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Discussion

1st pediatric code

Last night was probably the worst of my short career, I have been an RN in the ED for almost two years, We had an 18 month old come to the ED who was lethargic and had a high fever and vomiting and began having seizures shortly after arrival. The child apparently aspirated and had to be intubated as well as developing a pneuomothorax and requiring a chest tube placement, there were complications and the child had to be extubated and re-intubated, we almost lost him in the process. To make matters worse the pt is the son of an officer who is a great friend to most of us in the ED and also is the spitting image of my own 18 month old son. we flew the pt to the nearest metro hospial and got word towards the end of the shift that he is in MODS and isn't expected to survive. Looks like meningitis. I don't know how, but I managed to hold it together till end of shift but am falling apart now. I am not a religious man, but tonight I said my first prayer in nearly 15 years. Kudos to all you pedi icu/er/oncology nurses, how do you guys do this?

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Hugs to you. I took care of my first pedi sexual assault tonight that had to go to the OR for repair. Sometimes I don't know how we do this, never mind pedi, who sees this stuff WAY too often. Lean on your coworkers...most on the outside just don't get it.:icon_hug:

Man is it tough getting those codes. Those are the ones we remember in our sleep. Hugs to you.

What helps me during these codes is a strong faith in God and my own mortality. I pray every day that I don't see my own family in the ED or hear my address go out over the radio. I go into a code no matter pediatric or adult and do my best to provide the best care to the patient and their family, come out knowing I did the best I could, and move on to the ones that need more of my care while saying a prayer for the ones that have passed one. It gives me peace.

Go and hug your children, tell them you love them, and cherish another day with them.

:icon_hug:

I am so sorry. It's just not fair.

This may sound crass, but it will get easier. I've never had a pedi code where I didn't say a prayer, not only for the patient and their family, but for myself and thanking God that this wasn't my child. It's like anything else in nursing, the more you are exposed, the easier it gets.

Acknowledge the sorry you are feeling, talk with the hospital chaplain or another nurse, file the experience away and learn from it what you can, so you'll be better prepared for the inevitable next one. Then move on. You did the best anyone could do. Learn to let it go, it will get easier.

{{{{hugs}}}}

Blessings

so sorry you had such a rough night. sending gentle hugs your way. I have been doing this longer than i want to admit and i have to say that i still have a hard time dealing with the death of a child. feel free to vent here ; see if your hospital chaplain has any kind of bereavment counseling or if the ED has a debreifing conference. feel free to use your employee assistance group as well if you find it lingering. There is no concrete answer to why this happens;thats what makes it so hard for us to deal with. Peace to you and prayers for the child and his family. mary

I'm so sorry you had to go through that and I hope the child defies expectations and proves them wrong. I have seen miracles too many times to not believe in them. I also strongly believe what the Bible says, that children are special to God. Sorry, getting off track. :>)

I have worked with critically ill children for almost 20 years. In some ways it gets easier, in others it doesn't. The ones who remind you of your own children are the worst, or if you do know the parents. I do rely on my faith that there is a reason horrible things like this happen and in time, I'll understand.

The horrible truth is that sometimes I wear a protective armor and don't let them get in. If I let everyone break my heart, I couldn't go on. Yesterday I went after an infant post-arrest. I know he's not going to survive and it's a terrible tragedy, but I had to do my job and not let the emotions take over, if you know what I mean.

Talking it over with coworkers does help, or even going to a professional to talk it out. Our hospital offers the Employee Assistance Program. A few years ago we had a rash of hem-onc kids spending months in our unit and then passing away. Unfortunately, the one who kicked it off was a friend/co-worker's daughter. It got to the point where I wasn't sure I could continue working there, so I did use our EAP and it helped. It's confidential and free.

Another thing, you might want to ask your hospital about assisting the staff with a debriefing session with trained personnel. It sounds like many of you are going to be having similar emotions.

I hope this helps! Take care of yourself.

Sorry you had such a rough night.

I'm a PICU RN and it is especially hard if it's a child you know or a child that looks or is around the same age as your own children. I had to put a 7 year old in a body bag and do all the post death stuff and I couldn't help thinking what if this was my 7 year old, I almost couldn't bring myself to cover her face with the shroud....very hard stuff. I still remember that child and it's been almost a year!

Life just plain sucks sometimes, children shouldn't die. I think after a day or two of processing all this you will start feeling better, at least thats how it is for me.

  • Experts

Unfortunately there are no guarantees in this life. Children become sick and die, and we can only do what we've been trained to do while praying for the best. It is hard when the child is connected to someone we know or resembles our own child, that's true. Recently we've had a few children of coworkers on our unit and all of them will have ongoing problems. We support the families in the same way we do any other family, and debrief in our chosen ways.

Last Wednesday I was at the hospital for a meeting and ran into a former patient and his dad; the boy had been on our unit for four months and had been to death's door several times, but now looks like he's on the road to recovery. We stopped and chatted and at the end of the conversation the dad told me that my little friend's older brother (who shared a genetic disorder with the younger one) was also in hospital in another part of the city. I commiserated with him about how difficult it is to choose between one's children especially when they're sick, and I wished them all well, then left to attend my meeting. When I went in to work Friday there was a note in the staff room letting us know that the brother had died unexpectedly Wednesday night. Now I feel doubly horrible for that family because the dad was not there when the older boy died, and because now they have to contend with the fear that the same thing could happen to the little one. They've already been through so much!

When all is said and done, I will go back in there tomorrow and do my job to the best of my ability and try to forget that it might not be enough.

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