At 0640, was told I was getting a code from the floor, ok, let me assess my other pt real quick before new pt gets here, turn around and here comes the code, No call saying they were on the way mind you.....
Pt covered in blood, Neo at max, no respiratory therapist with a vent, the report I got was pts BP had been low since approx 2100. And they had been coding this pt for almost an hr. Thats it, nothing else, no other information, at this point, I didnt even know the pts name, history, nothing. Get pt hooked to monitors, nurse helping me gets drips going, started on Levo, BP 70's/30's. Pt white as a sheet, no palpable peripheral pulses, insert foley, immediate return of pure bright red blood, turn pt to get all bloody sheets from under them, blood pours from nose and mouth. Unit of blood going, NS bolus, Levo, Neo........ blood pressure still dropping, lab calls with Hct of 15, ya think??
So, I clean the pts face, and immediately recognize the pt. I had taken care of this pt for almost a month before moving pt to floor last week. When pt left unit, pt was joking, talking, smiling, the whole 9 yds. Pt was going to be discharged home yesterday.
Well, family decides to withdraw. Bring family in to say their goodbyes, and one of the daughters, ask me "You wont let __ be alone or hurt?" I told daughter that Id be there until the end. So they leave. Pt extubated, all drips turned off, cleaned up again after extubation (major amts of blood come out with the tube), In a matter of 15 min BP is unobtainable, heart rate drops to 40s. I go get the family, and ask if they want to be there. Daughters and S/o come in. They hold the pts hand, s/o other says "Thank you for loving me..." and I lost it. They were all there as the pts heart beat its last time, and as the final breath was taken.
Then I have to go and ask about donation. They decided to donate eyes, but due to the bleed pt wasnt a candidate for any other donation. We are all crying uncontrollably by this time. I go and call the eye bank, and get pt ready for them. Im in the room by myself with pt, and I remember one of the last jokes that pt had said to me and another nurse, and I lost it again..... took me almost 30 min to regain my composure. Of course by this time, the other nurse that the pt had joked with came in and we were talking about, I told him what pts s/o had said as pt died and he lost it too.
The 2 of us sat in the room with this pt sobbing like babies......
I have done hospice, have had pts die before, have cried with families before, but for some reason, this one bothered me so bad.
All of this and then I have to go with docs to talk to my other pts family about "the chances of her dying are greater than her going home". We wind up getting 3 more codes that I help my co workers with, and at 1835 get one from the floor that is another bleed, blood pouring from everywhere. Clock out at 1940, get home, but my things down, and the first thing I do is pour myself a VERY strong drink and go to my bedroom......DH comes in and asks "so how was your day?" Didnt even look at him, just turned up my drink, turned the lights out and went to bed.
Sorry this turned into a book, just needed to "talk" to others that had been there...........
