First Code through Five Senses

The Short Story: One early morning, the floor care assistant came and found me in another room. He said, "You should come see Patient X." I left the room I was in and proceeded to the patient's room. I immediately knew something was wrong. I tried to arouse the patient and called for help. As a respiratory therapy provider came in the room we pushed the Code Blue button. The respiratory therapist and I started chest compressions and respirations via trach. Other staff eventually came in with the crash cart. Long story short the patient was transferred to ICU. 


The Senses: What I can't describe with adequate words are the colors, smells and sounds  There is the cold, flat grey of the skin evident with lack of oxygenation. Fluid that leaves the body when it is close to death smells like...well...death. It is a smell that invades your face and tries to crawl its way out through every pore. It is a smell that lingers with you when you go home and scrub in the shower. Then you double wash your scrubs in hot water. The one thing I know I did right was count to thirty...loudly. I am a champion compression counter. 


The Reflection: Reflecting on that situation there are things I would do differently if I was in that situation again with that particular patient. First, I wish that some of the more experienced nurses in the room would have jumped in to help me. I was in a bit of a panic as this was my first code situation. Defibrillation did not occur early enough. Secondly, I would have confronted the NP who called me "ridiculous" in front of the ICU attending at staff. The NP was asked by the attending with me standing there, though he didn't realize it, if the patient's heart actually stopped. The NP stated, "No. I don't know why she was doing compressions...Ridiculous." My response to that would have been three people checked for a pulse in different places with no pulse so that was our reason. The telemetry monitor did not go off, most likely, as the system was off line for part of that night for maintenance. Regardless, I've had to make peace with the whole situation because I knew this patient well and I don't think that his wishes were honored in the situation. Every time I compressed his chest, I had to resist saying "I'm sorry." 


Comments

Post a Comment

Popular posts from this blog

Honduras 2016: The One and Only Thing

Image
This is about the only picture taken of me in Honduras this year that I want to look at. I met this sweet lady last year after she came to the clinic. She was 92 then....93 this year. She came last year in the same pink dress and managed to sweet talk me into giving her extra toys for her grandkids. Seeing her is always a joy. Her closed mouth smile hides her nearly gone teeth. When you are close to her you can see her eyes sparkle. She is full of life. When we ask her if she knows Jesus. Her sweet response is that she does and he lets her keep living. She stated how blessed she is. I got a lippy kiss on the cheek and whispered that she was happy to have a sister in Christ. She went on to say that she came back this year to see me because she remembered me and if I never saw her again I'd see her in heaven. How sweet this is. This is the value of lasting relationships in a  community. She knows that the local doctors are there for her. She can a...
Read more

Intuition 101: Trusting the Little Voice

Image
There is so much I do as a nurse that requires more than a describable set of skills. There is basic physical assessment and the ability to translate those seen and felt things into written word for mandatory documentation. There is the other set that requires you to know yourself and trust that your training and intuition work together to give insights. This is not something than can be taught. It can be developed though I would contend that some folks have a greater ability to tap into this "sixth sense" than others. (My own opinion from observation and working with diverse mixes of people). For the rationals who need concrete: It's a bit like the concept from Blink: The Power of Thinking Without Thinking by Malcom Gladwell. The flash of intuition mixed with the knowledge to interpret it can lead to insight into patient condition. This intuitive judgement is honed by experience, knowledge, training and mentoring. For the other part of my brain that talks in ...
Read more

Things to Put in Your Mouth: Raspberry Chocolate Chip Cookies

Image
Finished Product Raspberry Chocolate Chip Cookies This recipe is one I found to use up a couple pints of raspberries I bought at Costco. I can only eat so many plain. they were cheap and in season and I was a little too ambitious in my shopping. Before they went bad, I went on the hunt. Thanks to Pintrest, I found this recipe. I figured these round treats would work out well since I like raspberries and chocolate chip cookies.  Use the link above to access the original recipe and photos that are much better than mine. I don't take any credit for it. These smell amazing while baking and after!  Tips: * If the raspberries are really soft, don't halve them or you end up with raspberry mush. * Fold in ever so gently to a soft dough...like more gently than handling a newborn. If the dough is too soft it can always go back in the  fridge before you put it in the oven. * Refrigerate leftovers. The fresh berries make them more likely to mold if left out ...
Read more