I was the most experienced nurse on my side of the floor. The other two nurses on my side included a travel nurse who is supposed to be seasoned but really has a LOT to learn, and a new grad RN who has been off orientation for two weeks. Thank goodness I'm the one who had this patient. I just...I need to get this out. It's been festering inside of me and I have to get it out.
As soon as I hear her son call out in the hall, "We need a nurse!" I know that it's my patient and I know that it's something bad. I run into her room and see her seizing. Of course, our medicine Pyxis has chosen that moment to be on the fritz and claim that we need to close a drawer that is definitely not open. I know I have to run over to the other side of the floor and override Ativan in their Pyxis. As I'm running down the hall, I encounter a group of doctors doing rounds and I scream, "[Room number] is seizing, I need Ativan and our freaking Pyxis is broken and I'm going to [next door] to get it! Get in there NOW!"
I'm tearing up as I write this because it just scares me that our Pyxis being broken could have cost her life if we hadn't had another on the floor.
I'm saying, "darn, darn, darn" as I override the Ativan, causing a discrepancy because I don't have time to count them, and I resume running at a breakneck speed, my stethoscope and badge swinging wildly, my co-workers shouting at me to be careful because of the baby, and me almost plowing them down as I speed past them.
I ran so fast and so hard that my throat hurt for hours afterward.
I've never trembled so hard as I do when I am pulling up the Ativan in the syringe. I get into her room and push the Ativan while the doctors are holding her head - she's biting her tongue and blood is dribbling out her mouth and her fingers are turning blue. Everyone is moving like it's slow motion, so I grab the code blue alarm and my co-workers come running with the code cart.
I scream at the pharmacist to get more Ativan out of the code cart, but she freezes like doesn't know how to get it open so I move 5 people out of the way and do the motions to get it open.
It doesn't feel fast enough, and I'm screaming at people to grab me a non-rebreather, call the pulmonary ICU team, call respiratory, call the internal medicine attending!
Rapid Response nurses arrive and I'm so happy I want to cry, but I settle for sitting at the end of my patient's bed, rubbing her foot and closing my eyes and not praying, but praying in the way only an atheist prays when they're scared someone is going to die. She is put on a monitor, we're cycling her blood pressure every 5, then every 3 minutes.
Everyone is asking me questions - what happened?
What's her history?
Does she have any allergies?
I rattle off the answers quickly as if I had memorized her life, and maybe for those brief moments I had. The mask is finally on her, her body is still, her vital signs are stalling out, but she's still not responsive, so the doctors decide we're going to intubate her. I assist in lifting her into position for the procedure.
My heart breaks for her - she's had to be on a ventilator before and it is her greatest fear. She never wanted it again. RR nurses push the meds she needs to relax for intubation, they get the tube in, and they figure out where she's going to go.
I'm on the opposite side of the bed, and my pregnant belly can't fit through the tiny opening between the bed and wall. It takes me asking 5 times before they move the bed forward so I can find the family and tell them what's happened. People always think the doctors have those conversations, and sometimes they do, but sometimes we do, too.
Her daughter in law is sitting in the waiting room, and tears are in her eyes as I calmly explain what happened, my heart beating in my chest, my body slowly winding down from the massive adrenaline rush, and my child kicking me inside, letting me know that despite my unintentional efforts to overwhelm her, she is safe and sound.
The rest of the family arrives shortly and I watch them file in behind my patient's bed as they follow her down to the ICU, the attending rattling off medical jargon that they don't care about right now.
Afterward, everyone told me I did a good job. They told me I rocked it out, and that I looked like a pro in there. We laughed about me being a "big belly running down the hall" at 8 months pregnant.
We laughed about my cussing at the doctors. We fixed the discrepancy in the Pyxis. I called to report to the ICU and finally ate some lunch.
But I tell you, I wish I never had to see or do these kinds of things. It breaks my heart every. freaking. time.
I am professional but firm when I have a patient that codes or if I see that the primary nurse is freezing up, which happens more than I'd like to think about. I tend to take over and make sure things get done and if that means barking at lookie-loos then that is what I do. No room for an audience, only for helpful team members. I've been thanked for my demeanor many times after someone crashes. I get things done, and done right. Period. I also take every code as a learning experience. I never fail to learn something new. Keep up the great work!
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
"Critique" (like The Princess Bride's famous, "Inconthievable,") does not mean what you think it does. It is not a bad word and means, "detailed evaluation; review."
Even "criticism," which is likely what you're thinking of and often what people think it means, is defined thus:
1. the act of passing judgment as to the merits of anything.2.the act of passing severe judgment; censure; faultfinding.
3.the act or art of analyzing and evaluating or judging the quality of a literary or artistic work, musical performance, art exhibit,dramatic production, etc.
In short, a post-performance review/debriefing/etc. is a necessary part of growth after a stressful or complicated event. Feedback is a gift.