I can't believe they didn't put him in ICU the 2nd time around! Good thing you found him when you did.

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code blog

I'm graduating from nursing college in 7 weeks, and just had my first code yesterday.
I had taken care of this gentleman (who had undergone a CABGx4 2 weeks ago and had a small stroke 1 week after the procedure)all day and everything had been fine. I performed my second set of vitals and assessment at 11:00; the patient woke, nodded to me, and I carried on talking small talk to his wife while I completed my assessment. Not 5 minutes after I'd left his room, a respiratory therapist student pages the RN and myself to inform us that "the patient seems unresponsive".
As my RN and I charge into the room, we were greet by a horrified wife and an ashen man, staring blankly out into space in his chair. By the time we crossed the room, he was blue and by the time my RN approached him, he vomited what seemed like his tube feeding all over himself. She called the code- our rapid response team came right away. We got a pulse back-and the patient was taken to the CVICU. The whole time I felt utterly useless and wanted nothing more than to run into the lockerroom and cry- but, my RN looked at me, told me I was doing great, that nothing had been my fault, and that this is what we do. I belived her-and I'm very grateful to have someone so calm in such a crazy moment.

It might be hard to believe, Daisynurse, but someday it will be YOU who is some nursing student's calm in the storm

I hope everything works out for your patient. Good thing (uh, kinda) that you got your first code out of the way while still in school. Not only did I not see a code, I never even started an IV until after I graduated.

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code blog

I am glad, Daisynurse, that you were with an experienced RN.

Something happened at my facility three weeks ago that still troubles me: An old man died. And an RN may have died that night as well.

It was 0400 on a Sunday morning. I was busy in my office trying to find the bottom of a stack of papers when I suddenly noticed an RN quietly standing in the doorway. I do not know how long she had been there. I smiled at her. She said, "The man in room ___ is dead." Her voice was calm. Her eyes were not.

I stood up and walked toward her. I said, "He is a DNR... right?"

"Yes," she replied.

At the nurse's station, as I was reaching for the patient's chart, the nurse said, "I think he is... I don't know..."

There was no "DNR" sticker on the front of the patient's chart.

I ran to the patient room. His waxy appearance, his dependent lividity, and his very cool body told me he had been dead for quite some time.

For the sake of the man's apparent wishes, I called a code.

The man stayed dead.

I asked the nurse to tell me the story. She did - with a totally flat affect. Then she said, "I don't want to go back in there. And... I don't want to go in there..." The RN's charge nure reassigned the RN's other three patients. I pulled another RN from another unit to keep her company for awhile. The injured RN agreed to see me at the end of her shift.

I called the man's family. They trailed in and out of the man's room for three hours. "He wasn't supposed to die!" "They just fixed his hip!" "He was feeling better!" He wasn't supposed to die!" "What happened?!" "He wasn't supposed to die!"

I made myself available to the family until they were ready to leave.

The RN did not come to my office at the end of her shift. I called her the next night. She said she was OK, that her mother was with her. She thanked me for calling.

I told the RN's manager what had happened. I asked the manager to involve employee health.

I have not seen the RN since.

A man died. And I think an RN died with him.

LesleyJoy, what a sad story. Even when we are treated with kindness by others as she definately was by you and your staff the pain of what has happened and the responsibility we place on ourselves for that is too much.

I do hope that RN is not lost to nursing for ever.

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Julie
http://www.lifeinthenhs.wordpress.com

Julie,

I saw the injured RN last night. She has made some progress in reconciling that awful event. She lit up when I offered her a deal: until she is comfortable with ACLS assessment and treatment she will accompany me to every code. She will stand at my side as I observe the care. I will explain the care/rationale for care. She will ask questions. Her stated goal is to become proficient in the provision of care.

Onward, then!

Joy

When we had a death on the surgical floor, it wasn't all too often (but usually they ended up being off service pt's who were expected to pass away)- but we also had a policy in place that stated you were to resuscitate (unless you had a DNR) if you were with them when they stopped breathing, so say for example you were with them 5 min earlier then you'd call a code. If it had been an hour since your last check, even though they were a full code, you didn't know when they passed away and the likelihood of getting them back to where they were was slim to none. It sounds like this is what happened to your young nurse, I hope she's doing ok-and kudos to you for standing by her There is sometimes so little support around when were learning.