So, I had a bad day......

[CardioTrans, BSN, RN]

At 0640, was told I was getting a code from the floor, ok, let me assess my other pt real quick before new pt gets here, turn around and here comes the code, No call saying they were on the way mind you.....

Pt covered in blood, Neo at max, no respiratory therapist with a vent, the report I got was pts BP had been low since approx 2100. And they had been coding this pt for almost an hr. Thats it, nothing else, no other information, at this point, I didnt even know the pts name, history, nothing. Get pt hooked to monitors, nurse helping me gets drips going, started on Levo, BP 70's/30's. Pt white as a sheet, no palpable peripheral pulses, insert foley, immediate return of pure bright red blood, turn pt to get all bloody sheets from under them, blood pours from nose and mouth. Unit of blood going, NS bolus, Levo, Neo........ blood pressure still dropping, lab calls with Hct of 15, ya think??

So, I clean the pts face, and immediately recognize the pt. I had taken care of this pt for almost a month before moving pt to floor last week. When pt left unit, pt was joking, talking, smiling, the whole 9 yds. Pt was going to be discharged home yesterday.

Well, family decides to withdraw. Bring family in to say their goodbyes, and one of the daughters, ask me "You wont let __ be alone or hurt?" I told daughter that Id be there until the end. So they leave. Pt extubated, all drips turned off, cleaned up again after extubation (major amts of blood come out with the tube), In a matter of 15 min BP is unobtainable, heart rate drops to 40s. I go get the family, and ask if they want to be there. Daughters and S/o come in. They hold the pts hand, s/o other says "Thank you for loving me..." and I lost it. They were all there as the pts heart beat its last time, and as the final breath was taken.

Then I have to go and ask about donation. They decided to donate eyes, but due to the bleed pt wasnt a candidate for any other donation. We are all crying uncontrollably by this time. I go and call the eye bank, and get pt ready for them. Im in the room by myself with pt, and I remember one of the last jokes that pt had said to me and another nurse, and I lost it again..... took me almost 30 min to regain my composure. Of course by this time, the other nurse that the pt had joked with came in and we were talking about, I told him what pts s/o had said as pt died and he lost it too.

The 2 of us sat in the room with this pt sobbing like babies......

I have done hospice, have had pts die before, have cried with families before, but for some reason, this one bothered me so bad.

All of this and then I have to go with docs to talk to my other pts family about "the chances of her dying are greater than her going home". We wind up getting 3 more codes that I help my co workers with, and at 1835 get one from the floor that is another bleed, blood pouring from everywhere. Clock out at 1940, get home, but my things down, and the first thing I do is pour myself a VERY strong drink and go to my bedroom......DH comes in and asks "so how was your day?" Didnt even look at him, just turned up my drink, turned the lights out and went to bed.

Sorry this turned into a book, just needed to "talk" to others that had been there...........

[leslie :-D]

omg cardio ....all that adrenaline and then the crash. it doesn't become any more high pressure than this. and i'm so sorry. honestly i am.

leslie

add: do you think your post would get a better response in cc forum? i really would love to see others who have experienced what you have, respond to your pain. God be with you.

[nurse_clown]

:icon_hug:

sorry about your bad day. we can mostly handle what's thrown at us. but every now and then our humanity gets the best of us.

sending you my support. thanks for the post. i have always tried not to show any emotion at work. i save my emotions for home. but i loose it a lot at home. maybe i should be a little more human at work. one morning i couldn't wait to leave the building because i was starting to tear when i was going to my car.

[Annor]

(((((big Hug))))

[VivaLasViejas, ASN, RN]

This is much more than a "bad day"........a shift doesn't get much worse than that.

I would strongly encourage you all to have a debriefing session, preferably with the hospital chaplain and a sympathetic manager or two, as soon as possible. What you just went through is the sort of occurrence that, if not swiftly dealt with and processed, can do immense psychological harm; we nurses are only human, after all, and we have emotions just like everyone else, even though most of us have developed the inner resources to cope with the traumatic events inherent in our work. No one should blame you for crying, feeling bad, or even taking that good, stiff drink---but talking it out with others who experienced the same events is better.

I'd be more worried about a nurse who DOESN'T feel like he or she has been run over by a truck after something like this.......when one shuts down one's feelings, they lose the ability to empathize, and that's when a nurse should walk away from the profession.

Please don't be afraid to ask for help---it's how we get past these things and go on, instead of burning out, falling into a depression, turning to substances for comfort, or leaving the profession.

My prayers and ((((((((hugs)))))))) go out to you and your co-workers.

[CardioTrans, BSN, RN]

Thanks for all the words. The really sad thing, the s/o told me that at 0530 when s/o got out of bed, that there was this feeling of "somethings wrong". After the fact, I went back and looked at the code sheets...... the code started at 0545. This couple had been married 55 yrs.

All of these events happened on just one side of our unit. We have 20 beds, and all of this happened in the first 4 of 8 of the beds.

[crb613, BSN, RN]

CardioTrans....Bless your heart! I don't graduate until May, so I don't have any experiences to relate back to yours. I just wanted to say...you are a caring compassionate person, and I would want you be my nurse any day! :kiss

May God bless you.

[sirI, MSN, APRN, NP]

thanks for all the words. the really sad thing, the s/o told me that at 0530 when s/o got out of bed, that there was this feeling of "somethings wrong". after the fact, i went back and looked at the code sheets...... the code started at 0545. this couple had been married 55 yrs.

all of these events happened on just one side of our unit. we have 20 beds, and all of this happened in the first 4 of 8 of the beds.

even though this situation is so very sad, this says much about their relationship. so connected, they were.

i am sorry events such as these have to occur. i have to agree with marla, too. a decompression session is warranted. i hope your facility supports this.

and, i am certain you were the epitomy of professionalism and compassion.:)

we are here, cardio. {{{{{hugs}}}}}

[VivaLasViejas, ASN, RN]

Thanks for all the words. The really sad thing, the s/o told me that at 0530 when s/o got out of bed, that there was this feeling of "somethings wrong". After the fact, I went back and looked at the code sheets...... the code started at 0545. This couple had been married 55 yrs.

Oh, these are the stories that make my heart hurt....... I can't imagine being without my husband of TWENTY-five years.......how do people get through it, when the spouse they loved for 40 or 50 or 60 years suddenly leaves them to cope with life alone?

I've known a number of elderly widows and widowers who simply wither and die when their spouses pass on---my own mother was one of them---but I've also known many, many more who are strong, and through their faith and/or their ties to the living, they make it through the sadness and the sorrow. I pray that will be the case for the spouse your patient left behind.

[rehab nurse]

oh, my cardio....i've been a nurse 10 years, and i've had bad days too, but never like yours.

how horrible that your whole shift was codes, and dealing with the death of someone you knew. like mljrn said, you definately need some debriefing. i know the feeling of having ONE bad person and death, but what you dealt with just is unimaginable to me. it is hard to have that much go wrong on a single night.

and no one understands unless they've been there. you have my sincere empathy, and i hope days get better for you. many hugs, it sounds like you handled the family well, and were very caring allowing them to be there for the end. it's very hard to talk to families about their loved one dying, and you handled it with grace i think.

my hat is off to you. you sound like an awesome nurse! peace and hugs to you. take care of yourself.

[monkeyman1000]

Cardio, sorry about your horrible day. Be proud of yourself for still being human, I'd want you as my nurse. I don't know what your religious convictions are but there is a verse that helps me at times like this. "I will ransom them from the power of the grave, I will redeem them from death. Where o death is your victory?, where o death is your sting?"

[CardioTrans, BSN, RN]

Thanks everyone for your words of comfort and thoughts. I have been a nurse for almost 12 yrs and usually can control my personal feelings. There are times when I have cried with families, patients and even other nurses and FOR them.

I dont know if our facility per se has a group for debriefing, but I know that we as coworkers get together after really bad days and allow ea other to vent, cry, yell and scream. We usually take turns going to each others house, without our spouses, have dinner and talk amongst ourselves.

Im not a special nurse by any means. I just want the patient to be treated the way I would have wanted my family treated.