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.
i am glad you cried, nurses need to be real and human! the fact that you did it for a short time after the event is professional. you did great. it is critical thinking skills to listen to that voice that tells you something is not ok. you thought through the first steps and did well! i like that you are asking for an evaluation of how you preformed. you have the stuff great nurses have!
I think you did an amazing job! And don't feel like you are not qualified to be a nurse because you were emotional. I think that will make you an even better nurse. I've cried after codes. They can be extremely emotional, especially if they patient is awake and alert, then crashes. Again, great job in how you handled things!
Specializes in L&D, CCU, ICU, PCU, RICU, PCICU, & LTC..
When I read your post and the comment about "he had PE", my first thought was Pulmonary Edema. Never once thought of Pulmonary Emboli, though both cause severe respiratory effects. Different nurses, different work locales.
I wanted to share with you the fact that P. Edema can come on very quickly too, from that "just-not-right" phase. I had a patient who was fine, talking & joking, and before I reached his door was in full blown, frothing P. Edema!!
With 10-12 yrs in various critical care/specialty units I had more than my share of codes & emergencies. One man I coded 23 times in CCU & ICU before he got out and took his trip from Tampa Bay area to Disney World on a moped! Patients can really surprise you sometimes. Stay close to your patients to cheer and encourage both of you.
The most important thing is to STAY CALM. A few seconds to take a deep breath and assess is monumental in functioning and it sounds like you have that down pat already. (Run for items, move out for pros, etc). Best wishes for a long and fulfilling career.
Specializes in Med/Surg, OB/GYN, ER, OR, ICU, CCU, Long.
Number one good job listening to your instinct! Number two there should be very little running in a code if u have an organized well stocked and maintained crash cart. Number three I highly recommend mock codes at least once a month to reduce stress, increase proficiency, increase self confidence, improve team work, and get rid of that initial panic when some one codes. I highly recommend a very tough old school ACLS and TNCC course if you can find one. Always remember, they are dead!! It doesn't get any worse than that. You are at the bottom of the barrel. You can only go up. I also make it a practice to open my crash cart and go over everything in it until you can close your eyes and put your hand on anything you need! Amazing how smooth a critical situation can go. My last recommendation is a good open debriefing afterwards.
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.
- Pulmonary Edema is fluid accumulation in the air spaces and parenchyma of the lungs.[1] It leads to impaired gas exchange and may cause respiratory failure. It is due to either failure of the left ventricle of the heart to adequately remove blood from the pulmonary circulation ("cardiogenic pulmonary edema"), or an injury to the lung parenchyma or vasculature of the lung ("noncardiogenic pulmonary edema").[2] Whilst the range of causes are manifold the treatment options are limited, and to a large extent, the most effective therapies are used whatever the cause. Treatment is focused on three aspects: firstly improving respiratory function, secondly, treating the underlying cause, and thirdly avoiding further damage to the lung. Pulmonary edema, especially in the acute setting, can lead to respiratory failure, cardiac arrest due to hypoxia and death.
Thanks everyone for your feedback! I've gotten many kudos at work but I still think about it, not in a traumatic sense but more as a learning experience.
You did a great job! You acted quickly and did what you should have done! Kudos to you! Dont feel bad about crying. My first code I didn't even know the patient (hadn't dealt with her at all that day, wasn't my patient) but went to help in the code. After an hour I checked her pupils (no one else was, didn't know what else to do while waiting to relieve the person doing compressions) and there was nothing. Whispered that to a nurse and she said, "Well, tell the doctor!" and I did...the resident checked, looked at me (while I was doing compressions now) and said, "What do I do now?"...I kid you not, I said, "You are the doctor, what should you do?"...and he called it. I was smashed. I went into auto mode. When my nurse touched my hand and suggested I go to lunch, I literally LAUNCHED over the bed into her arms and completely lost it. She pulled me aside and we talked, she went with me to lunch, and after lunch said, "Now, clean your face. It's time to move on" and we did just that. Moved on. Held in the tears as we heard the family wailing and crying...and just moved on. Crying is normal. You can and SHOULD do it. Like someone else said, when you stop crying, that's the time to consider moving on.
I'm a student nurse (LPN) in California almost finishing out my program and I have to say that the fact that your recognized the situation and responded so hastily you as well as the other members of your team really did something incredible! I had my first full code while working here in socali at my clinical site ER. We had the call at around 1710 from the paramedics reporting that we had a full code drowning victim coming in so we set everything up at the bedside and along with another student, two RNs and the ED MD we received the pt moved him to a bed while still on the backboard and immediately began chest compressions. With the other nurses encouragement and the fast actions of the medical team (and the wonder drug dopamine) we were able to bring his HR from just 17bpm to 134bpm within minutes. This code lasted about 30mins as well and once stable the pt was sent to the ICU. Unfortunately for my pt, he had spent too much time underwater and now had organic brain syndrome.. Two days later his family made the hardest decision which was to pull the life support and to allow him to pass. It was hard and very nerve racking not knowing if you were able to do any good but even that recognition was enough and you helped save their life. Kudos!
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.
PrayeRNurse, ASN, RN
118 Posts
i am glad you cried, nurses need to be real and human! the fact that you did it for a short time after the event is professional. you did great. it is critical thinking skills to listen to that voice that tells you something is not ok. you thought through the first steps and did well! i like that you are asking for an evaluation of how you preformed. you have the stuff great nurses have!