Looking for support re: first full code

post moved to own thread.

We can't give legal advice on here per TOS. I would strongly recommend you contact an attorney and/or malpractice/liability insurance to discuss. If all your ducks are in a row, your charting done completely and appropriately, then you have done what you could.

As for the code itself...Honey, we can't save em all, and you will need to accept that. I gather from your post that you are in a LTC setting (forgive me if I'm wrong), and so probably have been with this patient for a while. I know it hurts a whole lot more to lose someone you have been caring for for a while. Try to see if there is any kind of debriefing or employee assistance to help you grieve adequately.

Try to use this as a learning experience. What actually happened? If patient had MI, what symptoms should have been there? Sometimes patients don't present with the traditional expected symptoms, especially in males vs. females. IE location and description of pain. Sometimes patients have that sense of impending doom before they crash. Did your patient seem particularly anxious the last time you saw them? Of course this is just an example as I don't know what happened, but you hopefully get the point.

That instinct and nursing spidey sense is something that will develop in time. Just learn from this, relax, have a glass of wine or something.

You know, sometimes people just die. There will probably be a post done, and that will get everyone to stand down.

Call your malpractice carrier and tell them about this. (You DO have malpractice insurance, right?) It is their job to defend you even if all you need is a pointer letter to the other side telling them to back off. The sooner they know about anything at all, the better.

As to the threatening angry sounds, if the contact was a relative, anger/shock/denial is a common first response to an unexpected death. Don't talk to anyone but your malpractice folks, certainly don't talk to the angry guy on the phone. Any such calls should be referred to administration without comment of any kind from anyone including the ward clerk and the housekeeping guy.

Contact a person in the same field as you or a cousellor and debrief!! No matter how much death we see as long as we have the ability to talk it through we remain human, if we don't let it affect us we wouldn't be human.

If you can talk about it with peer nurses, it can be really helpful. I have some friends from nursing school and we vent/debrief as needed. While they don't work with me, they can relate to the stress and I know I can trust them. Now is a good time to be gentle with yourself and accept that it will bug you. I think trying to force yourself to feel what you think you should feel is more harmful than just accepting the occasional thought or feeling as it pops up. I have dealt with some pretty intense situations at my hospital and sometimes, I will have a flashback as I enter one of those rooms or a patient says something similar.

If you can talk about it with peer nurses, it can be really helpful. I have some friends from nursing school and we vent/debrief as needed. While they don't work with me, they can relate to the stress and I know I can trust them. Now is a good time to be gentle with yourself and accept that it will bug you. I think trying to force yourself to feel what you think you should feel is more harmful than just accepting the occasional thought or feeling as it pops up. I have dealt with some pretty intense situations at my hospital and sometimes, I will have a flashback as I enter one of those rooms or a patient says something similar.

There really is a LOT of truth in this post. Don't force yourself to feel anything other than what you actually do. Don't beat yourself up about what you should have known or done, looking in retrospect, because you didn't know. Sometimes patients will just die with little warning. I've run quite a few codes, relative to the general population (about 20 or so), and I don't feel like I could have done more for my patients. Why? I did what I could for them and did my best. Our job, when we battle death (and we all will lose at some point anyway), is to nudge the patient toward life. Sometimes we can give them a pretty good shove toward life, but ultimately, they may be too far down the path to want to do anything other than "listen" to our persuasion.

Try to find someone that can facilitate your debrief and talk it over with the staff that was there. Chances are pretty good that the EMS crew won't have to be there unless it was somehow traumatic for them as well (probably not if it was relatively routine for them). Bottom line: talk it over and process those feelings (even if you feel ambivalent about it) because something is bothering you enough that you're posting about it here.

And yes, I remember my 1st code, and my most recent one. The rest are mostly a blur, though about 3 or 4 stand out in my memory.