worst ccu experience - page 2
HI, I was wondering what some of your worst CCU experiences were. Was it a mean doctor or patient, a patient going down the drain? I am just curious (or maybe tring to scare myself to death) I... Read More
May 13, '03Occupation: critical care Joined: Sep '02; Posts: 182; Likes: 1My worst experience was probably also my best, because I rose to a challenge and got through it (tears included) and continue years later....and my team rallied with me to get me through my nightmare.
I went to work asthe nursing manager of CCU for the 7P-7A shift, after several call offs. I went in, took charge and a 2 pt unstable assignment. If we could have come up with 2 more nurses I wouldn't have gone in, but knowing that even if we got 1 more nurse, if they weren't familiar with ur routines we'd have trouble..I went to work. What a night!!
I started with a 2 patient assignment:
Pt #1 cardiomyopathy, end stage with family deciding about code status-we withdrew the vent and pressors at 10P-he died before 11PM.
Pt#2 New AMI/Cardiogenic shock post angioplasty/stent multiple pressors coded and died by 1:30am.
In bed #1 got an admission 42 yr old, around 1am stable initially, who coded and died by 3:30a. I think that family had 50 family members (at least it felt that way)
My replacement patient for room number 2 came at 3am. He was a status asthmaticus/seizure disorder from the ER with a cardiac history, he too had an acute event and died after an unsuccessful code by 4:30am. I was totally fried!!!!!
Although at 5am on this day I had 2 newly emptied beds because of deaths, I did not get the next admission. My staff, who had been helping me all night with these 4 deaths switched asignments. As charge nurse and manager, if I had time earlier I probably should have split assignments, but apparently relatively benign assignments just crapped out on me!
At 5am we switched assignmentsso that I took a patient ready to be transferred to telemetry in the am so that one of the other nurses could take the next admission. We decided to play it by ear fro that last bed. Thet all told me that if we had another patient coming in that shift that I had sure done my duty that night and they'd pitch in to share the load.
So...although it was the worst shift I have ever worked...It was also one of the best. My co workers quickly developed a trust in my skills and commitment (although based on 4 deaths in less than 10 hours you'd never know I had any skills based on numbers and events)and we became a cohesive team.
I will never forget that night as long as I live. Thank God days like that are flukes and I've never encountered another quite so bad. I don't think I would have made it through 20+ years of critical care if things like that happened every day. I have to say though, I loved that night! Horrible and wonderful all at the same time.
There is no other profession that would allow me to:
Help an end stage person with cardiomyopathy die-and assist his family.
Care for an acute MI with complications-using all measures and code the patient without success, but feel like we tried everything.
Admit an acute Mi, young man, deal with his family and help themdeal with his death
Admit an asthmatic, cardia, seizure disorder pt who just couldn't thrive.
Reading this retrospectively I think-how could so many of them have died? Really-we had good support from physicians and Rt. It was one of those wierd things (that I hope I never live through again) I have talked with people about this night and they ask-"Why didn't you change assignments ?" Why would you take that assignment?"
It was because I had a few periods that I really only had 1 patient, got caught up...and then all hell broke loose again. As a new manager I hated to say I couldn't do it. I'm glad I made that choice.
My patient assignment decisions were appropriate at the time. There were no good assignments. We all pitched in and dealt with all emergencies (unfortunately I had to chart them all)The best thing was that my new staff quickly learned that I knew what I was doing, so my trial by fire was worth it. We were a team who would stick together, no matter what. In the next 2 years of my time managing this department, if there was a call off the staff covered it. It might mean that I'd be staff the next day, but I never had to be staff at night again. I asked them if they thought I was a night jinx...they said no ! They just knew that it took me a few days to get back to normal daytime routine, and thatsince they knew that I knew what they went through, I shouldn't have to do it again. You wouldn't believe the schedule switches they would make to cover shifts...unbelievable.
They told me they respected me, and that they appreciated me. I choose to believe that is the reason I never had such a horrendous night again. I would hate to think that they thought I was a jinx!
May 15, '03Occupation: RN PACU, Private Practice in Massage Therapy & Healing Touch Specialty: Cardiac/Vascular & Healing Touch ; Joined: Apr '03; Posts: 590; Likes: 29Wow, I am bowing in your honor. What a gal to live to tell about such a night. May God Bless hour helping hands.
May 15, '03Occupation: full time student Joined: Mar '03; Posts: 360; Likes: 2Since I am not a nurse don't have nursing story but when I worked in Resp had a ER code of a 3-4 year old girl whose mother beat her in the head with a boom box (portable stereo) when she came in we knew she was gone but we just had to try, looking down on that poor child I could see indentations in her head like a melon with bruises. Every squeeze of the bag brought more stuff oozing out of her nose and ears. Don't know how long we worked but I know I was at her head and tears were streaming down my face. The ER doctor was an old time doctor who ususally would start chewing on my a## for crying but he stopped code and said lets all join hands and pray for this poor childs soul, looked up and the charge nurse (nickname Ironmaiden) was actually crying too...... went home and woke up my 4 year old and just held and hugged her This was over 16 years ago and I can still see that poor childs face all battered and bruised. I think I could have went out to that waiting room where 2 police officers sat with the so called Mother and killed her. The officer asked the Doc to give the Mom something to calm her down after she became histeryical after they told her that her child was dead and he told them if he gave her something she would never wake up He even refused to let her see the child told the officers to get her out of his hospital.... We all clapped when he said that and they did leave. Whole hospital took up a collection to help with childs funeral. Mom went to jail for 5 years sad thing is that at same time a Man did't have his horses hooves trimed and it crippled 2 horses and they had to be put down and he got 12 years that really peed me off. Mother of the child had 3 more kids after she got out and they were taken away for child abuse .....Some people should just never be parents
I hope I never have this terrible of an experiance again
Sorry so long
RhondaLast edit by Rhoresmith on May 15, '03
May 16, '03Occupation: RN PACU, Private Practice in Massage Therapy & Healing Touch Specialty: Cardiac/Vascular & Healing Touch ; Joined: Apr '03; Posts: 590; Likes: 29wow! what a story! Thanks for being so human! & your team caring for her soul, that is holistic care!
May 25, '03Occupation: RN Joined: Sep '02; Posts: 15; Likes: 1Being a nurse for a only a year, I just want to say thank you for all your stories...It's nice to have some validation.
May 31, '03Occupation: Agency nurse turnig to case management Specialty: Step down, ICU, ER, PACU, Amb. Surg ; Joined: Apr '03; Posts: 2,186; Likes: 20Well.....1 was on the floor and did not happen directly to me, 1 was in the ER and 1 was in the unit....
#1: Was gophering for a code that my friend was working on, elderly woman in her late 70s...BMV, compressions, IVs, drugs, defib...the works (except no ET tube...don't remember why)....all of a sudden the woman sat up, looked at my friend, pointed at her and said "You!, I've been looking for you! I came back to find you!" Freaked my friend right out, and after that, would go to great lengths not to have that woman assigned to her on later admissions and for the rest of that one hospital stay.
#2: Late 50s to early 60s male came in to the ER. diaphoretic, crushing CP, nauseated...all the classic symptoms of a MI. Fit thrombolytic protocol....signed his consent to get thrombolytics (TPA at that time), placed 2 lg bore IVs, making araingments for a helicopter ride to a big med center and started the TPA. Flight team gets there, puts the fella on their monitoring equipment, gets him on their stetcher and BOOM! The guy goes into V-tach/fib on the monitor. Flight nurse never bothered to see if the guy had a pulse or if he was awake....just screams out, as he applied the paddles to the guy's chest wall, "STAND CLEAR!" and BOOF! shocks this guy at like 360 j on the first hit....Guy sits bolt upright on the stretcher and screams out "What the f*** is going on here???? That f***** hurt, man!" I heard later, he got to the med center alright and was doing well after a CABG.
#3: Psych patient admitted to CCU for a cogentin OD and the attending would not order the antidote (I think it was neostigmine) Had a 1:1 on him all night and things were going fine (considering he was tachy and borderline HTN) all night until 5 minutes before end of shift, he decided that enough was enough, started jerking wirse off, went for the IV, having audio/visual hallucinations, ran in to help the CNA sitting with him and yelled for someone to call a man power. Trying to hold a 6'2, 175# built like a brick s*** house guy in a bed, with help from a doc was no fun, while waiting for someone to respond to the man power, meanwhile 3 other nurses stood by and watched with out helping. After 15 minutes, 1 housekeeper showed up with the 4 point leathers.....by that time 2 dayshift nurses jumped in to help me, got the guy in restraints while 1 nurse manager contacted the doc and the otherone paced the foot of the bed, beside herself......the end result was that my thumb was dislocated and gave me a nasty tendonitis in the wrist, eventually 4 months down the road needed surgery to release the tendonitis and reconstrcut the thumb. Almost cost me my nursing career...was out a yr before going back. That happened in June of 96, went back to work full time in April 98 and turned around in 2000 and did it all over again, almost trying to keep a co-worker from getting stuck with a needle still in a kid's arm while taking rescusitative measures on him because of too much GHG(gamahydroxyglybutiline), a work out suppliment used to build lean muscle mass, which is now a controlled substance. Thought the kid broke my right wrist slamming it into a stretcher, turned out that it was only a bone contusion......Do I regret these things??? Not for one moment, because I know I was doing the very best for my patients and co-workers.......
Jul 5, '03Joined: Apr '03; Posts: 42; Likes: 3Not being listened to when I was SERIOUSLY concerned about a patient. I tried every avenue but got no support and my manager even ridiculed me to the other nurses, as the patient continued to deteriorate. The saddest part was when the patient arrested (coded). 15 people turned up to resuscitate him. If only one of them had listened to me while he was alive. He didn't make it, I left that job and I still hate my manager at the time with a passion.
Jul 7, '03Occupation: RN Joined: Feb '03; Posts: 1,250; Likes: 62Great riveting stories......thanks for sharing.
Jul 9, '03Occupation: Nurse Manager Specialty: 9 year(s) of experience in critical care, med/surg ; Joined: Sep '02; Posts: 940; Likes: 18Very powerful stories! I hope that someday (soon) I have a great story to share with you.
Jul 11, '03Occupation: RN Joined: Jul '03; Posts: 152; Likes: 10I completed my nursing practicum for the adn program in ICU with the help of a dedicated preceptor.I had spoken with her at length and other nurses on that floor as an lpn before I even entered the adn program.I requested at the beginning of the 2 yr program to do practicum in icu with the nursing staff at the college.After lots of static,I finally had my wish granted.I stayed up until all hours studying drips and meds and procedures to be on the up and up.I was offered a full-time position and accepted,surviving for 1 yr.If anyone would have told me about the saying "nurses will eat their young" in the icu setting,I would have run for my life then!I even attended a 4 month transition to icu program to be ready,so no one would give me static.Once I got into the real world of nights in the icu with no administration around,the fun started.The house supervisor and these 2 other nurses were smoking buddies and friends on the outside.Need I say anymore.All i had ever wanted to do at that time was to be an icu nurse and in an instant,those nurses took that away.