Worst Nightmare as a Nurse Came True

[idrinkpop]

Hi, I'm new to this website and still a fairly novice nurse (2 years on a med/tele/CI floor). I guess I'm looking for a place to vent. My worst nightmare as a nurse came true the other day -- found a pt on the floor, unresponsive, cyanotic, and mottled. It was absolutely horrible. His tele was d/c'ed just a few days before (he was s/p recent CABG, admitted for DVT). I did my usual rounds at 1400, and at 1455 was when we found him and called a code blue. So I have no idea how long he was lying there on that cold floor, dying. And I was absolutely worthless during the code. After the code team came into the room, I just stood in the hall, crying. They were able to get a pulse and transfer him to ICU. He was on a vent. I don't have the guts to ask what happened to him. I'm terrified to find out because, I know the odds are against him.

The guilt and grief is overwhelming me even after talking to the MD, my manager, my mentor, and my best friend who's a nurse... and they all say the same thing "there's nothing you could have done." But I still can't help but think "if only I had checked on him 15 minutes sooner..." What if... ??? Everytime I close my eyes, all I can see is him laying on the floor face-down, then rolling him over, and seeing his blue skin and lips. I want to work ICU in a few years and now I don't know if I can handle it.

I do plan on speaking to a counselor/chaplain because I just don't know how to drop it and get over this. I love being a nurse, but this code is eating me up inside. I was just wondering if anyone else has felt this way too or has had a similar experience?

TIA!

[whiskeygirl, LPN]

I just want to point out that you did the quick assessment, looked at the chart and called the code. YOU WERN'T USELESS!!

Thank you for sharing.

[helicoptergal, BSN, RN]

Hi I just wanted to tell you that I am sending you out some good thoughts. That a nightmare come true as a nurse especially if that was your first code situation, and you did the right thing. I think it is pretty admirable to have finished your rounds and go back into the pts room with in an hour. You work in the busiest nursing floor med-surg and I dont know your ratio but I am sure it is about 7 pts to 1 nurse. The fact that the pt was a "code save" is only because YOU found him in time. And he is now intubated in the ICU. You gave his family time to spend some time with him. And whatever his outcome you have to know that you did everything in your power to provide the best medical to that pt. I hope that in time that you will feel better. :redbeathe:heartbeat

[zenman]

But I still can't help but think "if only I had checked on him 15 minutes sooner..." What if... ???

I do plan on speaking to a counselor/chaplain because I just don't know how to drop it and get over this. I love being a nurse, but this code is eating me up inside. I was just wondering if anyone else has felt this way too or has had a similar experience?

TIA!

If only you had become a nurse years earlier you could have saved many more people. So, that one doesn't work. But please talk with someone so it doesn't eat you alive. I think we all have had a similar experience because we chose to be around the people who need us.

[TuTonka]

I have times and pts that still make me cry when I think of them. Dear the what ifs will kill you if you let them. You did the right thing. It is not your fault amd if a grief counselor will help you get through this then go. Nurses like you are greatly needed in this profession. ((((((((( Big Huggles)))))))))

TuTonka

[talaxandra]

I think you did well to stay so composed - your first arrest is hard enough when it is a patient you do not know. When the patient is yours and you are the one to find them it really is way more stressful and the feeling of responsibility can be huge.

[sunshineonleith]

I know your first code can be horrifying and saddening and full of self-searching.

BUT, try to remember this:

All a code really is, is a healthcare professional finding someone who has essentially died, and doing what they can to bring that person back to life - YOU did that for this person! YOU are the reason they aren't dead right now, and their family has a few more days to say good bye, or years more to enjoy this person.

You can't hurt a dead person - all you can do is try to make dead better, and that is exactly what a code is for. You will always be able to fine tune your performance in any stressful, scary situation and its good to reflect on what could have gone better, but ALSO remember to give yourself a big and well deserved "hooray" for doing the right thing for your patient - calling that code.

[morte, LPN, LVN]

The others are right- there is nothing more you could have done. You have multiple people to take care of and things to get done during your shift. I had a horrible experience my 1st year.

I walked into a pt's room to test his blood sugar before I did my morning med pass (I always do diabetics first to make sure they aren't crashing on me- that's another story in itself). Well, he was a very friendly man and we always joked around- he was always up all night too. I told him I'd be back with his morning meds in a little while he said "okay honey". That morning, I decided to spice my med pass up by starting at the opposite end of the hall- why I don't know but I did. When I got to his room, I got his meds ready and started talking to him before I even got to the bed. The CNA had walked in behind me and I thought it was odd he didn't say anything to me. I looked at him with just the light of his tv and thought to myself he looks a little pale. I stood there with a cup of water in 1 hand and the pills in the other and went to put it down. I tried to wake him but all I felt was a cold body. I checked for a pulse as did the CNA and then it dawned on me that this was my first code. I ran out of the room to check his chart for a DNR (things are done differently at my LTC place) and there was no pretty yellow paper or order so I called the code. I was shaking so bad that I couldn't even go into the room. A more experienced nurse went in with others and did what they had to before the paramedics came. He was everyone's favorite patient. WHY did I start at the other end of the hall that morning? I bet if I would have started at the other end, I would have JUST found him unresponsive and could have possibly saved him. But noooooo, I started at the other end and it took me much longer to get to his room that morning.

Bottom line was you never forget your first... learn from it. Since that code, I've been in charge of about 14 others so far. That's right, I take over now because I know what I'm doing and now I'm that nurse that runs ahead of the new nurse standing out in the hall. Nursing is a learning experience, we are always learning.

ref to the underlined.....i was thinking of this sort of thing when i read the thread on intuition.....sometimes i think this is the patients way of dying without all the fuss and muss......not trying to be at all disrespectful.....there obviously was some reason you switched up your routine....

[Saifudin]

Your feelings are understandable and the level of your sincerity for your work is admirable but I agree with the others, try not to second guess your actions prior to the event over and over. If your stuck on this point then counseling may be helpful to get over this hurdle.

For me this is not a 'worse nightmare' scenario. A 'worst nightmare' scenario for me would be causing a patients death by an error of practice. You said the patient was found to have a pulse. Perhaps if you had come a few minutes later he would have had no pulse. What if you had gone to the BR or answered a call light, or took a drink of water, or, or, or, but you didn't, you found him and he is ICU and his family has more time with him so think about that.......