So I had a fellow co-worker tell me that I am no longer a rookie nurse…now usually this would be a good thing, but in actuality…this statement was not a welcome statement at all. It was a night of many firsts for me…1) first really bad patient deterioration 2) first code and the final first 3) first pt death.
The evening began like any other shift for at least 15 or 20 minutes then things begin to go wrong. The tech came running into the nurses’ station saying that one of the patients was bleeding. I go into the patient’s room and find the patient sitting up in bed holding her nose. She was gushing blood all over herself, her sheets, and everything else within her vicinity. I grab some towels and manage to get her nosebleed to stop. After getting back to the nurses’ station, I asked the day nurse inform me on this patient next so I would have an idea of what was going on. She was admitted for a GI bleed, but had been stable ever since she had been brought to the floor a couple of days earlier. The day nurse was not aware of any problems or concerns; in fact, she thought the patient was going to be discharged the next day. I paged the doctor just to give them a heads up. They said they would come assess the patient.
The doctors arrived and said that the nose bleed was most likely due to an increase in her blood pressure. They told me to go ahead and give her the scheduled blood pressure medication. I gave the medication and finished my assessment. Everything else seemed to be okay. I asked the tech to get another set of vital signs. Her blood pressure was decreasing back towards normal, but her Heart rate was a little increased. I spent the night keeping a close eye on her with nothing out of the ordinary occurring.
Morning came and it was time to draw labs. She was a nurse draw and had quite a few to draw. I went in there and she was watching tv. As I drew her blood, she was telling me about her family and how she couldn’t wait to see them all again for Thanksgiving, since her children all make the long trip home to see her. I finished getting the blood I needed, and told her I would be back in a few minutes with her medicines.
The lab results came back showing her hemoglobin was 4.2 (a decrease from 10.6 the morning before). I paged the doctor and was ordered to hang 3 units of blood stat. As I was walking into the room to check her vital signs before hanging the blood, I noticed she was lying down in the bed, and didn’t respond when the light was turned on. I quickly went to the bed and found that the patient was not breathing. I yelled for help and pulled the code light. As the tech arrived to check her vital signs for me, I was connecting the ambu bag and began ambuing her. Another tech was grabbing the code cart for me, while the other nurse was entering the room to be of assistance, and checked for a pulse. There was none!!!!. The nurse started compressions while I ambued. The tech arrived with the code cart and we got the patient hooked up to the zoll machine and continued compressions. Rapid Response and the doctors showed up and the craziness began. Amidst all the business of the code, the patient’s daughter walked into the room. (She had gone home for the night, and was just returning). One of the techs quickly grabbed the daughter and pulled her out of the room, and took her to the waiting room.
Unfortunately even with all the interventions being done, the patient was not saved. About the time, the code finished the hospital Chaplin arrived. The doctors and rapid had to take off running to another code. This left the Chaplin and I with the burden of finding the daughter. I had to tell the daughter that we had done everything we could, but we could not save her. The daughter began to cry, which made me want to break down crying with her. (I’m not going to lie, there were tears in my eyes, and it was one of the hardest things I have ever had to do). The Chaplin stayed with the daughter as I went to finish up my shift as if nothing had happened.
So depending on who you ask…I am no longer a rookie nurse because I have experienced my first patient death…I think I would much rather prefer to stay a rookie
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