to start on the upcoming June one. I am amazed everyday here with the different things I see and experience. I just hope that I can stay positive and close this chapter in my deployment with a happy ending. I have made some good friends and worked hard. I have seen soldiers survive unimaginable injuries and have eased them into death. I remember today and everyday the sacrifices of my fellow soldiers for the freedoms I live to enjoy. Remember, FREEDOM ISN”T FREE.

Love to all,