Where were you in 1966?
I was certainly not at Stanford yet, but last week I met a group of nurses who set the stage for nursing practice at Stanford. In the early sixties medicine was grappling with how to care for patients after a heart attack. At that time, the primary method to respond to MI’s was to open the patient’s chest and do a direct heart massage by hand. External chest compressions were just being investigated and EKG’s were brand new. In the words of the then Chief of Medicine, the EKGs were a flash in the pan and holds no new teaching or clinical value.
Enter Dr. Alfred Spivack, one of the early Cardiology Fellow’s at Stanford’s School of Medicine. He was very intrigued with this new technology and began to study how the medical community around the world was caring for Heart Attack patients. These patients had a very high sudden death rate after the initial heart attack and what the new EKG’s were telling us is that these patients were experiencing dysrhythmia that caused subsequent heart attacks and deaths. At that time, Cardiac Care Units were just being implemented at a few hospitals in Scotland and Australia. Dr. Spivack went to Stanford Hospital leadership who grudgingly gave him four beds on W1A for this new CCU. He recruited nurses from the ICU’s and started Stanford’s Cardiac Care Program. There were no residents or trainee or other MD specialties. The nurses did it all. They diagnosed all types of arrhythmia’s and with Dr. Spivack, determined a plan of care. He trained these nurses in the use of CPR and how to deliver high dose electrical shocks to reverse any and all dysrhythmias. Together, the nurses and Dr. Spivack put in the first CVP lines to measure pressure in the heart. Most of these nurses came together with Dr. Spivack in honor of their contribution to cardiac care. Some of these nurses you still know and work with today — Maryanne Champagne, Nancy Houston-Miller to name a few.
Nurses are leaders, explorers and innovators. Everyday, nurses use their creativity to improvise and improve their workflow. That creativity could one day lead to a potential new discovery that could change or save someone’s life. I continue to be amazed by all the groundbreaking work that our Stanford nurses do. You are all our visionaries and reformers for modern health care.