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Nurses aren't in the spotlight on 'Hopkins 24/7,' but just beyond the camera's range, they are a vital link in this vital work.

September 28, 2000|By Patricia Meisol | Patricia Meisol,SUN STAFF

"I am thoroughly enjoying the `Hopkins 24/7' show, as I am a nurse here at Johns Hopkins ... but my one concern is, where are the nurses? Teamwork is what has made Hopkins the number one hospital in the country ... not just the doctors ..."

"What's the big deal with this nurse issue? Let's get something straight. Hopkins established its reputation because of its doctors, not nurses ..."

- Comments by Internet chat-room visitors, reacting to the ABC series "Hopkins 24/7"

The Johns Hopkins Hospital operating room floor is a scruffy place: old tile floors, block walls, cold steel doors that swing open with a continual parade of men and women in green scrubs. Once inside, they dig into boxes of shower-cap paper hats and lean into the wall as they cover shoes in blue paper slippers.

Pushing paper masks up against their noses, they tie them behind their heads in two places and scrunch up the bridge for better ventilation before they take up a post inside one of the 23 operating rooms lining the seventh floor.

These are the nurses unseen by the TV cameras.

Some wear rubber-soled clogs, with holes to let air circulate. Janet McIntyre, 46, the coordinating nurse for pediatrics surgery, prefers sneakers as she moves in and out of the operating rooms, checking for safety issues, relieving people for lunch, running down three flights of stairs to a supply room of boxes stamped with enough codes to confuse the Pentagon.

Once, 20 years ago, she wore hard white shoes, a white uniform and cap. Now, in her scrubs - a safety pin securing her rings inside her shirt pocket during surgery - she is indistinguishable from the doctors.

Nursing is her passion; she is the right hand to the surgeon, mentor to residents and interns, and special assistant to anesthesiologists, all things that serve a nurse's central role of patient advocate. She also gives out her phone number to patients. Hopkins is a big place, and she volunteers to be their guide.

"I know the system," she says, "I can direct them."

Nurses wait in line to work in McIntyre's pediatrics OR.

The close-knit team of 12 nurses and eight medical techs offers a back story to the real-life dramas being aired by ABC about the doctors who work the floor: Ben Carson, who cut out part of the brain of toddler Alex Moody to stop her seizures; Paul Colombani, the chief pediatric surgeon, who tried to save a young girl from cervical cancer; and Michael Ain, the pediatric orthopedic surgeon who overcame his condition as a dwarf to succeed in medical school and specialize in correcting skeletal deformities in children.

McIntyre has taped episodes of "Hopkins 24/7" to show her daughter, a pre-med major at College of the Holy Cross. It doesn't bother her that she does not appear in them; she's content to know that in the operating room, her opinion is valued.

As the coordinating nurse, she's in charge of the schedule and safety; several times on this day she will weigh in on safety - remind an intern to wear protective goggles or a doctor to wear a special mask. She wants to make sure the whole room is "in sync."

"It's my Catholic upbringing," she confides.

In the hallway, she signals Sarah Byun to take off her earrings before going into the OR.

At 23, Byun is the newest nurse on the floor. She took part in the toddler's seven-hour brain hemispherectomy and held the door open for ABC camera operators as often as she handed Dr. Carson supplies during the operation.

But her work in the huge operating room was outside the field of operation - and the camera's view. As circulating nurse, she sits over to the side, climbing on and off her stool, recording details, reaching for supplies, leaving hourly to reassure the waiting parents.

On this day, she's playing the same role in a gastrointestinal case involving a 1-year-old with reflux. She runs Dr. Colombani's operating room while he inserts a feeding tube into the child's stomach. As soon as she sits down, she is up again, off to a hallway cart to find the right sized dilator, a rubber tube that allows the surgeon to see better.

Next the scrub nurse - the nurse or tech who hands equipment to the surgeon at the table - needs sponges. Then the tech asks for suture, the silken thread used to stitch shut a wound. Byun pulls individually wrapped packages from shelves of marked boxes behind her and walks them over.

In the report on her desk, she describes all that happens here today - the lines of fluid the child has been hooked up to, his medical history, the location of his family during the operation, and her efforts to keep the child warm.

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