13 March 2012

my first code.



Disclaimer: this does have some heavy medical discussion, but there is a happy ending, I promise!

All or most of you probably know by now that I am a nursing student.  I changed my major three times and was almost done with a degree in history before the Holy Spirit inspired in me to do nursing.  Like many other things that God tells me to do that sound completely crazy, it was such a wonderful decision.

With that said, today I am linking up with Anna and Renee today to talk about nursing experiences.

Being a nursing student, I've seen and performed a lot.  More than many of my nursing student peers, actually.  I've started IV's, I've put in an NG tube (during my first ever rotation!!), I've seen almost every organ in the human body except the heart and the brain and spine, I've even seen the female ovaries; I've seen an amputation (and was allowed to feel real bone and muscle!!); I've been in a trauma OR; I've cleaned up various body fluids; I've seen several circumcisions and even helped out in a few; I've witnessed a baby's first breaths; I've given a suppository; I've worked in many psych units; I've pulled out urinary catheters; I've administrated medications via all the routes except intradermal: oral (PO), IV, IM (even one in the bum!), subcutaneous; I've done a wet-to-dry dressing change on a woman with a CABG (sorry all you non-medical folks); I've prepared a body for the morgue; and SO much more.  I'm pretty darn lucky, guys, for a nursing student.  I feel like I've won the lottery for nursing student experiences!  But, there is one experience that I haven't mentioned.

After I finished up taking care of a patient, I heard over the intercom system for back up on my floor.  Immediately, I included myself in that back up because, hey, they could use any helping hand.  An outpatient who came in for a chemotherapy treatment had coded.  Dopplers were needed to find a pulse, while medication after medication was used to help restart his system and CPR was performed by at least four different people.  I watched in awe as at least 8 people were performing different tasks, were working in amazing unison, all trying to save this patient,

Now, apparently, after 20 minutes, hospitals tend to call time of death.  Especially with the heart muscle and the brain, damage occurs within seconds, and after 20 minutes of little to no perfusion to vital organs there is usually too much damage that has been done. Also, after 20 minutes the risk of patient's returning is so rare.  Even if they do, patients are admitted to the ICU (intensive care unit) for a good amount of time following the event.

With all that said, in the midst of what appears to be well-orchestrated chaos by various people who came together to work as a team dedicated to save the patient's life, I stood there watching.  Respiratory therapy; physicians; nurses from the floor, including the floor's charge nurse, the outpatient facility in which the patient was receiving chemotherapy, and the charge nurse from ICU; techs; a pharmacist; and a physician's assistant were all doing something to save this patient.

I was there ready to help and was asked to get a doppler to find a pulse, but otherwise they didn't need any help from me.  A pulse was eventually found in the groin area, a positive sign that brought much relief to the team who continued CPR (yes, both chest compressions and assisted breathing), administering medications, trying to determine a blood pressure, etc.

I stood there for 19 minutes, friends.  Nineteen minutes.  That is a colossal amount of time in this situation (ah, Einstein and that darn relativity).

After 19 minutes, a blood pressure was detected and his lungs were starting to breathe on their own.  This patient was still unconscious and was now in the process of being transferred to ICU, in which the charge nurse from the ICU was so gracious and allowed me to accompany him.

A little over a week later this patient had finally woken up.  The nurse on that shift asked the patient what they remembered, in which the patient offered the following response: "Not much.  But I remember going to a beautiful place." 

Now, not one part of this story has been fabricated.  I did not see the records for this patient nor did I arrive on the scene at the exact time that the clock started so maybe the time wasn't exactly nineteen minutes officially.  But it was about nineteen minutes on my watch since I had stepped in to the room and about when I heard the good news.

One of the nurses that was working in the outpatient facility and was present during the code would routinely check up on this patient in the ICU.  This nurse told me the patient's update shortly after the they had regained consciousness, on the next shift that this nurse and I were both working.

I am sure that we all read about the "miracles" that happen in hospitals, OR, etc.  I do not know what I would do had this outcome turn out differently.  As emotional as I am, I have come to find that I am pretty quick on my feet to react and put emotions aside when I'm working at the hospital (of course, never doing something outside of my capabilities of a nursing student unless in the presence of at least one licensed nurse).  However, after all the chaos stopped and I resumed my responsibilities on the floor, I definitely needed to take about five minutes.

I don't think I will ever forget this experience.  Fortunately, I have never witnessed a death and many nurses say that there are far more people that walk out the hospital doors than those that don't.  I'm glad that during my first code I didn't have many responsibilities because I feel like I can better understand the situation for when I do have a specific role to play.  But I remain very humbled, slightly emotional as I recall the memory, and continuously in awe of God's presence and will. 

5 comments:

  1. Great post, Amy. I love stories like this... happy endings! You have already done SO MUCH and you are still just a student! What great experience you are getting... I am quite jealous that you have gotten to do so much!

    I am planning on linking up with these two ladies next week.

    ReplyDelete
  2. Well orchestrated chaos is the best description for a code! I've been in some that were just plain chaos and obviously did not turn out well. I'm so surprised that you have gotten to do so much as a nursing student! I didn't get to do half of that stuff until my final clinical on my own! Thanks so much for linking up with me and Anna today!! I swear I'm going to get caught up on your blog soon friend! I'm soo behind on everyone's! Hope all is well! :)

    ReplyDelete
  3. Those near-death experiences always give me the chills. I've had a couple patients tell me about their experiences... always amazing.
    I'm happy you're getting to see and do so much! (and thanks for linking-up!)

    ReplyDelete
  4. you've had such a great nursing school experience! i really didn't get to experience anything that great until my 225 hour capstone and the pediatric hospital i work at now. if you love nursing school you are going to LOVE LOVE LOVE being a nurse on your own. it is a million times better!

    ReplyDelete
  5. awesome. never had this during my nursing school rotation, but I've experienced these as an ER nurse. One of my found memories was when my co-worker and I witnessed a patient literally having an MI in front of our eyes. the look of doom was terrifying. Thank goodness at the end he turned out just fine.

    Do well in nursing school. Hang in there!!

    ReplyDelete

I love receiving feedback, so thank you! =)
Your support means the world to me.

Have a charming day ;)
xo, amy