Are we saving lives?

[adventure_rn, MSN, NP]

My favorite patient tried to die on me the other day. After a couple of months in the Neonatal ICU, he was just days from being discharged. He would need a home monitor for occasional immature heart rhythms, but he was more or less a normal little neonate.

When his pulse ox alarm rang to my phone showing an O2 sat of 30%, I was certain he'd kicked his probe off. But sure enough, when I ran in to check on him, he was apneic and blue. After panicking for a split second, I called for help and jumped right into the neonatal resuscitation protocol. Ten minutes, five nurses, two doctors, and some CPAP later, he was sating beautifully at 99%.

That night I was still very shaken up and was processing the event with a friend. She responded, You saved that baby's life! That's amazing!”

It still doesn't really feel that way. When I think through that story, the narrative still goes My patient tried to die on me,” rather than, I saved a patient's life.” Instead of taking pride in the resuscitation, I'm ruminating on my darling little patient taking a turn for the worse.

I'm reminded of the first code I ever witnessed while working in the ED. A guy came in for a small bowel obstruction rule out, which turned out to be gas. One minute he was eating a ham sandwich, the next he was in cardiac arrest. The team stabilized him and he was whisked away to the ICU. I was in awe, and blurted out to the attending, That was so bad ass!!! You saved that guy's life!” Instead of basking in the glory, he responded, There's a, 80% chance he'll die in the ICU.”

Perhaps a reason for this mindset is that if we as nurses need to make a ‘heroic effort' like resuscitation, our patients are in a terrible physiological state, often with a poor prognosis. It's hard to recognize and celebrate your contributions when your patient is actively dying on you. Even if you've stabilized them for the time being, do you really feel like you ‘saved them'?

Saving lives is engrained in the public perception of healthcare workers; I can't help but think of the Grey's Anatomy mantra It's a good day to save lives.” Nurses absolutely do save lives every day, but my question is: do they feel like they do?

So, nurses, what do you think? Do you feel like you save lives?

[NickiLaughs, ADN, BSN, RN]

I do feel that way in the ER, in the ICU I rarely felt that way.

one time in ICU I Had a pt I knew was gonna code, I just knew it and even tho all my interventions (abgs, labs, ekg) didn't show sure enough she flat lined a short while later. We got her back, only to send her home on hospice the next day. Her extra few days were unlikely worth the extend of how many ribs I broke,mother intubation, etc.

Another case, this one in the ER, we got a cpr from the field, younger middle aged. Anyway, post cpr she was already trying to extubate herself. Two days later she's doing phenomenal as it turned out she had a pelvic mass which almost bled her out at home. The fact that she was doing well and will hopefully with some surgery return home to her family. I'm ecstatic.

Sure the cards count against people when they code, but there are successful cases, and those ones make all our attempts worth it.

We do get burnt out from the ones that don't go well, make sure to give yourself time. And sometimes we need a change of venue or a vacation!

[Dacatster, ADN]

Worked in the ed many years. Often I that I was glorified bandaid nurse, and that was working in a level 1 trauma in Chicago. Then on occasion, yeah I saved a life or two.

[Alex Egan, LPN, EMT-B]

Anyone who goes into healthcare to save lives should watch the movie bringing out the dead.

Frank: I realized that my training was useful in less than ten percent of the calls, and saving lives was rarer than that. After a while, I grew to understand that my role was less about saving lives than about bearing witness. I was a grief mop. It was enough that I simply turned up.

[beckster_01, BSN, RN]

I don't consider a life saved until they come back to visit as an outpatient- which does happen on occasion. I did have an experience similar to yours, although it was an adult, and a very different situation. She had a large saddle PE, they finally decided to give her thrombolysis. Well, sure enough within 15 minutes of giving the drug she starts coughing up frank blood, and coded shortly after. It was a successful code and she left the ICU before too long, but while part of me rejoiced that she had a good outcome, I also realize that she coded as a direct result of a medication that I physically gave. We all know the risks and she gave informed consent, but it is still a crappy feeling.

On the other end, we just had a well loved patient come visit us from home. He was on CVVH, triple pressors, and malnourished making it difficult to wean his vent, but in the end he got to go home with no trach :) We need to know that those wins happen, but you don't always get to see them.

[blondy2061h, MSN, RN]

As I've matured as a nurse, I've learned to feel proud of the times where I've picked up on subtle changes and stopped a progression of things to the point where the heroic measures are needed, almost more so than the adrenaline pumping code blue, all hands on deck, scenarios. The times where the patient is throwing a few more PVC's than last night, so I draw AM labs early and find their K is 2.1. The times where I ascultate and hear a new murmur or an abnormal rhythm. The times I notice that patient is pretty tachypneic, even at rest. Those sorts of things.