Time of Death 10:40. Wait, What?!

You can’t be a nurse for any amount of time without witnessing and/or participating in a code. This is my most recent experience in a code that had a surprise in store for us! Nurses Announcements Archive Article


Time of Death 10:40. Wait, What?!

The words drifted around the room as everyone stood quietly engrossed in their own thoughts. The air conditioner rattled then chilled air touched my shoulders prompting goose bumps all over my body. Surrounded by people, the atmosphere was desolate. Pulling the blanket up to the patient's neck, I looked at her face. Her mouth was open, eyes closed. Death is hollow. In the absence of breath, no amount of warm blankets can bring back blush to the skin.

With my mind racing I thought of the hour long code we had just finished. I replayed it in my head, marveling at how in an instant death claims us. Gazing at her face I saw the patient exhale. I could have sworn I saw her chest move, but I know the mind can play tricks on us, especially in highly stressed situations. I drew my hands back to my chest and stared. I had seen dead patients do that before, but this disturbed me. Had she really just exhaled, it looked like she had inhaled too, but that wasn't possible. Looking at my co-worker to my left, I whispered, "she just exhaled, I know they do that sometimes but . . ."

My co-worker was staring at her too, but then he got a confused look on his face. The next thing I knew, he reached down and put his fingers on her neck and said, "she isn't dead."

Scanning the faces of the doctors, CRNA's, and nurses in the room with me, I momentarily panicked. I tried to make sense in my head of what was happening. How could she be alive?

Hand still on her carotid, my co-worker said, "Yeah, she has a pulse! I saw her tongue move and thought . . . wait a minute, she ain't dead." The anesthesiologist running the code looks at the CRNA after he felt the patient's pulse for himself and tells her to re-intubate the patient and that the code was resumed. The patient was re-intubated and the heart monitors reapplied, the IV drips had not been turned off. Everyone in the room seemed to come back alive and stood alert for further orders. Poised to continue giving compressions, I felt a slight soreness in my shoulders.

The patient's pulse remained strong enough that compressions were not necessary. The patient was transferred to ICU as soon as it was appropriate. Unfortunately the patient passed away later that day.

Reflecting on what has transpired, I helped clean up the room and get ready to continue doing cases. Just like that, the room was vacant of the signs that trauma and death had created. I thought to myself how quickly we are gone from this earth. The body is so strong and resilient, but at the same time very fragile.


I was the one who went to get the patient from her room. Her nurse had told me she was ambulatory and that she had taken all of her prep for her colonoscopy. However, while waiting for her to get blood drawn we had a chat. As we chatted, she told me she had not finished her prep and that she had not had any results from what she had taken. The phlebotomist struggled to find a vein, finally opting for a finger stick. Observing the patient's arms and legs, I saw she was extremely edematous. "Are you able to get up to go to the bathroom?" She cut her eyes at me, "Who told you I could get up? I haven't gotten out of bed in months!" I admired her spunk, and appreciated the attitude. I explained to her that I was going to take the stretcher back, then come back and take her to the department in her bed.

Later, as the procedure was in progress, something prompted me go into the room to check on her or my co-workers, I don't know. Things didn't feel right. I went into the room and shut the door, crossing my arms I began making small talk while watching the screen. As the EGD was finished, the tech began setting up for the colonoscopy, and the CRNA asked for someone to call the anesthesiologist. Things progressed quickly from there and soon we had the code cart open and ready and the patient was intubated.

Everyone took a role without much being said, someone stood by the code card and found the drugs that were needed, the CRNA used the ambu bag. One person began recording and another called the supervisor. The patient had a pacemaker, and the monitor showed a rhythm but there was no pulse. "Let's begin CPR," said the anesthesiologist. I was one of the compression people. I felt something give at the sternum, a crunching sensation and I cringed on the inside.

There was a striking calm throughout the entire code. I enjoyed being a part of the process. Usually once you hit the code button the room gets swarmed with people and you get pushed aside. Since we had everyone present that was needed, we did not hit the code button, at the request of the anesthesiologist. This time I was able to push medication, do high quality CPR and observe the whole process first hand. Putting my ACLS skills to work felt good, the head knowledge knitted together with the hands on skills. Everything was done according to protocol, with fantastic communication, professionalism, and level headedness. I am very proud of my department for a job well done.

We were all shocked that the patient revived after an hour of no response. We figure that the drips and the pacemaker combined help do that, however, it was not enough. Knowing that we had done everything possible helped me personally deal with it. I will never forget her, or her spicy words and self advocacy.

Gastrointestinal Columnist
61 Articles   324 Posts

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1,763 Posts

Thank you for sharing this.


636 Posts

This was a really good story and I enjoyed reading it.

Chaya, ASN, RN

932 Posts

Specializes in Rehab, Med Surg, Home Care.

Knowing that her team was right on top of the situation and did everything possible is a great comfort to family/ friends.


9 Posts

Incredible story, and I appreciated reading about your confidence in the crew on hand. Well done! It's amazing that you felt that your protocol and your knowledge along with hand skills all just seemed to flow together. As a student, I often wonder how on earth that's going to be possible but in time it will come. Amazing job!


20 Posts

my question is she had no results from her prep or did not finish the prep and had so much edema why was the EGD and colonoscopy still going to be done?


1 Post

I was questioning the same thing. ...And the fact her primary nurse on the floor didn't really know about her....she is ambulatory...pt said she hadnt walked in a long time..where did the correct information about this patient get lost at...from previous nurse...alot of questions in my head....sad...scary...sad


2 Posts

A code that last 1 hour ?


2 Articles; 289 Posts

Specializes in Psych.

I'm not ACLS and have not participated in a full code [ just choking and unresponsive pts with a pulse] - but isn't it possible for electrical impulses to still indicate there is a pulse even after a pt has died? Thank you for the story.

I'm not ACLS and have not participated in a full code [ just choking and unresponsive pts with a pulse] - but isn't it possible for electrical impulses to still indicate there is a pulse even after a pt has died? Thank you for the story.

There will still be some electrical activity for a period after a person has died. There can be muscle twitches and such. There can be pulseless electrical activity in the heart that doesn't generate an organized contraction. A pulse is the wave of blood coursing through arteries after a heartbeat. It is evidence that the heart is pumping efficiently enough to deliver blood to wherever you are palpating, e.g. neck, wrist, so it's not possible to have a pulse when the heart has stopped.

My one full ACLS code was 40 minutes. I can't imagine an hour.

Specializes in O.R.

Thank you for posting.

Gastrointestinal Columnist

Brenda F. Johnson, MSN

61 Articles; 324 Posts

Specializes in Gastrointestinal Nursing.
my question is she had no results from her prep or did not finish the prep and had so much edema why was the EGD and colonoscopy still going to be done?

Good question, the colonoscopy probably wouldn't have happened, but some doctors go ahead even in light of such information. What I cannot put in the article is my true feelings about the decision to proceed with the procedure. Let's just say, I feel that the patient could have been treated medically until more stable.

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