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"People are nervous. In our chambers, they aren't
allowed to wear their clothes or watches or have books.
We have to teach them to clear their ears," Hall
said. "It's like diving, and one of the main problems
we have is with ears popping.
"Depending on the condition they're being treated
for, they are in there for up to six hours, and at a
minimum two hours. We do have TVs they can see."
Patients are monitored while they are in the chamber,
Hall said, with no more than two patients inside per
staff member.
Hall's unit does an international training course for
hyperbarics and has an advanced hyperbaric symposium
for health care professionals annually. "About
30 people attend each course, and probably half are
nurses or techs."
The two types of hyperbaric chambers are monoplace
units and multiplace chambers.
Monoplace units treat one patient at a time and are
made of acrylic with a pressure capability of three
atmospheres compressed with 100 percent oxygen.
Multiplace chambers can treat from two to 18 patients,
with a pressure capability of six atmospheres. These
chambers are on compressed air, and patients are provided
with oxygen through an individual delivery system.
Staff members enter and exit the chamber through an
access compartment. In this compressed air environment,
nurses face the same risk of getting the bends as scuba
divers. Compressed air is an oxygen and nitrogen mix,
and under pressure, the body absorbs nitrogen.
As the body decompresses-by a diver ascending, or a
nurse exiting a hyperbaric chamber-the nitrogen is released.
If decompression is too fast, it can form bubbles. Nurses
keep track of the time they are in the chamber, keeping
dive tables just like scuba divers. Those at high altitudes,
like Furnas in Denver, have to take that into account
as well. Flying in an airplane is not advised for several
days after spending time in the chamber.
"It's a manageable risk," Vincent said, "but
there have been some cases of decompression sickness
in the industry."
How much nurses actually work the equipment varies
from unit to unit. At monoplace chamber facilities,
nurses are more likely to be involved in running the
chambers.
In multiplace facilities, specialized techs run the
chambers while nurses manage overall patient care, attending
inside with the patient-and watching that martini effect.
Demand is growing, Vincent said, and so is supply.
More than 500 facilities provide hyperbaric treatment
in the country (a list is available at www.scuba-doc.com/listchambr.htm),
and the addition of the new Medicare diagnosis likely
will spur substantial growth.
Better reimbursement makes it more cost-effective for
hospitals and companies. Because staff members at multiplace
chambers have to decompress between shifts, these facilities
have to employ a large staff.
"The field is always growing and changing,"
Hall said. "There is a lot of research, so it is
a great opportunity for nurses who want to get into
research.
"This is a very interesting specialty because
there's a lot of stuff that hasn't been substantiated.
A lot of what we get comes from Navy and Air Force practice,
and clinical applications provide a lot of opportunities
to look at different equipment and profiles."
Nurses attracted to the field tend to be those with
a "firehouse mentality," Wreford-Brown said.
It also helps to be a team player.
"I think it is the best of several worlds,"
Furnas said. "I like critical care, but not as
a steady diet. You get ambulatory patients and pediatrics.
There's a nice variety, which keeps things fresh."
Not to mention six martinis with no hangover.
Contact Melissa Gaskill at gaskill@dbcity.com
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