Extremely BAD night...

Specialties Emergency

Published

So, someone please tell me how to get past this last night shift, because I'm not sure how it's possible right now...

1st patient of the night- codes and dies.. Normally would make for a rough night in itself right? It gets worse...

Later in the shift, 4yr old CPR in progress on the way from EMS.. Broken neck caused by step parent.. Suspected sexual assault (turned into obvious sexual assault)... Didn't make it... HORRIBLE NIGHT... Oh, it gets worse..

My colleague has a pt react to contrast, says "give 0.1 of Epi" says the doctor... Nurse (for some crazy reason!) gave it IV not IM and NOT diluted... Causes pt to have an MI and after 3 hrs of working on them, dies...

How is it possible for a shift to go THAT BAD!!!!! I left work feeling completely defeated... Someone please help me to cope with this bc everything feels surreal right now...

Specializes in PACU, presurgical testing.

SweetMelissa, I cannot imagine the stress and grief of a shift like this, and I'm praying for you and your colleagues right now. I TOTALLY agree with the suggestions for debriefing with your unit, as well as utilizing EAP or an outside counselor. We had a code in PACU when I was a student, and I don't think there was ever a debrief. Eventually everyone just got past it, but I think it was needed. But even if your unit doesn't offer this (or take your suggestion/request for one :) ), you need to get someone to listen to you. Write it out in a journal. Write out how it made you feel (helpless, angry, frustrated, scared), what you observed, either as a narrative of the events if you need to or as a list of emotions or thoughts you may have had then or since.

I'm no psychologist, but journaling helped me after our code, and seeing a counselor has helped me deal with some personal traumatic stuff that was affecting my work. I don't know how long you have been a nurse, but I'm sure you know the odds of another shift like this are pretty low. Sounds like you provide episodic care (ED?), so perhaps you can focus on THIS patient, one at a time. In PACU we have to do the same thing when something goes bad; in a way, it helps because each patient is a chance to start again.

God bless you and bring you peace.

A full mL of undiluted Epi was given and then flushed with NS. The reaction was not nearly severe enough for it. The doc wanted it SUBQ.

To everyone who offered their support, I really REALLY appreciate it. My point was not to get a lesson on how to administer Epi and at what dilution ratio, etc. so for those of you who offered words of advice, thank you so much. It means more to me than words can say. I'm taking a week off to get my head straight, we will be debriefing in 2 days. I hope this hasn't killed my love for the ER..

Specializes in ED.

To the OP,

I think its nights like that when we look at our next patients and will make us specifically look for the good in our patients to hold on to, which is a precious gift to have and be able to do.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
A full mL of undiluted Epi was given and then flushed with NS. The reaction was not nearly severe enough for it. The doc wanted it SUBQ.

To everyone who offered their support, I really REALLY appreciate it. My point was not to get a lesson on how to administer Epi and at what dilution ratio, etc. so for those of you who offered words of advice, thank you so much. It means more to me than words can say. I'm taking a week off to get my head straight, we will be debriefing in 2 days. I hope this hasn't killed my love for the ER..

Take this time to realize that the bad shift isn't your fault, that there was really nothing you could have done about it, and that being a nurse sometimes is really hard.

I think that the discussion about Epi is important for maybe someone going to work tonight will be in that position and will think...you know I read that on AN this afternoon I think I need to double check that dosage. I wish more often that we used situations to learn and not punish someone so severely.

((HUGS))

Take this time to realize that the bad shift isn't your fault, that there was really nothing you could have done about it, and that being a nurse sometimes is really hard.

I think that the discussion about Epi is important for maybe someone going to work tonight will be in that position and will think...you know I read that on AN this afternoon I think I need to double check that dosage. I wish more often that we used situations to learn and not punish someone so severely.

((HUGS))

Completely agree! Thank you for sharing your story. I will say, what you've shared will stay with me. It can get confusing the different dosages and concentrations of epi. I will always be mindful of this.

I was looking back at what I posted last, realized how rude it sounded.. Sorry about that.. Thanks everyone who did any research and looked into the Epi scenario. Definitely a good learning opportunity.

Here's one Allergist's spin on the epi/contrast shock scenario:

Epinephrine in the treatment of anaphylaxis

This was very helpful, thank you so much for looking into this topic. I really appreciate it

Holy crap, and I thought I've had bad nights. I hope things are okay with you, and in your ER. And I've never had to give epi in the case of anaphylaxis, so it's good to learn the correct way of giving it.

Specializes in critical care, ER,ICU, CVSURG, CCU.

luv you sista, it happens some times, not often, you have received some good advice :

Specializes in ER, IICU, PCU, PACU, EMS.

I'm guessing you had your debriefing already. Did it help you out some?

I'm sorry to read about your terrible night. I hope that the time off gave you time to find some coping strategies to deal with all of it.

A while back, my shift experienced 2 back to back pedi codes - one was horrifically tragic dealing with abuse. We were seriously traumatized although no debriefing was offered to us. A few nurses left afterwards and went into other nursing areas.

I'm glad that CISM was there for you and that you guys took advantage of the resource.

I'll keep you in my prayers.

Best wishes and hope your way.

I'm guessing you had your debriefing already. Did it help you out some?

I'm sorry to read about your terrible night. I hope that the time off gave you time to find some coping strategies to deal with all of it.

A while back, my shift experienced 2 back to back pedi codes - one was horrifically tragic dealing with abuse. We were seriously traumatized although no debriefing was offered to us. A few nurses left afterwards and went into other nursing areas.

I'm glad that CISM was there for you and that you guys took advantage of the resource.

I'll keep you in my prayers.

Best wishes and hope your way.

I did, and yes it did... Very much so... Gave all of us the opportunity go over everything, cry together, and appreciate that we did everything we could...

I can't imagine having 2 pedi codes in one month let alone one night, my heart goes out to you.. I'm sorry your facility did not offer any type of crisis help for your staff, I would definitely discuss that with your nurse manager or CNO, it's not right that you and your co workers can go through something so devastating and the higher ups think you're just supposed to go about your job, unaffected. Makes me livid. We are human. We have huma

We human feelings*** that wall can't stay up forever... No wonder some of the ER nurses I have met have become so callous..

Thanks for the words of encouragement, means so much to me :)

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