Coding Mr. S

I've been in a couple of codes during my short nursing career but this week was the first time I coded my own patient. It was incredible to see the amount of teamwork that went into trying to revive him. Doctors and nurses work really hard to get your loved ones back.

Sadly, after nearly 45 minutes of CPR, defibrillation, fluid boluses, and meds, Mr. S didn't make it. He was still breathing when the doctor running the code asked everyone in the room if there were any objections to ending the code and providing the patient with comfort care until he passed. This can be "disturbing" to the family someone in the room noted, "when the code is ended and the patient is still breathing. Respiration is the last thing to go." But Mr. S had no blood pressure, no pulse. His body hadn't been profusing for nearly an hour ...And so there were no objections and the code was ended. Mr. S stopped breathing. We washed his body and "bagged" him, tying a tag to his toe with his name and time of death on it. I had only known him for a couple of hours.

Alone

I had some time last night to spend a few minutes holding one of my patients' hands and I thought of this picture, she was so weak and small. I'm not sure if she understood what was happening or that I was there but I hope she felt something. I did.

Night of the Living Nurse

It's been far too long since I've been awake during the day. Today, coming off almost two weeks of nights I feel like my skin just might set fire from the light of the sun.

Sometimes I can't believe how hard this job is and I catch myself wondering, "Why in the world did I sign up for this?" But the good usually outweighs the bad from day to day. Looking into someone's eyes in the middle of the night, knowing they probably won't be around much longer (not that most of my patients are that acute), and trying to give them a little comfort from their physical pain and the pain and loneliness that comes from being in the hospital is heart wrenching. It's weird to share such intimate moments with "strangers."

Xmas on Ice (Chips)

 

It's Christmas on Trauma and what does Santy have for you? One size large 3rd degree burn from a scalding pot of grease, one malodorous nasty wound infection, one holiday stabbing at the mall, and a paaaartridge in a pear treeeee...!

It's sad when patients are NPO and can't have anything to eat or drink and they literally beg you for ice chips. "I'm sorry", "I wish I could..." (the worst is when you forget and ask them if they've ordered breakfast yet. Ouch. Sorry!)

Even sadder is being a patient hospitalized on Christmas who holds the holidays in very high regard and is alone with no family or friends in the area to visit them. But possibly saddest of all is dying on Christmas at 7:00am. Good morning and good night, and Merry Christmas.

Expired

I saw my first code the other day. Codes are called over the hospital intercom system so that people from different areas of the hospital can respond, and a nurse on my floor was one of the people who responded that day. As she was running out the door my preceptor yelled for her to take me with her.

When we got to the other unit the patient was on the floor. I couldn't see much because the room filled up with about 40 people in a matter of seconds. During a code there are different "jobs" that people do: there is the person who runs the code (normally a physician or NP, I believe, because they give the orders for administering drugs), a nurse who prepares/administers the drugs from the crash cart, a recorder who writes down everything that's being done and the effect (if any) the actions have on the patient, people taking turns performing chest compressions and administering breaths to the patient, and probably a bunch of other people who do other things I'm forgetting about. Oh and there are about 20 other people in the room who just want to see what's going on but who are not actually doing anything at all (and they eventually get yelled at to leave the room).
The code went on for 15 minutes -which seemed like an eternity to me- and I mostly hid outside the room trying to stay out of the way. The patient was in PEA and nothing they did was having any effect. Towards the end, the nurse who brought me with her motioned for me to come into the room. She had been working as the "recorder". Shortly after I went in, the attending physician entered the room and gave a signal for everyone to stop. The time of death was announced and the nurse from my floor put a check in the box next to the word "expired" in the "outcome of code" section on the sheet used for recording.

Sometimes Life is Happy...and Sad

Spring finally arrived...

 And graduation from nursing school was overshadowed...

...by the loss of a dear friend.

Miss you, little kitty.

End of Life

My patient this week was in his 9th decade -a WW II veteran from the Marine Corps who'd been all over the world. I got my first shot at shaving a patient with him, which was scary and also kind of funny. I didn't cut him, thank god, but he looked kind of like a mangy puppy after I finished. He was so happy though, he just kept telling me what a great job I'd done even though he had no idea what he looked like. 

I was so surprised at how lucid he was when I met him. I like how he called his hearing aids his "ears", his glasses his "eyes", and his oxygen cannula his "breathers."

Thinking about how he was reaching the end of his life made me a little sad. I don't think he's going to make it too much longer. Even though he's had a long life and a pretty good one judging by his spirit, it's still an end none-the-less. He'll have some time now to look over his life and think about everything he's done and seen, and when he's gone someone will have lost their dad, their husband, their buddy... It's like the end of an era. Makes ya feel a little melancholy...