Cardiac Arrest - ALONE

DutchgirlRN, ASN, RN · Mar 2, 2008

As long as you did what the patient needed at the time, administration will just have to understand about the paperwork. You can't possibly do two things at once. The patient was obviously more important. You did great! And I see you have only 4 months experience? Where were the other nurses?

Katnip, RN · Mar 2, 2008

:nurse:That's my question, too. Where were the manager, the charge nurse, nurses from other units, intesivists, secretaries, and yes, housekeeping. They all know or should know CPR. They can bag and do compressions, freeing the nurses up for meds, dropping lines, and recording.

This happened to me, too. We had 3 codes come in by ambo and one code on a patient already there. EMS helped with what they brought in, but there were only two docs. On my team, I was the only nurse until the staff scheduler came in. Secretary bagged, housekeeper did compressions. I did meds and defib, and scheduler recorded (she's an RN). Our patient survived, the others did not. Of course we had the one who crashed in front of us, so that was to our advantage.

ERRNTraveler, RN · Mar 2, 2008

In the past, I have had to grab whoever was handy (housekeeper, secretary, etc) to write things down on scratch paper, so I could chart them later. I'd just call out what drug I was giving, so they could jot it down with the time. Then I just charted everything after the code was over.... It's not ideal, but sometimes you just have to make do.....

suzanne4, RN · Mar 2, 2008

One trick is to place tape on your pants and just put the time there that you did something, especially if you are the only one. Works quite well in a pinch and then you can go back and remember what was done when.

Thru the years you learn all different tricks and this is one that has always worked for me.

And I am sure that you did a wonderful job, but again, where were all of the others?

mom2michael, MSN, RN, NP · Mar 2, 2008

I feel your pain as this is a common practice for me at my PRN job. When a critical patient comes in....they scatter and whoever is in the room is left to do it all. Frustrating. I've been lucky because EMS has never actually left me while my fellow nurses have. They've done all the CPR, bagging, start IV's for me, etc...leaving me time to do what needs to be done.

The tape in the pants is a great idea - my arm also makes a nice dry erase board. We actually have dry erase boards in our rooms that we try and write the times on and it seems to work out well if you can find someone to write down stuff.

I'm thankful this is only my PRN job and the practice my fellow nurses deploy only seem to occur on certain shifts and I just simply don't work those shifts anymore.

Psqrd · Mar 2, 2008

We used to write it down on the sheets by the patients head...it worked in a pinch and it always came out in the wash.

P2

Blee O'Myacin, BSN, RN · Mar 3, 2008

So two days ago our ED gets three cardiac arrests coming in and I'm left with one all to myself with two residents and a trauma surgeon being present! It was definitely a first and was rather overwhelming, at least the documentation part of it. I was able to function as a the medication nurse with the crash cart, and get hands on with CPR and the pacer, but with all that going on I always seem to lose it with documentation and in keeping track of times of when medications were given, etc. Where were my other nurses! *sigh*

Why weren't the residents doing the CPR? Or the trauma surgeon? Did you ask them to do compressions since you were busy with the meds and the crash cart?

I hope you documented your behind off, made a union complaint and wrote a nice, long letter to your nurse manager about the lack of staff and the fact that the other three doctors in the room couldn't be fussed to touch the patient. Did they expect you to intubate as well? How about getting that chest xray machine from down the hall and take the patient over to CT while you're at it?? :angryfire

That shouldn't have happened to you ((hugs)).

Blee

kxvc · Mar 3, 2008

I just wanted to mention that not all support staff knows CPR. I was surprised to learn upon my transfer to a different facility within the same company didn't require BLS for ALL staff like the previous one had. I was still allowed to take the course, and I did, but it was my choice to do so on my own time. Ask around now that way you're not stuck alone in another emergency.

Anagray, BSN · Mar 3, 2008

You did such a great job!!! thank you for being there for the patient ( well the residents too!! and the MD in charge of residents, and for the " great" management staff of your ER). I hope they give you a raise for all of them.

Nat

Trauma Columnist · Mar 3, 2008

Whew - another wild night in the ER! Sounds like you did fine with the resoureces you had available. I too use the sheets for charting, though I endorse the tape on the pants thingie too.

rjflyn, ASN, RN · Mar 3, 2008

I was going to say your kidding my the secretaries or housekeeping do CPR. At my facility they are not trained. On top of that if the HUC left the desk the dept would grind to even more of a halt. More likely would be keeping the medics around to do it, if the see its nuts more often than not they will hang around for a while and do it.

As far as times, you do what you can do. Get the time the hit the stretcher and the time you pronounce and then just go from there based on how many doses of what gets given. Just remember you cant make them any deader. Also you always have the ever present paper towel dispenser for a note pad.

Rj