Thursday, November 22, 2012

Do Something!!!! Please!!!!

I know that I have written quite a few articles on patients coding or declining...but unfortunately that is a sad part of the job.  (This time it didn't happen on my wing or any of my patients...no one can blame "Crash" this time).
It was 0715 one morning.  I had to take a quick break from report to grab a paper towel.  As I entered the hallway, I saw two residents enter the room of a patient on the wing straight across from mine.  Within 10 secs, I saw the Assistance please light go off.  I quickly yelled at my techs and the other nurses on my wing and we took off running.  One of the techs stopped to grab the crash cart along the way.  As I went running pass the clerk's desk I told her to call a code.  As we entered the room, we saw the patient laying in the bed with a nasty bluish gray color.  He wasn't breathing and the continuous pulse ox was not picking up a pulse or an O2 sat.  The residents were just standing there with a scared look on their faces.
I pretty much jumped onto the bed and the patient and started chest compressions.  The other nurse quickly checked for a pulse, and went to grab the ambu bag.  Of course there was no ambu bag or suction set up in the room.  Two other nurses quickly started looking for a vein to put in an 18 gauge IV.
The whole time, we are all looking at each other wondering where Rapid response, respirtory and other doctors were.  Since I work on an acute care floor, we are not allowed to push medications during a code, either the doctors or rapid can do that...and since the two residents in the room, were not responding to our yells to do something...we were kinda stuck in a hard spot.
We continued chest compressions, ambu bagging (we had to run and find one), started three IVs (three nurses all at once got them at once) and freaking out for fifteen minutes before everyone else started showing up.  (Although from the moment I did my first chest compression, I knew the patient was not going to make it, due to all the fluid that was coming out of his nose, mouth, and ears).
Once rapid showed up and took control they were able to get the residents into motion but only by telling them step by step directions.  We continued coding the patient for another 30 minutes, because no one wanted to admit this was one that we could not save.  However, the attending eventually called it and night shift ended their shift on a depressing note.   It's definitely a difficult thing when we are reminded that sometimes there is nothing we can do, no matter how hard we try.

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