First Code Blue on my patient!

[miss_c]

i'm a relatively new grad; i just finished my first year on a telemetry floor. last night i had my first patient code. now i've assisted with other code blues, but have never had it happen to my patient. i had only been her nurse for 2 hours, and had spent most of the hour prior to her condition changed in her room. i just had that "gut feeling" something was wrong, and had told my co-workers that. i was at her bedside when her r/r suddenly increased to 48 per/min. i quickly assessed pt, vitals, 02 sat, heart and lung sounds. everything was at her baseline, excluding the r/r. had charge nurse stay with patient while i called the doctor.

i had to get a little forceful with the doctor to get him to take the situation as serious as i felt it was, but i got the orders i wanted. i was finishing writing the orders, while the charge nurse was getting patient ready for transfer to icu. when all of the sudden i hear a rapid response called to my patient's room!

the patient had quickly become unresponsive and cyanotic, sats in the 70's. i paged doc stat, informed him that he needed to see her now! while on the phone with doc, i hear the code blue called! er doc comes up; primary doc comes in shortly after. patient was quickly intubated, but passed a short time later.

everything had happened within minutes (change in condition, rapid response, code blue); she just went downhill so quickly! i just feel so guilty, like i could have done more! i keep replaying the entire night, over and over. i feel sick to my stomach. do you ever get over it? do you ever quite blaming yourself?

[sunnycalifRN]

You did everything right!! Nice job! Don't blame yourself, you did nothing wrong, in fact, you did everything right! Unfortunately, you will always remember but it wasn't your fault.

BTW, I still remember my first code, too!!

[CathyLew]

sounds like you were on top of the situation. Everyone seconds guesses themselves. your on the phone with the doc about that patient when the code happened... I would say that is on top of it.

It is not like you were out on a smoke break--heard the rapid response and said... oh, well... I am on break, someone else can handle it. And if you don't think that happens... just wait and see!

Don't beat yourself up. I think we all remember and second guess our first code.

[CSDGuy686]

You did everything possible. You called the doc when you had your gut feeling, and your charge nurse called RRT when she noticed a change in your pts condition. Sometimes its just a patients time to go. Do not beat yourself up over your patients passing. It is normal for you to have feelings of sorrow; we are nurses and we're compassionate about our pts well-being, therefore we feel this way after something like this occurs. The feeling of guilt will soon dissipate and you'll notice you'll will be giving the same advice to another nurse with the same issue some day. I'm with the comments above.

[kool-aide, RN]

You did a great job. You did everything you were supposed to do, you took charge, and you advocated for your pt. I'm sorry it didn't turn out better, but you can't help that. We can't save everyone.

[PAERRN20]

You did everything right. Perhaps it was something such as a PE, pulmonary infarction, NSTEMI, rupturing AAA, etc. Those are all possible causes that can make a patient go bad very very quickly. Hang in there.

[JB2007, ASN, RN]

You did a great job! You noticed the change in your patient right away and was taking the next steps that needed to be done when the patient passed. There are just times when no matter what you do or how fast you do it the patient is going to die. From what you told us in your post you did exactly what you were suppose to do. Good job!

[MouseMichelle]

YOu did everything completely right, and if I was a patient I'd want you as my nurse. Stop blaming yourself, it is what it is, I know easier said than done but you did well. It's okay...it was her time...seriously it's okay

[rnccf2007, BSN, RN]

You did a great job! No nurse wants to see their patient not make it through, but unfortunately it happens. In my four years as a nurse, I have saved lives and have also been unable to. About two months ago at the LTAC where I previously worked, I had a similar situation as yours. The previous day, the patient had been improving and was to start vent weaning the next day. However; when I came to work the next day, I noticed that his condition had deteriorated. I basically spent most of my day with this patient and was on the phone with primary and consults throughout the day and many tests were ordered. Toward the middle of my shift the patient started showing signs of improvement and all tests showed no acute changes in his condition. However, at shift change, the vent alarmed. We ended up having to bag the patient and could not get his sats above 79%. While I was on the phone with the doc to get a transfer, the patient went into respiratory arrest and was intubated. I got home from work four hours after my shift ended and replayed the entire day over and over. What did I do wrong? What more could I have done? I believe that this particular patient bothered me so much because he deteriorated so rapidly. The next day I came to work and found that he had died four hours after I left work. I felt guilty. However, my co-worker who was with me during the code told me what I already subconsciously knew---"You did everything you could, it was his time to go." Just remember, you did everything that you could! And...sometimes as is in my case guilt can pop up after four years of experiencing patient deaths. However, I do not blame myself, because I did do everything that I could. Please do not beat yourself up, you sound like a great nurse!

[RescueNinja]

Kudos to you! You did a wonderful job :)

[Cessna172]

If I am ever in the hospital, please let me have a nurse like you. Good job. I feel it's somewhat normal to replay the events, in your head. It lets us reflect on what we did right and what could be done differently.

[MomRN0913]

sounds like you did a good job, and you had a good team. As an ICU nurse I think I replayed every code in my head where the patient seemed seemingly stable and went south. But it happens, and by no fault of our own. To me, it sounds like a PE.