ED Shocker

My reaction after my first code in a long time. Nurses Announcements Archive Article

So I am an ED RN at a large hospital in St Louis,MO. I started my career later in life in my early 30s. I am a 15 year Disabled Army Veteran with 2 tours in Iraq. I am currently 37 years old. I am a loving husband and have two beautiful daughters that I love dearly. I have great faith in God and try my best to impact the lives of those around me.

I was part of a Unit that did Roadside Bomb removal and due to a shortage of medics were cross trained to be a combat life saver placing IV lines, needle-chest decompression, tourniquet and dealing with amputations and sacking chest wounds. I ended up being fairly good at all of those and it inspired me after a long road of recovery to use my GI bill and go to school to become a RN. I faced a lot of adversity dealing with residuals of traumatic brain injury and a processing delay and through a lot of therapy and treatment passed an accelerated program with a respectable GPA.

I started my career in a Trauma/Neuro ICU fellowship and had to step back after a while as it was a little too close to home with my combat experience and also having some cognitive delay from a TBI I felt concerned that in 12 hours of non-stop chaos I couldn't keep up mentally and didn't want to hurt anyone.

After a long search through multiple different areas in nursing I have found my love. The emergency department at night has just enough chaos to feed the adrenaline junkie in me but has such a variety that it isn't just 12 hours of titration to keep people from death.

To be honest in all my time in the unit I never had my own patient crash and only assisted with codes of others. Two weeks ago in the ED I had my first code since the military and it was a patient I never expected to go that route. I'll spare the details to keep privacy but long story short after reviving and getting up to the ICU they coded again and ultimately died. Once I got back downstairs I took a moment and went outside of the ambulance Bay in the wee hours of the morning to take 5 and decompress.

I felt weird. I was uncomfortable in that post CPR moment. I remember the absolute shock of the patients wife's blank expression as she just didn't even process that I was breaking ribs and crushing her frail husbands chest trying to save him as the DR tried to intubate. After I wanted to go give her a hug and console her as she was waiting in The ICU waiting room for an update but I just couldn't do it. I had to go back downstairs and try to process what had just happened. I wouldn't know what you say anyway.

I have never had an adrenaline dump like that and soon found myself puking in the bushes and choking back tears. I was shocked! This isn't like me. Is it always like this? I felt like it was hard to let go of it. I am OK now but the impact was much more than I expected. Any tips to help process these moments?

I have always counted myself good in chaos and am seldom at a loss for words. I would be encouraged to hear your stories and suggestions so I can grow and learn to deal better in these situations. Much love ... Matt, RN

Specializes in PICU, Pediatrics, Trauma.
Matt,

It sounds like this was the 1st civilian death of a patient you were responsible for.

It's normal to feel upset when your patient dies suddenly & unexpectedly...especially the 1st one. Who you will never forget.

Add to that your combat experiences, TBI, and the effects of cumulative stress over the past 15 years.

What you felt is NOT abnormal.

It's normal to feel upset. Did you talk it over with your Manager or co-workers? Many times a debriefing or even an RCA occur after an event like this. I don't know if you'll feel & react this way the next time or not, but you might want to consider talking to an EAP or VA counselor. Find someone to talk it over with, talk it out.

Best of luck to you, and thank you.

YES! I agree with every word. I'll just add a bit... Talking it out helps, taking time to care for yourself is very imoirtant. I've experienced a PTSD reaction in the past. (See my article if you'd like: "The Straw That Broke the Nurse's Back"). Sometimes I think ALL nurses should be in therapy prophylacticly.

Many specialties have the potential for creating emotional reactions...chronically or acute.

What do you say to the wife or others?

Not much, but a hug and "Im so sorry this happened." "He/she got the best of care"(assuming you agree). Or "Everything that could have been done, was done.". This helps tremendously for many. You don't need to do much more than that to show you care and give a little comfort.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Mike...

THANK YOU FOR YOUR SERVICE!!!!!

((HUGS))

You are a very brave man. It is not abnormal. We all find our way to deal. I turn to prayer and a strong sense of faith that I don't make "those" decisions. Families...I agree sometimes just a hug and quietly there to listen. A simple, I am so sorry, is fine.

Mr. Chicago is right on the money.

Up Vote Up Vote ×

The hospice people tell us that every death brings back all the previous ones. You've seen more than most, and with the additional burden of being not just patients but colleagues. Give yourself time to process (I hate that word, but there's not really a better one) with a professional. It will make ALL the difference.

Up Vote Up Vote ×