I save a life today. Oh my god. And the amazing thing was how calm I was during the entire ordeal. I had admited the pt yesterday for a GI bleed, and discovered the pt could not swallow. Got an NPO order including meds on the patient.
First I have got to say I was always scared that I would not pick up on a pt that turned south. Well, today I proved otherwise
Walk in today to do my thrid assessment (I had put the pt as priority number three on my seven patients today.) Took one look at the pt, and realized something was not right. The pt was non responsive and looked sick. was on 3L O2 NC and perculating at 90%. Take a look and the medex to see if I have R/T treatments on them. No. Call the charge RN in to confirm what I was seeing. She and I looked at each other, and then I ran out of the room (btw, this is after another pt was coded and died at 7:30 am because someone missed something. So we have no crash cart, it is being restocked.) and tell the sec to call the PA and send them to me stat. Five seconds later the pa calls and want to speak with me, When she asks me what is wrong, I just say "the pt is at deaths doorstep." The was the only way I could someup what I was seeing (Hey its better than saying the grim reaper is standing next to the pt). I ran back to the room, grab a computer and start doing a major 10 minute head to toe assesment to get a clearer picture while fully charting each system. Neuro very bad. Resp: Horendous Rhonchi, crackles, wheezing in and out. Pt's mouth open. Cardio, pulse very weak and thready absent in some areas. GI, forget about it, not critical right now, but pt has BSX4.
PA walks in with doctor, immediately ask for crash on standby. Charge went to covering unit to grab it. We are now taking BP's every minute. BP was ironically stable at 120/70's with pulse in 80 and 90's.
I then made the call, get the pt a mask, they immedialetly start to pink up for a few minutes and becomes somewhat responsive. I now want this pt off my unit. They are too unstable.
Then the pt starts to crash, we intubate, and get loads and loads of brown sputum. We put them on tele. And then I go and call the ICU to give report. (I even got to ambu bag a real pt for the first time.) I am going through my CPR procedures in my mind getting ready to if the unthinkable happens.
We get the pt to the ICU and I do the hand off. The Charge said she would go with the pt to the ICU. I said I would rather do it, because if something did happen, I could give the full history right then and there. And it was my patient.
I stopped by the ICU on my way out and they were stable but intubate.
It was a tough shift (Yesterday most of my pt's were demented. Only one AOX3 pt. Today It was more towards the AOX3. But one escaped from the unit and got a cigarette, and threatened to sue us because we would not let them smoke.
Today, I saved I life, and caught a code before it happened. As much as I want code experience, I am glad I caught it before it happened. Not bad for 6 months as an RN.
