Worst Nightmare as a Nurse Came True

Nurses General Nursing

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Specializes in Med/Surg, Step-Down, Case Management.

Hi, I'm new to this website and still a fairly novice nurse (2 years on a med/tele/CI floor). I guess I'm looking for a place to vent. My worst nightmare as a nurse came true the other day -- found a pt on the floor, unresponsive, cyanotic, and mottled. It was absolutely horrible. His tele was d/c'ed just a few days before (he was s/p recent CABG, admitted for DVT). I did my usual rounds at 1400, and at 1455 was when we found him and called a code blue. So I have no idea how long he was lying there on that cold floor, dying. And I was absolutely worthless during the code. After the code team came into the room, I just stood in the hall, crying. They were able to get a pulse and transfer him to ICU. He was on a vent. I don't have the guts to ask what happened to him. I'm terrified to find out because, I know the odds are against him.

The guilt and grief is overwhelming me even after talking to the MD, my manager, my mentor, and my best friend who's a nurse... and they all say the same thing "there's nothing you could have done." But I still can't help but think "if only I had checked on him 15 minutes sooner..." What if... ??? Everytime I close my eyes, all I can see is him laying on the floor face-down, then rolling him over, and seeing his blue skin and lips. I want to work ICU in a few years and now I don't know if I can handle it.

I do plan on speaking to a counselor/chaplain because I just don't know how to drop it and get over this. I love being a nurse, but this code is eating me up inside. I was just wondering if anyone else has felt this way too or has had a similar experience?

TIA!

Specializes in ICU/Critical Care.

There really is nothing more you could have done. The point is, is that you found him. Don't beat yourself up over it. Codes are emotional. I don't know if this was your first one, but when I had my first patient code on me, I cried also.

Specializes in OB/GYN, Peds, School Nurse, DD.

Awww (pet pet) I know just what you mean. I had similar things happen to me as a young nurse and it really upset me. I took all the blame for all kinds of things that weren't within my power to control.

You fellow nurses are right--you couldn't have foreseen or prevented this. You're asking the wrong question though. Not "what if I had gotten there sooner?" but "what if I hadn't been there to help?" Because you did all the right things. You called the right people and then let them do their job.

As a nurse you know that sometimes bad results happen for no good reason. Young men, old ladies, little children die. We all die of something. I think it would be very helpful for you to debrief with a grief counselor or chaplain. They can't take your pain away, but maybe they can help you understand what you can and can't control.

The Serenity Prayer might be a good one for you. If you're not religious, then subsitute the word "God" for the Higher Power of your choice.

God,

Grant me the serenity to accept the things I cannot change (like patients who die unexpectedly)

the courage to change the things I can (like the negative thoughts that are crowding out the facts)

and the wisdom to know the difference.

We aren't called to save everybody. You can be a caring nurse, a wonderful nurse even if you sometimes lose a patient. We don't control life and death--if it's time to go, then we'll go. And so will everyone else.

((hugs)))

Specializes in Med/Surg, Step-Down, Case Management.

Thank you for your kind words. This was my first code.

Specializes in ER.

You found him, you called a code. You did the right thing. I still remember my first code. It will stick with you forever. I think talking to counselor will help you through this. I can tell you are a caring nurse...we need more nurses like you. Don't let this discourage you from pursing the ICU.

The others are right- there is nothing more you could have done. You have multiple people to take care of and things to get done during your shift. I had a horrible experience my 1st year.

I walked into a pt's room to test his blood sugar before I did my morning med pass (I always do diabetics first to make sure they aren't crashing on me- that's another story in itself). Well, he was a very friendly man and we always joked around- he was always up all night too. I told him I'd be back with his morning meds in a little while he said "okay honey". That morning, I decided to spice my med pass up by starting at the opposite end of the hall- why I don't know but I did. When I got to his room, I got his meds ready and started talking to him before I even got to the bed. The CNA had walked in behind me and I thought it was odd he didn't say anything to me. I looked at him with just the light of his tv and thought to myself he looks a little pale. I stood there with a cup of water in 1 hand and the pills in the other and went to put it down. I tried to wake him but all I felt was a cold body. I checked for a pulse as did the CNA and then it dawned on me that this was my first code. I ran out of the room to check his chart for a DNR (things are done differently at my LTC place) and there was no pretty yellow paper or order so I called the code. I was shaking so bad that I couldn't even go into the room. A more experienced nurse went in with others and did what they had to before the paramedics came. He was everyone's favorite patient. WHY did I start at the other end of the hall that morning? I bet if I would have started at the other end, I would have JUST found him unresponsive and could have possibly saved him. But noooooo, I started at the other end and it took me much longer to get to his room that morning.

Bottom line was you never forget your first... learn from it. Since that code, I've been in charge of about 14 others so far. That's right, I take over now because I know what I'm doing and now I'm that nurse that runs ahead of the new nurse standing out in the hall. Nursing is a learning experience, we are always learning.

Specializes in Emergency Room.

((((((big hug)))))))))))))))). its always emotional when a pt codes. the fact that you took the time

to come here and tell us your experience tells me that you care alot about your pts. nursing is a great profession. just think about the lives you do save everyday with your critical thinking skills and judgement. we are the eyes and ears of what pts can't or won't tell us. don't stop doing what you are doing.

Don't indulge yourself in "what if..." Questions. No matter what, the past is the past. You did all that you could and it is not your fault!

Specializes in SICU, Peds CVICU.

When I feel sad for a patient who has died (which your patient might not have), I think of them in heaven. I'm not particularly religious, but it makes me feel like, even though they've passed, I helped them get to a better place.

Specializes in Cardiac, Adolescent/Child Mental Health.

Be gentle with yourself.

:icon_hug:

Specializes in LTC.

Even if this patient doesn't make it out of ICU you gave his family a couple of extra hours or days to say goodbye.

Specializes in PICU now, Peds and med-surg in the past.

Try not to be so hard on yourself, you really couldn't have known and everyone who told you so was telling you the truth. Med-surg can be so busy, even complete chaos and you can't be in 6 or 8 or 12 different places at once. I've been in a similar situation where the patient died and I felt much the same as you. Not to say that I got over it but I did learn to accept that I don't have control over everything and that I was busy doing my job, it's not like I was sitting at the nurses station taking up a chair. You also aren't the first nurse who felt "useless" during your first code, it's not easy but you will get there. They're never EASY for me but you learn to just do what you have to do and deal with the emotion later. You may always have codes that you cry after, I do, especially now that I work with children and that sensitive, caring part of your personality is probably the strongest attribute you have as a nurse. Keep supportive coworkers, mentors and friends close to you, and if you believe in God like I do, sometimes all you can do is realize that God has a will and it will be done no matter what you do. Take care and good luck!

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