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Discussion

First Code..

I had my first code last night.. It was terrible. The woman was 94 years old, had pneumonia and C-Diff. 2 weeks ago she was walking, talking, and in amazing shape for a 94 year old. I was so shocked that she coded. I feel like my facility killed her.

Her daughter approached me and expressed her concern for her mother saying she didn't understand how her mom could get so sick so quickly. It was shift change and I hadn't seen this woman in 2 days so I went to check her out. When I got to the room, she was in bed with her mouth open looking at the ceiling and my heart dropped. I went up to her, called her name, felt her radial pulse (still in disbelief), found nothing, felt her carotid, nothing.. Called the code. I work in a nursing home so I wasn't expecting a team to relieve me.

I broke this woman's ribs. I know that's supposed to happen, but it happened so easily. With little to no effort I crunched a woman's bones like twigs. The sensation under my hands and that sound was horrifying. And she cried/moaned with every compression.. Is that normal?

Throughout the code, I freaked. I doubted my every move. I still feel like I didn't do things right. I feel like a failure for not saving this woman. I am so sad for her and her family. I've spoken with my co-workers and they're all supportive, saying I did everything right and I did everything I could do for her.

I honestly re-evaluated my career choice during this episode. It was crazy and traumatic.. I didn't cry, but I was on the verge of crying for 2 hours afterward. I was shaken to the core.

I guess I just wanted to let it out.

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  • Experts

What an awful experience for you. But what makes it worse is that this woman should NEVER have been an attempt of resuscitation. How old is old enough to be allowed to die when it's time? It obviously wasn't your call to determine her code status, it was her family's and her physician's. You didn't fail this woman, it was her time to go and she went. I really think you'd feel even worse if the patient had been a 34 year old woman and all attempts to resuscitate failed.

She probably wasn't moaning, because I doubt she was aware of what was happening. What you were hearing was air being forced out of her chest by the compressions. Breaking bones with compressions is a given with someone of this age. She could easily have broken her own wrist just by picking up a tea kettle.

You're feeling the effects of witnessing your first death and those feelings are totally normal. But please don't throw away your career over it. The day you stop feeling sadness and grief when a patient dies is the day you lose your humanity, and nurses have to be allowed to be human to be good at what we do.

My heart goes out to you in this time. Not because I feel sorry because something bad has happened to you but because you feel so shaken and unsure of the whole experience. This was a learning experience for you. You did what you could and no one can come back and say you didn't. Not to mention it was your FIRST time. I am so afraid of the day I will have my first code. Sometimes when I still have rapid responses (in times of chest pain, etc) I have grown to be more confident and know with each experience what I need to do. First time I had a rapid response I was like durrrrr what do I do now??? You always hear stories from the seasoned nurses about how many ribs they've broken and how codes become easier and etc etc.

I can't say a whole lot though because I AM still waiting for that inevitable first code. I just gotta pray that someone is going to be standing near by that knows what the heck they're doing because I sure won't.

The first one is horrible, I know. :( **HUGS** I'll never forget my first experience at this either. I felt exactly the same way as you described yourself to feel. I was tore up emotionally over it for days, I questioned myself and everything I did. It was tough. In time, you process things and it does get better.

Hang in there!

  • Author

Okay guys... I just got back from the hospital. I was visiting the woman that coded!!!!!!!!!!! She's alive and talking!!! A little confused and totally exhausted, but ALIVE!!!!!!!!!!!!!

The family was there and since I only knew the daughter, she introduced me as "The nurse who saved Grandma's life...." It was amazing! I feel so much better. I was so sure that she had died....

The daughter pulled me aside and told me she had heard I was leaving my current job.. I told her I was going back to school and taking on a private duty job that worked better with my school schedule. She told me "That's great; further your career. But whatever you do, promise me you'll stay in nursing.. You have the heart and the skills of a great nurse!" Awwwwwww! Btw, I'm going back for RN.

Thank you all so so so much for your support! It amazes me how emotional nursing is; one minute you've hit rock bottom and considering a new career and the next you're on top of the world feeling proud of the decisions you've made and the people you've helped.

I know this woman is 94 years old, but a life is a life.. Even if she passes tomorrow, it'll still be worth it. She's getting to see her daughter from out of state today.. If she'd passed, that wouldn't have happened.

Oh my god, I'm so happy! :D

You now know exactly why I loved tele so much. Many of our codes survived and were able to go home with family. It was always such a miracle to me!

Wow, alive?! She's a kicker... I guess it wasn't her time to go.

Good work... Couple of things to ask you more experienced nurses:

I work night weekends, 7 months on a tele floor and I haven't even seen a code. We have 1 every month or 2 with RRT being so easily available. The one night I've had to call out due to illness, my coworkers had a code... one that has been taught to us as preventable. The other nurses had to listen to a case study on what happened and what was done wrong... I am just SO glad I didn't come in sick.

I decided knowledge was power and got my ACLS certification.

I grieve for my living patients too... I'm very compassionate and caring but can't seem to detach from being emotional, especially if something bad happens to them when we've built a relationship... any advice?

I'm just worried I'm going to lose it...

  • Author

I've always found giving advice about emotions to be difficult. I can't tell you how to hide your feelings or detach from them. Caring, compassion, both great traits for a nurse.

I'm sure one day, a patient you cared for will pass. At that time, you will grieve just like you would if a friend passed. Understand that we all have to die some day and some days come sooner than others.

Many people in my family believe it is selfish to mourn the death of loved ones, because they have the better end of the deal. Maybe beliefs like that will help you.

As for me, I allow myself to grieve for one day. After that, I'm stealing from my friends, family, and other patients.

This is the work we're into. This is how it is. We see death, life, second chances all the time. Every one has their own way of dealing with it. It's up to you to find your way.

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