I think one of my toughest was thown at me within my first year of RN. I encountered a patient in a room next to my own patient. I heard struggled gargled breathing and there was a man spurting out massive amounts of blood out of his mouth. I ran in, hit the code button and started my ABC's!
Apparently the man had suffered a very fatal liver condition and was bleeding out. I assessed the lungs quickly before suctioning and they were filled and he was barely breathing...even when he did it was shallow and short. I grabbed the yanker and as soon as I got a small bit of suction, blood started coming out even harder! Even suctioning was creating increased bleeding! CRUD!
So finally the code team came, and at this point intubation wasn't even possible because he would bleed to death (like he wasn't already)...nothing we could do...he was going to die and make him comfortable.
Could not find his nurse anywhere! So I took it upon myself to try to get him comfortable and just then a CNA came in the room. Apparently his own nurse, knowing there was nothing we could do gave up on him and just told the CNA to make his bed, clean him up for the family who routinely came in at 0800 (it was 0745). She was tugging at linens and getting in my way as I tried to help this STILL LIVING patient have a moments comfort during his death! I finally had to yell at her to get out!
Family comes and his RN would have nothing to do with it! And my charge nurse was temp busy and said "tell them what you know..." THANKS! So I greet the family outside the door (with it opened enough for me to see the patient) and explained the happenings of the AM. The family was furious and in histerics...one about hit me in the chest saying "why didn't you save him"....uhgggggg!
So the MD finally comes in after taking a shower and eating his breakfast at home (as I found out later) and said that this was sudden and there was nothing anyone could do...that he had a sudden heart attack and died. Okay not what happened at all and wouldn't account for the macabre of blood all over the room!
Okay fine, not my probelm anymore...I got it handed off to the right folks and my patients needed me. Then the MD gets a hold of me and asks what happened, I explained...and he DARED to tell me that his lungs were clear and he just bit his tongue! Ummmmm no...he was projectile vomiting liters of blood about 4 inches in the air supine and tongue intact!!! It was all over the room!!!!!!!
Okay so basic story...he denied anything I said, said the patient was not terminal (which he was but he had not told the family...so total CYA on his arse), and I got labled a troublemaker!
Took a long time before my fellow nurses saw that I was right and they should be leary of this doc! That he would sell his own grandmother up the river to protect himself!
That was a very frustrating and tough day for me...seeing such a horrid death, a screaming family that felt I just let him die, being told that I was wrong and lying, people believing it, self doubt, worry, wondering if I would be sued or my license taken...all of it!
I worked there 3 more months before another thing happened that had me walking out after shift and never returning...but that is a whole nother fun story...LOL!