So last night I experienced my first patient death and I can't help but feel guilty. Pt was admitted with UTI and confusion. Noted expiratory wheezing in lower left lobe upon admission. Pt was drinking bowel prep for a colonoscopy in the AM and unable to stand. Therefore I was in her room hourly checking her brief. I went in to check her brief and noticed she had developed crackles. Her fluids were running at 125ml/hr. I turned them down to 30ml/hour, pulled her up in bed, sat her high-Fowler's, assessed vitals and oxygen saturation. Aside from crackles the only thing not within normal limits was respiratory rate-22. Asked or if she was feeling short of breath- she denied. I immediately left the room and pages her DR anticipating an order for Lasix. Ten minutes went by, he never called. I went to reassess the pt- still alert and responsive, no changes. I paged the doctor a second time. When I went back in to check on the pt roughly 10 minutes later she was unresponsive. I did a sternal rub- no response. Pulse check- no pulse. Called code at that time. She did not make it and I can't help but feel guilty. Asking myself what I could have done differently...should I have ignored protocol and just called the Dr's cell. Did I let too much time pass between pages...just so many questions. How do I get over this feeling????
Nov 16, '17
Hugs to you. I had a similar experience not that long ago. I debriefed with my manager and some very experienced nurses and they assured me there was nothing more I could have done. A respiratory rate of 22 is high but not so high as to call a rapid. You did everything you could and sometimes these things just happen. The body will compensate until it can't and then go quickly. I would suggest you debrief with your manager like I did. It really helped.