Hi. I don't post here often but I'm a PCT on a med-surg floor. I'm supposed to start my nursing program soon for Fall 2012. I was doing my rounds on my patients when I decided to check on this particular patient who wasn't feeling too well(vomiting alot). I checked on him often throughout this morning, trying to reassure him the nurse was going to give him some medication and maybe he could drink some water since he can't tolerate any of the clear liquids I tried to bring him. Anyway, I go in the room to check on him and just didn't look right. I can't really explain it(I know you're thinking-yea, duh guy is dead). So I start looking at him more closely for chest rising-nothing. I walk up to him and touch for his carotid pulse-nothing! Then, I start shaking him and yelling his name. So I then I panic and push down the CPR button on the bed, which makes his head drop rapidly(that would wake anyone up if they weren't dead!).
Meanwhile, I press the staff emergency button and call my nurse with my phone. She rushes over and starts yelling his name and shaking him. Once she tells me to call the charge nurse and says "omg", I realize that I'm having a code on this floor on my patient who was just normal, alert, and oriented. We were just joking a few minutes ago! So she freaks out and I freak out in the sense that she's trying to push the code button(but you have to pull, not push!), the charge nurse runs in and starts yelling for the crash cart. All I hear is yelling for the crash cart and I just ripped off the patient's gown and started compressions. So, I'm doing them(about 60-30 apart), still not believing this is actually happening. The crash cart gets to the room, and my nurse takes over the compressions.
I get out of the room to make room and RT and other people(doctors, code team, etc..,) comes in and I go back in and they start yelling for stuff like O2 connectors, suction tubing, etc.., I'm running back and forth to the supply room, grabbing stuff and trying to connect it to the right place in the room. I'm so nervous doing this because I know every second counts! I just left the room after I realized all the professionals had it under control. On my way to the supply room, I see my nurse crying and trying to compose herself. So, I went into a private room and one of the nurses asked me if I was ok, I said no and had a good 3 minute cry.
Anyway, the patient was resuscitated. I went back in the room to watch the code even though I really didn't want to because it really hurt me to see him like that. But I told myself I should see how a code really works. The code lasted about 35 minutes. I assisted in getting his stuff together and making sure the vitals were in before he left. His vitals were normal except for a brief moment when he was sleeping his 02 levels were looking low, but he was snoring(i believe he has sleep apnea) while I was taking them and I know usually his 02 levels are normal. However, when he was eating breakfast and alert, the o2 levels were fine.
I thought he had maybe aspirated on his vomit. Turns out he had a massive PE(I still need to research that!)
It was a good learning experience but it was hard for me because it happened early morning and I had many more hours to go. It was obvious they weren't going to send me home still we were at almost full capacity on the floor. So, I just kept telling myself, after having another cry in the bathroom, to keep it moving because I still had other people who wanted things.
It was my nurse's first code too, which explains why she freaked out as much as I did. But everyone says I did fine, that thank goodness I kept checking on him. My charge nurse was pleased. I'm glad he's alive but I can't stop thinking if the code was a waste because he's only gonna die again because I people don't make it from PE's, especially one that size. But I'm also excited because I saw a code and it was just intriguing once I wasn't the one involved but watching...
The code started as chaos but it quickly got together.I didn't think I would've had to deal with this on med-surg and just the other day I was thinking if I could ever work ICU or ER as a nurse because I know they deal with codes alot.
I think what affected me the most is that the patient and I got along well and then BAM, gone. I feel sort of bad for crying, but not many people saw me cry and I definitely tried to keep it together in that patient's room.
Sounds to me like you did a great job, especially for your first code. Just start you basic ABC's (or CAB now), call for a code, let the team take over and be available to run for stuff because you know best where to get it! The guy had a PE which would explain his sudden arrest.
You did great! You knew your patient and you knew something wasn't right. You also didn't freeze up and were able to function under pressure and did all the right things to help him. And crying isn't a problem so long as you can keep it together when you need to and it sounds like you did just that. I cried after my first code too, but my reaction was delayed. I got off shift, I drove home, and as I sat in my driveway I just started crying. I had gotten to know the man and it freaked me out that he crashed so suddenly and was unable to be resuscitated. Makes me appreciate life more.
You, my dear, are an inspiration, and I'm the one ahead of you (in nursing school). Your actions saved his life!!!!!! You, becoming a nurse is going to be a blessing to the patients you care for. God bless and good luck in nursing school!!!
You did GREAT! Every one of us has 20/20 hindsight about what we should've done better, faster, etc. You listened to that inner voice--which is totally awesome! It is perfectly normal and ok, imo, to have a few minutes of shock after an event. It is perfectly normal to cry. But you pulled it together and went back to work. That is what you have to do.
You're going to be a great nurse! Now you just have to get thru school and NCLEX! You can do it!
Sounds like you have good instincts. And a kind heart.
Next time remember your ABC's. Start compressions as you call for help.
It gets easier.
Yes, I will definitely remember that! I was afraid that maybe I was wrong and everyone would be mad that I just pulled the CODE button without making sure...
But next time I even have the slightest inclination, I pulling that button and screaming for help!
WAY TO GO for your fast action!!! My dear friend died in his 20's of a pulmonary embolism in the hospital when he was about to be discharged after a motorcycle accident. He and his wife had just had twin baby boys 4 months earlier.
What an awesome comment!! I had a similar post on "emotions" as a nurse.. though mine was a hospice patient, and it seems as though the nurses that replied weren't as understanding as you. As long as you can get the job done and attend to your patients throughout the rest of your shift, it sounds like you did fine! Great job on helping out! :)
It sounds to me like you did everything you were supposed to do. PCTs as "runners" during codes are the best, because you know where everything is on the unit and can get it quickly because, as you said, every second counts. Most codes are chaos at first, and then our training kicks in and things move more smoothly.
If the patient was able to be resucitated and had stable vitals when they took him to ICU, he may well make it. I've seen patients with pulmonary emboli do just fine, although it does depend on where it is in the lung.
It's okay to feel upset or sad when you code a patient, especially if it's someone you connected with. It sounds like you had your "moment" after the code and then were able to continue your shift and meet the needs of the rest of your patients. That is the mark of a true professional. Well done! :redbeathe
I have to say that you did an awesome job! As other posters have said, the patient is alive due to your quick thinking. When patients get quiet and just don't look right, watch them closely! Many people take a long time to develop this sixth sense. It is GREAT that you knew how to drop the bed and also how to call for help. A good thing if possible to always have in the patient's room that I check DAILY is suction tubing, a yankauer tonsil tip, and a BVM.
While patients do get DVTs and P.E.s, we can manage them well if they are caught soon enough. Did I say good job for watching this patient closely? Keep those TED hose or SCDs on the patient! Also, that is why they should be getting Lovenox for periods of extended bed rest.
I know many, many people that get overwhelmed sometimes that are a lot stronger than I am that lose it afterwards. Just goes to show you that you are human and that you care! Try not to ever get jaded and cynical!
Once again, good job! You will do great in Nursing school!
P.S. Come back here often when you do get into nursing school. I doubt I would have gotten through school without help from "Daytonite" who was awesome!!
Specializes in Wilderness Medicine, ICU, Adult Ed..
Sunnybabe, you are my heroine, but I do have a bone to pick with you. In your post, you claim that you "panicked." No, you did not panic. You felt very afraid, but that is how you are supposed to feel when facing a dangerous situation, especially the first time. "Panic" means becoming hysterical, irrational, and either freezing motionless, or running away and hiding (both of which really do happen - trust me on this!). You felt very afraid, but, instead of panicking, you stepped in and took intelligent action on your patient's behalf. You get an A+, because how you feel in an emergency does not count; only how you behave, and you behaved superbly! The fact that you acted rather than panicking shows that you have the makings of a true nurse. That is what makes us different, you know. We are just like everyone else, except that when everyone else in the crowd is gasping and backing away, we are stepping forward.
Oh, and one last thing; do not question your career choice or ability because you cried over a patient. The time to question your decision to become a nurse is when you are no longer able to cry over a patient.
I feel sort of bad for crying, but not many people saw me cry and I definitely tried to keep it together in that patient's room.
Creamsoda, ASN, RN
728 Posts
Sounds to me like you did a great job, especially for your first code. Just start you basic ABC's (or CAB now), call for a code, let the team take over and be available to run for stuff because you know best where to get it! The guy had a PE which would explain his sudden arrest.