A bad code, question skills and career choice.....

txerrn6942 · Aug 13, 2013

You probably did nothing wrong and hindsight is always 20/20! As an ER nurse of over 20 years, there is always something I could have done faster, better, or more efficiently. But bottom line, probably none of it would have mattered. We are merely an instrument in the bigger picture of life. We cannot control when it is someone's time to meet their maker. It has already been decided.

Be joyful, that you were there to spend the last moments of that persons life with them. Learn from your experiences and if needed, do things better next time. We all learn things every day, even after 20 years.

Sun0408, ASN, RN · Aug 13, 2013

Was it an unexpected code?? I know many of us have this "feeling" the pt is getting ready to code or just go south on us. The unexpected codes usually throw people off for a minute.. As previous poster stated, there is always something we could have done better or faster. We are human and will make "mistakes" for lack of a better word. My last code the pt wasn't even hooked up to the lifepak for a good 2-3 minutes but it felt much longer than that, once the leads were on and the pads were placed, it took more time to find the cable to connect the pads too..

AZER · Aug 13, 2013

Sun0408, Yes, it was unexpected. The patient had come in complaining of chest pain but the entire work up had been done and looked good, CE negative and EKG looked good..ect. No history, marathon runner. He had just been given a GI cocktail to see if it was heartburn. It was about 10 min into my shift. I couldn't find the pads on the crash cart, delay.. later the tech found the pads ON THE CRASH CART! How could I not have seen them? Can I trust myself?

AZER · Aug 13, 2013

txerrn6942, thank you for your post. I have been telling myself repeatedly that I will do better next time.

Sun0408, ASN, RN · Aug 13, 2013

Those are the hardest, the unexpected "healthy" person that codes. You will trust yourself again. In a rush, things are easily overlooked, you were not the only one attending this code right?? Did someone else get pads?? Was it a shock-able rhythm?? You can't blame yourself completely. Talk to someone at your facility, other staff that was there, the grief counselors etc.. Just talk to someone you trust that will understand. You will move past this..The best we can do is learn from our mishaps and prevent the same mistake in the future..

Hugs

AZER · Aug 13, 2013

Thank you for your post. I appreciate your input. Yea, it all came together after the first 3-4 minutes (but as we all know that is a critical gap) and we worked on him for 45 minutes.

Altra, BSN, RN · Aug 14, 2013

Been there, done that, got the T-shirt. I will forever remember a young father of two children who after presenting with intermittent chest pain but a normal EKG ... stopped talking to me and his family mid-sentence and coded. We did not get him back.

I work in a large academic Level I trauma center with all the big toys and all the specialty expertise immediately available ... but we cannot and do not save them all. You save the ones you can, and respect the memory of those you can't.

AZER · Aug 14, 2013

Altra, Thank you for sharing your story with me. I understand that everyone can't be brought back.....

I guess what I am looking for from other nurses is whether or not they still find themselves at risk for hesitation or becoming flustered even after they have experience. I just feel like I should be beyond that feeling and the fact that I am obviously not is really concerning me.

If you don't mind my asking, did the suddenness of the cardiac arrest on your young patient affect your response?

Ciale · Aug 14, 2013

Just reading this makes my stomach turn a little bit. Did you run a troponin? I'm pretty sure we're all in "bad codes" at some point. I'm a brand new nurse and I've already been in a couple. The other day I infused LIFE SAVING drugs into an iv that wasn't even in a vein! I just trusted that the ambulance crew had a good IV in place (came in hot doing compressions/no encode) and didn't even check it's patency *cringe cringe cringe* I've worked in ER as a tech for a few years and I watched the smartest most experienced nurses forget to turn on oxygen flow to a bvm during a code, fumble with pulse ox and bp cuffs when the patient doesn't have a pulse and countless other ding-dong moves. Don't get me started on physician goofs.

Long story short, I think it's the nature of the job. After my crap code (in my mind...no one ever said anything to me about it), I asked the doctor for feedback on what could have gone better fully expecting him to tell me I suck. He said "there was probably nothing we could have done that would have made a real difference and that's why they call it "PRACTICING medicine" because that's all we can do...practice"

So cliché but time heals all wounds. If you weren't a compassionate nurse, you wouldn't be on here talking about this. It's ok.

Guests · Aug 22, 2013

Some days, I'm on top of my game and everything goes smoothly, I anticipate well, and never miss a thing...

Other days, it seems like I'm a pre-nursing student with three pinkies on each of the four left feet attached to my single arm.

It happens... nobody is at their peak all the time... Montana threw picks, Rice dropped passes, and Jordan missed free throws.

When I first accepted the ED position, my med-surg preceptor said, "Remember this... no matter what happens, the patient is better off than if you weren't there at all."

Keep your incredibly high standards and strive for perfection... but don't beat yourself up over those times that you fail to live up to your own expectations of yourself.

IrishErin · Aug 22, 2013

When I first accepted the ED position, my med-surg preceptor said, "Remember this... no matter what happens, the patient is better off than if you weren't there at all."

Love this!