Nurse power: cardiac catheterisation

We all know the reception team runs a vet clinic; a vet-led team is mainly able to function because of a good support team in the clinic.

Secondly, we nurses know how to find everything, as well as:

• how it works
• the password needed
• how to order another one

To support this, a recent discovery in the archives offered a perfect description of the nurse’s role in research and advancing progress in medicine.

The question

It’s a little outside of my research period, but let us go back to 1920s Germany, where a medical student was mulling over a question raised by a lecturer:

“Is it possible to reach the heart through the veins or arteries without the need for traumatic surgery?”

This type of access for cardiac treatment is now routine, but open heart surgery was the only option in the 1920s – an extremely invasive and high-risk procedure.

Enter the vets!

There had been an article describing how a vet had reached a horse’s heart with a catheter via the internal jugular vein.

The context of the procedure was not given, but the article inspired this medical student to consider venous access to the heart in humans. He decided he could use a catheter to reach the heart via the cubital vein.

Enter the nurses!

The student tried to get ethical approval to try this on a patient, it was denied. He then asked if he could try this on himself… but was again denied. Then the power of the nurses comes into force.

“Undeterred, the young surgeon spoke with the operating room nurse; as the keeper of the equipment, he would need to have her permission.” ¹

So the chief of the hospital had refused twice to support the experiment, but the real key to being able to carry it out was the “keeper of the equipment”.

Impressed

So impressed was the nurse with the idea that she volunteered to be the patient. However, the medical student would not consider it, and just required her to give him access to the equipment and take the all-important x-ray to prove his theory was possible.

What happened after this is not clear, but we do know this was the early evidence that access to the heart did not always have to involve risky open surgery – and all facilitated by a question and a nurse.