Suzanne Searle

H7, another world entirely…

Some memories of mine.

In 1978 I enrolled in the ICU nursing course on H7, the adult medical intensive care unit at Health Sciences Centre in Winnipeg, Man. Their post graduate nursing program already had an excellent reputation across Canada and was one of the first of it’s kind in Canada, if not the very first. The instructors were employed by the intensive care unit itself. It was one of the best experiences of my long nursing career. I had graduated from The Health Sciences Centre School of Nursing in 1975. I worked many years in Winnipeg before moving out of province.  I am still working fulltime. That ICU nursing program gave me the basis and the advanced practice skills and tools to build a multifaceted career in nursing.

Classwork, pathophysiology, nursing theory were all combined with practical bedside nursing care with a mentor buddy. Needless to say, I learned a great deal  in that 12 month course. I then continued to work as a bedside nurse on H7 for some years after that. Only registered nurses with at least 3-5 years of medical/ surgical bedside experience could even apply to enter the ICU course . Nurses came from all over Canada to be a part of this program. Some of them never left. There were quite a few from Newfoundland, as I recall.  I enjoyed every minute of it.

I have since worked in pediatric, neonatal and adult ICU’s in 3 different provinces. I have also taught intensive care nursing and developed ICU nursing curricula.

Dr Bryan Kirk, the director of the ICU at that time, was a visionary. Dr. Kirk was the leader of this collection of attending intensivists, residents, nurses and allied health personnel. All the adult critically ill in all of Manitoba and NW Ontario were sent to H7 to receive the very best and most innovative care. It was an ICU/CCU and we, as nurses, regularly rotated through ICU and CCU.

We received them all, patients with: third degree burns with respiratory involvement, almost drownings, hypothermia that required slow re-warming, trauma, ruptured aortic aneurysm that had to urgently be transported to the operating room, septic shock, any and all cardiovascular problems, high C-spine fractures, overdoses, diabetic shock and the list goes on and on.

H7 was one of the first units to place tracheostomies in long time polio patients who had lived in iron lungs since the 1950’s polio epidemic. We taught the patient to breathe on the new portable ventilator. The patient also learned to function with the trach cuff deflated. The patient was then able to speak, despite being ventilated by a machine. The small ventilator fit on the back of the wheelchair and would run on a battery. This brand new approach afforded these patients with newly found freedom and a whole new life.

In the late 70’s, there was no place other than an ICU that a patient, who could not be weaned from a ventilator, could go. Dr. Kirk accepted a 13 year old girl from Children’s Hospital with cystic fibrosis who was ventilator dependent , as she had end stage pulmonary disease. This patient had primary nurses assigned to her care. I was one of those primary nurses.  We developed a chronic care plan for her. After weeks on H7, she stabilized.  In collaboration with her parents and her nursing team , Dr. Kirk decided that we could provide ICU care in her home. It was truly a team effort.  After all the necessary equipment was placed in her own bedroom, this little girl was returned to her own home in Winnipeg. ICU primary nurses travelled there daily to provide 24/7 care with the help of H7’s respiratory therapists. Her parents and brothers were able to see her every day. She was surrounded by her loving family until she passed away at home.  This type of palliative care was revolutionary in 1979.

H7 was the first unit in the Health Sciences Centre and possibly one of the first in Canada to create an “in house pharmacy” with our own dedicated pharmacists. This also took place in the late 70’s.  IV medications and total parenteral nutrition was prepared on H7 by pharmacists. Previous to this, all IV meds and IV pump mixtures were prepared by the “med” nurse for that shift.  We had all rotated through the medication nurse position.  This was also a revolutionary idea at the time.

I remember working almost 24 hours straight during one of Winnipeg’s worst blizzards. I had been working a 12 hour night shift and the unit was full. Not only could the night shift not get home but the day shift could not get to work. All the staff just kept right on working. We took short naps in shifts and cinnamon buns and coffee were brought right into the unit for us. We certainly never even thought of leaving those critically ill patients. The camaraderie was magnificent. We always pulled together in a crisis.

I remember another time when we were informed that seven patients were being flown into Winnipeg with severe methanol poisoning. All seven would need mechanical ventilation, cardiovascular support and urgent hemodialysis. They all arrived at the same time. Extra staff was called in to cope with this emergency. All seven patients needed arterial lines, Swan Ganz catheters, central IV routes, E-tubes and ventilators and femoral dialysis lines. No one went for a break that night. Each patient had a team of H7 professionals  around them all night long, consisting of an RN, intensive care resident, RT, dialysis nurse and health care orderly. Yes, we had orderlies in those days and they were worth their weight in gold.  When I left at 8 AM, all seven patients were still alive.

If H7’s resident patient, Kevin Keough,  was unwell, an RN would be assigned to care for him alongside his usual health care orderly. Kevin, at the age of 9 years, had sustained a high C-spine fracture. He could not breathe without a ventilator. He was paralyzed from the neck down. We all had the opportunity to care for Kevin at one time or another. Kevin was a teenager at that time and had already lived on H7 for some years. Much has been written about Kevin in the past, so I am able to mention his name.  Kevin’s care and environmental adaptations were also revolutionary for the time. Kevin, as a human being, was bright and funny with a very wry sense of humour.  I always enjoyed spending the day with him. Kevin lived into his 40’s. He was able to move into his own apartment in time.

In the late 70’s, H7 staff would be flown up north to transport critically ill patients out of northern Manitoba. An RN, intensive care resident and an RT would travel to the airport, loaded down with ICU equipment, board a Cherokee aircraft and fly north. Often, this was needed for a patient with cardiogenic shock. It always seemed to be in the middle of winter. We would stabilize the patient at the small northern hospital, board the plane and fly to Winnipeg. An ambulance would be ready and waiting at the airport to rush us back to H7. More than once, I performed cardiac compressions in the aircraft with the resident holding me up in the air by my belt so I could get the necessary leverage. There was not much headroom in those old Cherokees. Sometimes the IV lines would partially freeze while moving the patient outside from the hospital to the plane. The Respiratory therapist would have to hand bag ventilate the patient for the entire trip. It was exciting work.

If the situation was extremely unusual, you could bet that the patient would end up on H7. One day, we received a patient from the plastics ward with actual Tetanus (Lockjaw). This patient was a farmer who had never received a Tetanus vaccination. He had sustained a crush injury to his hand while trying to fix a piece of farm machinery while it was still running. He had developed full blown Tetanus. This was something that most Canadian health care professionals had never seen.  He was intubated and placed in a pharmaceutically induced paralysis and coma for weeks.  When he was allowed to waken, he had no memory of his ordeal. His care on H7 was so excellent, that he had few sequelae. He was transferred to the Rehab hospital for intensive physio and recovered completely.

In the late 70’s, as a fund raising effort for H7, H7 nursing and allied health staff compiled an annual cookbook of favorite recipes. These were published and sold. They were very popular. Several pieces of new equipment were purchased with the proceeds.

I had many mentors and friends while working on H7. I remember them all.  I felt respected as a health care professional. My confidence as a young nurse soared.  It was a place of nurture and endless intellectual stimulation. I felt that I was a member of a team. I have worked in several different fields of nursing over the last 40 years in three provinces. My years on H7 remain as some of my fondest memories. It was a very special place.

Suzanne Searle, BA RN CCRN