The Realities of Nursing

[helper T cell]

Today one of my patients coded and didn't make it. It is pretty much impossible for me not to believe I could have prevented it in some way. The whole experience made me realize just how much lack of experience I have as a new nurse. No one is blaming me and there were no errors made...... but i just keep wondering.. Did I miss something...were my priorities of pt care during the time leading up to the code correct. I feel uncomfortable about my assessment of the patients condition leading up to the code and it is only in retrospect that I can see that the pt was in fact deteriorating.

I wasn't alone when it happened and other people were also aware of the pt's current condition. md had seen pt approx 1/2 hour before. I just can't stop wondering if I could have done anything better or differently for the pt.

Everyone says I did fine blah blah blah, but in my heart I feel totally worthless and I am just so scared that I am a failure at nursing. I really feel I may have not really realized the reality of what can and does happen and the responsibilities we have as nurses. So thanks for letting me put it all down as maybe others with my level of nursing experience know how I feel.

[Virgo_RN, BSN, RN]

I know how you feel, if that helps any.

[mrscurtwkids4]

I think most nurses, especially new nurses, have a tendency to be hard on themselves when a patient of theirs codes. It's so much easier to be overly critical in retrospect than at the time things are happening. Hindsight is 20/20. I'm still in my first year of nursing also. And as new nurses, we have to learn that some patients aren't going to make it no matter how wonderful a nurse we are. So long as nothing was totally missed, we can't always know something is going wrong. We each have to learn to figure out a healthy way for coping with the loss of a patient. Tearing ourselves up over something that we may have no control over is not the most healthy way of dealing with it. Learn from each experience and that way you might have more insight for similar situations in the future. Having a time of reflection and healthy critique with coworkers is a good thing. This can bring more eyes to the situation that can point out things that could be done better in the future. Just know it's not uncommon for you to feel like you are to blame, but it isn't really the truth, just a normal reaction.

[llg, PhD, RN]

I really feel I may have not really realized the reality of what can and does happen and the responsibilities we have as nurses. So thanks for letting me put it all down as maybe others with my level of nursing experience know how I feel.

As a very experienced nurse, I can remember feeling the way the OP described. In fact, I still feel that way sometimes. Most people do.

While most of us realize that nurses have a lot of reponsibiilty and that we deal with life and deaf (and quality of life) issues on a regular basis -- sometimes it takes real events to "bring that point home to us" every now and then. It will probably happen periodically happen throughout your career. A particular patient or a particular incident will have a deeper than average impact on you -- either causing you to question yourself as a nurse -- or reminding you of why you became a nurse in the first place.

As you browse this website, you'll see lots of people discussng those cases that stand out in our minds and cause us to pause and reflect upon our practice. They are called "paradigm cases" when they lead us to greater understanding.

Work through the situation by refleting upon the case, discussing it with colleagues, using it as a learning situation, using it as a reminder for the future, etc. That will help you to gain a perspective that will ease your mind and also help you to grow as a nurse.

[sarahrain]

Dont feel bad about it, it is beyond your control. You have minimal asssess to monitor the patient closely. Perhaps, you can suggest to your health care institution to start ERT - emergency response team. To put the patient on triage based on their vital paramenter/presentation and to get the anesthetist to assess them. This has prevented a few code blue in my hospital indeed.

I did feel bad if I couldn't pick up the sign of symptom of my patient deteriorating. And because I am working in ICU, we could detect any subtle changes in second.. Unlike general ward.. you have to be very much depends on the impression of the presentation of the patient. There was one code blue happened in the ward of my hospital, the patient was vital parameter is normal from their intermittent observation but it didn't click their mind to monitor the patient's ECG - the short run of VT might just brush off your shoulder..

Move forward.

[nursemike, ASN, RN]

I've been exactly where you are, and while I agree with the consensus that you shouldn't beat yourself up, I do think it's right to think long and hard about the situation. In my case, there are several things I will do differently, next time, and while I accept the advice of my more experienced peers that it probably wouldn't have mattered, next time it might. Rerunning the situation in your mind is probably inevitable, so try to make it work for you, instead of against you. And a certain amount of soul-searching is probably inevitable, and appropriate, as well. It's right to be a little in awe of the responsibilities we undertake.

The fact that we have room to learn from situations like these does not make us bad nurses. The best nurses I know are still learning. A bad nurse, in my opinion, would be one who didn't worry and didn't analyze.

In the end, we all die. The best we can do is delay the inevitable, and try to make it as comfortable as possible when it comes. Sometimes even that is beyond our capability. But I have no doubt you did the best you could, and that the best you can do will be better as you gain experience.

Good luck and God bless you. Sometimes truck driving school don't look half bad.

[helper T cell]

Thanks so much everyone for your replies. It really does help. I'm going to go in and meet with my nurse manager today and hopefully my preceptor to go through things. Just a quick note to thank-you all.

[SoundofMusic]

Well, as one of my favorite professors used to say, "We aren't always running the show." This just could have been this pt's time to go.

I believe we all have a day and time where it will be our time and no amount of intervention is going to stop that. I like to believe that anyway.