Olden Days of Nursing: Coronary Care Unit

 

I helped open the first CCU in New Jersey in 1967. New monitoring technology and implementation of coronary-pulmonary resuscitation precipitated the development of CCUs across the country in order to reduce deaths from acute myocardial infarcts (AMI).

Bethany Hospital in Kansas had opened the first CCU in the United States on May 20, 1962. The second one opened soon after in Philadelphia’s Presbyterian Hospital. It was at Presbyterian Hospital that Rose Pinneo, head nurse of the unit, along with physicians, Lawrence Meltzer and Roderick Kitchell, coauthored Intensive Coronary Care: A Manual for Nurses in 1965. 

I remember the manual and especially Rose Pinneo. Pinneo became a role model for all the new CCU nurses at the time.

I kept this picture in a photo book over the years. Just recently, as I went through all my old photos as a “sequester in place” pandemic project, this picture took on a new significance. It would fit under: “Olden Days of Nursing,” a new grouping of stories I am starting to post on my Blog.  

It was only after I began to do some research that I recognized that right from the inception of CCUs, nurses ran the show. At the time this benefit eluded me. I was still a neophyte. I had not yet dealt with the paternalist health care system and rigid legislation that limited nursing practice. 

I was pleasantly surprised to read about how nurses were positioned to take charge right from the inception of CCUs:  

The opening sentence (in Intensive Coronary Care: A Manual for Nurses) in set the tone: “It may seem curious that the first book dedicated to a new concept of treatment for acute myocardial infarction has been directed primarily to nurses rather than physicians.” They (the authors) emphasized that the new treatment technologies had to be used immediately in order to save lives. To achieve this goal doctors must abandon traditional notions of a nurse’s limited role in clinical decision making.The authors declared, “Intensive coronary care is essentially an advanced system of nursing. It is not an advanced system of medical practice based on electronics.” Their prescription for saving lives was explicit: “A CCU nurse must be able to perform…therapeutic measures by herself without specific orders.”[Italics mine.]

. . . Support for giving specially trained nurses authority to defibrillate patients grew quickly in the late-1960s as concerns about the legal implications of the practice declined. The CCU-inspired empowerment of nurses represented a critical first step in the evolution of team-based care that is such a conspicuous part of current-day cardiology practice.

Resuscitating a Circulation Abstract to Celebrate the 50th Anniversary of the Coronary Care Unit Concept, W. Bruce Fye, Circulation. 2011 Vol 124 (17), 1886-1893. 

The first few of months in the CCU, I supervised the set-up of the physical space, hired nurses and organized the classes to be given by cardiologists. I gave lectures to the hospital staff nurses and administration about this new clinical specialty unit. 

I worked in the CCU for only ten months. Newly married, my husband and I moved to another state because he had a great job opportunity. Over the next few years, we moved five times, had two children and I worked part-time at two other CCUs. When I started school for my bachelors’ degree in 1970, I never went back to the CCU. Cardiology is still my favorite specialty.