Come in breathing....

Editorial Team / Moderator · Sep 15, 2014

This bothers me too - I have had someone look me in the eye and beg me to not let them die, and then they did. It is the worst! And knowing that we did everything possible doesn't really make it all better, sometimes it takes time + using CISD resources, and talking about it with those who were there or whom you trust. I encourage you to reach out to those resources in your facility, don't let something like this fester, ever. It is one of the hardest parts of what we do. *hugs*

nurse2033, MSN, RN · Sep 15, 2014

That's why pulling someone back from the brink is so awesome. Some people have terminal conditions that nothing can fix. It's sad, but you should feel that you did everything that was in your power and abilities, but sometimes that just isn't enough.

akulahawkRN, ADN, RN, EMT-P · Sep 15, 2014

Long ago I came to the realization that our job is to give people a nudge (sometimes a good shove even) toward life, but if their body's too sick, too broken, or just too worn out to keep going, we're not going to be able to make someone survive. Those on the brink we may be able to rescue, and that's awesome when we can do that.

Until we figure out how to become immortal, death is something we'll all have to face.

Guests · Sep 19, 2014

Perhaps my most disturbing code was also my first as the only nurse in the room at a tiny, critical access hospital.

The patient was brought in by the family and immediately placed in a wheelchair which is how she rolled through my door. She was talking to me and with obvious signs of impending respiratory failure... very anxious (terrified is probably a better word), accessory muscle use, cyanotic lips and nail beds...

As we progressed through our workup and treatment, she ultimately went into cardiac arrest. We did get her back and ultimately loaded into an ambulance and off for the 45 minute trek to a higher level of care where she was ultimately pulled off of life support about 18 hours later.

I think what most bothered me was that she had been a (reasonably) healthy person prior to this event, that her family was in the room during the entire time (and uttering things like, "come on, mom, you can do it... hang on"), and that I later came to realize that I was friends with some of her family members...

And that she is the only person so far that I have had that eye-to-eye contact with in her last moments of full awareness just before she crumped.

She was the patient who showed me just what an emergency sepsis truly is. I still think about her when we do sepsis training or when patients present with s/sx of SIRS.

Editorial Team / Moderator · Sep 19, 2014

She was the patient who showed me just what an emergency sepsis truly is. I still think about her when we do sepsis training or when patients present with s/sx of SIRS.

I think over time we all end up with those primary examples we immediately recall with perfect clarity for the major ER cases - sepsis, STEMI, CVA, bacterial meningitis, etc. They are in my mind like a deck of cards to shuffle through when teaching newbies about ER bread-and-butter. Unfortunately a lot of the ones that stick are the tragedies, but every now and then a triumph gets mixed in the deck.

PerfectlyNumb · Sep 24, 2014

Wow, music in my heart…that is what really bothered me. My terrified patient, struggling to breathe, looking me in the eye for comfort, trying to talk to me…then subsequent intubation and cardiac arrest. My last words "try to focus on breathing, we are going to help you breathe." I felt so helpless as the situation deteriorated…family in room during code. I felt horrible that he couldn't talk to me. I felt even worse because he was so scared in the moments before he died.