by Matthew  N. Skoufalos

 

April 15, 2013 was not a normal day in the city of Boston.

It was Patriot’s Day, a local holiday commemorating the Revolutionary War battles of Lexington and Concord, which also coincides with the annual running of the Boston Marathon.

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And it was the date that a pair of explosives were detonated at the finish of the race, killing three people, injuring another 264, and keeping hundreds of others from completing the actual contest.

For 28-year-old Stephen Sladek, RN, it was a day that even began uncommonly. Sladek had been shifted off his normal 7 a.m. to 5 p.m. rotation, and was still trying to get his bearings at the beginning of his workday when he was jolted by a barrage of text messages.

“One of my good friends was at the marathon, and she told me ‘Oh my God, there were two explosions,’” he says.

“Not even 10 minutes later, they called a Code Amber.”

At Brigham and Women’s Hospital in Boston, Patriot’s Day is a holiday that nurses and other employees commonly request off, but it was still relatively slow, with few procedures scheduled, Sladek recalls.

Once the Code Amber went out, however, anyone who wasn’t currently assigned to a case was pulled into a makeshift O.R. command center and divided by specialty. Sladek was tapped early. His background in vascular, orthopedic, neurologic and trauma was specially useful because many of the incoming trauma patients were suffering from lower-limb injuries. Brigham and Women’s received the most patients that day of any area hospital.

Sladek cut his nursing chops at Aria Health’s Torresdale Campus in Philadelphia, after earning a diploma in nursing and an ADN from Aria Health School of Nursing. After five years, he hit the road as an operating room travel nurse. His second travel assignment was at Brigham and Women’s, and after a yearlong post, he was offered a job. In Boston, Sladek re-enrolled in school, this time at American Sentinel University to earn his BSN degree. He says that being back in school helped him improve his critical thinking skills and renewed his focus on teamwork, both of which were essential on the day of the Boston Marathon.

Brigham and Women’s is only about a mile from the marathon route, Sladek says, and with so many first responders nearby, “they were able to ship people really quickly.”

“I got pulled right away to take care of a patient who had a traumatic ankle injury,” he said. “From the time that we found out to the time that I had my patient, it was basically 45 minutes.”

Sladek’s patient was the first one brought into the O.R. and the last to leave, he says. After extensive vascular work, the surgical team was able to save the patient’s foot despite working with a mostly destroyed ankle. Eventually, however, “they decided that for mobility issues and for establishing a normal life again, the patient needed to have a belowthe-knee amputation,” Sladek says.

OR Today | August | Spotlight “If they would not have taken that patient’s leg below the knee, eventually down the road they would have had to do some sort of ankle fusion, and they never would have been able to walk normally.”

The days and weeks that followed were just as hectic, Sladek says. He says he saw another four or five patients with similar injuries to their lower extremities. One patient had taken shrapnel to the thigh and abdomen and required a muscle graft to close the wound. The hospital recruited some volunteer war veterans who’d faced amputation to speak with patients facing similar circumstances.

The emotional weight of those days was compounded by media saturation coverage of the bombings—and the search for the perpetrators afterwards—that even followed Sladek home from work. For a little while, he says, “it was inescapable.

OR Today | August | Spotlight“Even when I would leave work, the first thing you would do is go and turn on the TV and it was all over the news,” Sladek says. “Even when I was home, in my own time, I was still constantly bombarded with all of this. “With the manhunt going on and with all of it hitting so close to home, going down into the city was a little nerve-wracking, knowing what just happened,” he says. “It probably took me a good week to sit down and think about it in my own head and process what occurred.

“For most people working in healthcare, that’s probably the general consensus,” Sladek says. “We just didn’t have time to process the event.”

When he did get to think about it, Sladek was troubled by guilty introspection: he had been planning to take the day off and attend the marathon, and the overwhelming relief of not being near the incident almost made him irrationally ashamed.

“The next thing that went through my mind was why would someone make a point to hurt innocent people,” he says. “And the last thing: every day I take care of people who have injuries and diseases going on, and it was really gratifying to know that I was able to, in part, help someone that has now a lifelong, devastating injury.”

But even among all that grief, in the moment, all that he could focus on was his training, Sladek says. It’s what got him through the enormity of the situation.

“You put your feelings aside and really focus on what the situation at hand is,” he says. “It went into where it wasn’t about me, it was about me taking care of this person now, and to fix what injury they had.

Even without knowing the nature of the procedures they’d be tasked to handle, Sladek says that his team “basically kind of threw a table together just on experience with cases like that,” he says. And thanks to their training, “we basically had everything we needed to do that case.”

“We were able to make a really solid judgment call.”

Although Sladek came to Boston as a traveling nurse, he plans to remain n the city until he finishes his BSN. He says he’s fallen in love with the smallness of the community in Boston. In many ways, the tragedy has reverberated throughout so many lives, he says.

“Even if two people didn’t know someone actually hurt by the bombing, you had a friend of a friend who knew someone who was.”
The biggest thing he took from the event, however, was that dealing with the trauma of the bombings “really solidified” his choice “to pursue what I think I was meant to do,” Sladek says.

“I can definitely say that the whole events really boosted my confidence. After I finished that case I kind of sat back and I was walking home from work, and I don’t really remember a lot of what happened. I was so focused and so confident that I didn’t have time to think,” he says.

“Having mass casualties like that is something that you see on TV,” Sladek says. “Being involved in that situation and seeing how well my coworkers came together as a team was really inspiring to me, and it really reminded me of why I do what I do.”