worst ccu experience

BadBird, BSN, RN · Sep 17, 2002

My worst scare was when we called a code (which was done via telephone) and no one answered. The operator took a break and the person filling in didn't know what to do so just did not answer the code phone. We couldn't even stat page anesthesia or resp. because the same person was at the phone and just wasn't answering anything. We called directly to the ER and the doc flew up. What a mess and what a write up to say the least.

nimbex, RN · Sep 26, 2002

two codes at the same time... at night with limited staff... could have been bad, but we called to the MICU next door and a nurse came to help.

mattsmom81 · Dec 26, 2002

Worst situation ever: a patient is doing poorly and the doc just ignores your calls for help...and lets the patient arrest to possibly not recover. It is the most helpless feeling in the world.

shoelace · Jan 29, 2003

It is a most helpless feeling... I was in that situation once... pt with CP, called MD who said "It's just indigestion." ... then we couldn't get ahold of her again, as the patient coded. The worst part of that was the patient looking up at me (as everyone else was quite busy, I was up by her head trying to calm her, tell her what was happening.) It was very surreal... there was so much chaos in the room surrounding her body, but it was like she and I were in a whole other universe. I told her what was happening, and then she looked over at my face and asked, "Am I going to die? I'm so scared, I don't want to die." She'd just been sitting up and eating dinner an hour before.

I told her that she wasn't going to die, because I honestly didn't think she would.. we'd find the MD, fix the problem, and although she'd be quite critically ill, I didn't think she'd die.

She did, though. Tamponade. It was the worst night of my life, thinking I told her she wouldn't die, but she did.

New CCU RN · Jan 29, 2003

My worse situation was similiar to yours shoelace. I had a pt who'd already ruled in once for an MI, was waiting for a CABG. He had an IWMI. Anyway, he'd a IABP for a few days but they pulled it that afternoon because they felt he was doing fine without it. Within a half hr he began having major CP...EKG showing the worse ST elevation I have ever seen. Paged the docs, started a NTG gtt, got another EKG, same thing, not any better, man is vomiting all night long. The resident said flat out she doesn't knwo what to do, I beg her to call the fellow or the attending, fellow says just give him some Ativan. Right ...like that is gonna fix ST elevation. The resident didn;t even want to send enzymes, but I sent them anyway hoping to prove to her that something BAD was going on. He came back with a Troponin of over 150.

Anyway, this song and dance went on all night long. I am feeling so bad for this man and keep on telling the docs, he needs to go to the cath lab....this isnt under control. He keeps on telling me this is the worse he has ever felt in his life. He looked just like a deer in headlights.

Problem was it was Christmas Eve...they didn't want to bother the attending, despite all the obvious signs that his man was not getting better.

That morning we intubated him bc he went from 2LNC to a 100% NRB and his sats started dropping on that. The put the balloon pump back in that morning. When CT Surgery came to round on him the refused to do the CABG for the next few days because he got unstable that night. Over the course of a few days, he gotten sicker, and sicker, spiked temps and got septic. Of course then CT Surgery really refused.

About a week later after all of this, the family decided to withdraw. Fortunately they were able to extubate him and he could talk to his family, and he said that they were making the right decision, etc. Still was the saddest thing ever and as I am writing this tears are still coming to my eyes.

JohnnyGage · Jan 29, 2003

My worst experience also ended up being very rewarding. I had just started working in a CVICU -- still in orientation. I was a fairly new nurse working on some paperwork when I spied a friend (also a CC nurse). We had worked together at another hospital where I was a nursing assistant working my way through school. Her aunt was in our unit. She had some pretty advanced breast CA and kept getting pericardial effusions. She had come to us after getting a pericardial window.

I chatted with my friend for a while and then went on to do other things. I had to take a patient down to CT and was gone for about an hour. When I got back to the unit, there was a full-blown code going on in the room of my friend's aunt! The window hadn't worked, she was tamponading and going downhill very fast!

I ran into the room to help out. We ended up doing an emergency sternotomy. All of us worked very hard. Toward the end of the code, I checked her pupils and saw that they were fixed and dilated. I excused myself from the code and went out to the lounge where the family was waiting in tears.

Katie (my friend) said that she knew right away what had happened when she saw me. As she ran up to give me a hug, I told her, "Her pupils are blown, Kate, it's over." She burst into tears and told her family what I meant. I held her for a while before we walked back to the room where she could tell the team to stop.

We lost touch after that, but I realized that day, that nursing was what I was really meant to do. I also discovered that I could be strong in some extremely painful situations.

I received a card from Katie several months ago thanking me for all I had done that day. My being there -- and being the one to break the news to my friend -- really meant a lot to her and her family.

New CCU RN · Feb 14, 2003

wow that is a great story johnny

RNCENCCRNNREMTP · Mar 16, 2003

Not CCU but in the ER

0250 Code #1 arrives. 500 pound man transfer in from another hospital with "lower extremity swelling and chest pain/sob" (can you say PE). Arrived in arrest, worked for 30 minutes, dead.

0305 Code #2 arrives, 29 females from private car. In pulseless VT. Shocks and drugs gets her back to a pulse. Admit to CCU and died next day. Cause of initial arrest unknown.

0345 Code #3 arrives, older woman with terminal disease, family wants it all done. We do it all she dies.

All this in 1 hour with 3 nurses and 1 MD. Sweeeeeet. I had fun!

healingtouchRN · May 6, 2003

there have been a few in my time.....what comes first to mind is when I was in charge in my old job 8 or so years ago, my staff just didn't show up....one guy (a new grad but with little hope) came in, & admin. sent a float nurse who was on something (crack maybe) & we were full with 12 pt's, post MI's with vents Post CABG on reverse isol with warmed blood, the works, really sick people, & meanwhile I really believed help was "on the way"! Well, the nurse that was impared made a story of her brother was ill (Funny, I didn't hear the phone ring for her) & she left hurriedly, so I aquired her pt's, meanwhile calling admin. between real pt care, running up & down the hallways. It should have been 6 nurses on & that wasn't the case. The house super. was clueless in the CCU. I transferred from that facility soon after that, after I made it clear to admin that I would never work like that again. :rolleyes:

sandgroper · May 6, 2003

A 36yo male admitted to CCU to exclude MI. Arrived on the unit late evening when his CP had resolved.

On morning rounds the next day, the registrar asked him "tell me about this pain you had yesterday?"

Patient says (clutching chest) "about the same as the pain I have now"

Thoracic aortic dissection, now ruptured! Sternotomy failed to bring him back.

gwenith, BSN, RN · May 6, 2003

Don't you love the patients that despite "the talk" won't tell you about thier chest pain!

I am trying to decide which one to post............

A code who woke up during chest compression ( guy doing the compressions was 6'++ and BIG) and looked around - we still lost her.

The old lady who was failing - nothing to be done - called in family and she woke up first time that night to say "What are you doing here anyone would think I was dying,"

But nothing that has happened in CCU begins to compare to the time I spent in a regional ICU/CCU and the children that we lost. One day when a thread is started I will vent but until then the memories stay................