Question: What do you do with a recovery room nurse who has laryngitis?

Answer: Teach her how to pull femoral artery sheaths.

So my “flu” of last week petered out into a cold, and then eventually robbed me of my voice. I almost called in sick because of my inability to talk. Think about it. Do you think you could do your job without a voice? I mean, half of what I do is explaining to the patient what the heck is going on. And the other half is giving discharge instructions.

Oh but there’s another thing that cardiac recovery room nurses do and it doesn’t involve much talking. They remove femoral artery sheaths. This is something that the staff nurses usually do but because of my silent state, they decided it would be useful to train me on this skill.

Now, I used to think, what’s the big deal? It’s just pulling a line and then holding pressure. I used to pull lines from the radial artery all the time. The femoral artery just requires a little more pressure right?

Wrong.

It doesn’t require a little more pressure. It requires SO MUCH MORE PRESSURE that your hands eventually become cramped and numb from holding them in the same spot for twenty minutes. “You might want to fill out some of the charting before you pull the sheath, because afterwards you might not be able to hold a pen.” Ha, I thought, she’s got to be exaggerating. Turns out she wasn’t.

Sheath pulling also requires the ability to respond calmly under pressure. Last week the doc was pulling the sheath on one of my patients and after he was finished holding pressure, the artery blew. Let me tell you, it wasn’t pretty. All I saw was an arc of blood pulsing into the room, covering everything, including the doc. And at that point the only thing he could do was to start holding manual pressure again. The patient turned out fine, BTW.

At any rate, after learning the skill myself I have a new respect for those who pull sheaths. It takes patience, a steady hand, and lots of muscle.