Monday, June 30, 2008

Nurse Follies: Loosing My Nerve

This weekend was not one of my red-letter weekends. In fact, if there were a class for all new grad nurses on "Things You Shouldn't Do In An Emergency Situation", my weekend would probably be one of the cases studied.

Usually, I'm on my A-game. This whole surgery has wrecked my game...professionally, personally (don't even ask me about my fucked up sleep pattern). Now, I'm more on my D-Game. Give me a couple months, and I will be back to normal. I hope.

Anyway, Friday was a disaster if only for the fact that one of my patients was slowly circling the drain. She was one of those patients that doctors know they should be in the ICU, it's simply a matter of when they should actually send her over. Among the sickest of patients, with a disease process that has no cure, there's nothing more that can be done for her. Naturally, she's a full code.

So, I spent all night Friday on pins and needles. She looked like ass on wheat toast, and I just knew we'd be coding her before Saturday morning rolled around. I even told Smo to be ready.

My loathing of code blue situations has been well documented. Some nurses live for them. Smo is one of them. She is my polar opposite when it comes to codes. She loves them. I'd rather saw my foot off than have to actually participate in one. If I want an adrenaline rush, I'll go jump off a bridge. I know, I've seen me do it.

Miraculously enough, Sick Lady makes it through the night, and despite me begging the residents all night long to transfer her to ICU, she doesn't go over until 10am the next day. When I'm at home, medicated.

Saturday was the anti-Friday in that nothing happened, my patients slept, and I had nothing to do but clean out my work email Inbox.

Sunday, things are trucking along without a hitch, until one of my confused patients manages to get out of his restraints, and pulls out his NG tube, leaving just enough in his nose where tube feeding is trickling down his throat. Fantastic! I call the doc, get the chest x-ray and she tells me to put the NG tube back in. So, Smo is helping me with the NG placement (which I've done countless times without incident), when the patient starts gasping for air, squeaking out, "I can't breathe." His oxygen saturation starts tanking.

Now, this has happened to me before. It was my very first code, and the guy croaked before my very own eyes, in this similar fashion. His O2 levels dropped, so did his heart rate. Then, they both hit zero about the same time.

So, when I saw the screen, my mind flashed back to that fateful night. I start looking frantically around for an ambu-bag. Naturally, there isn't one in site. There's always one on the code cart, so I take off running, literally running down the hall, to the code cart. With my leg, instead of looking like a graceful sprinter, I probably looked more like the bronze medalist from the Special Olympics 50 yard dash.

I manage to attack the attention of another nurse and tech when I barrel around the corner and rip the ambu-bag off the code cart.

Me: I need some help!
Stewie: What's wrong?
Me: I don't know!! Come anyway!!

By the time I make it back to the room, I can't get the fucking ambu-bag out of the wrapping because the plastic is fused to it. So, I'm ripping at the bag like a crazed dumbass. "Chill out, Heather." Smo mutters. I think she might have poked me in the arm for emphasis. Then, I realized the patient had recovered. By this time, there's about a half dozen people in the room.

Yeah, I felt like the village idiot. I know, I completely lost my shit.

Normally, I'm pretty much cool and stuff in an emergency situation. Last night, I couldn't find my ass with two hands. By the time morning rolls around, my coworkers have found amusement with the entire event. I won't be living this one down anytime soon.

Smo is disappointed that it didn't evolve into a code because she hasn't been in one in a while and is itching for some action. She's sick like that. I like to avoid code situations altogether by preventing them from happening in the first place.

Which is the one thing that is keeping me from transferring to the ICU. They routinely have codes, and when they do, it's not like they can ship them off to a higher level of care (if they make it through the code).

Like I said, give me a couple months. I'll get back to my normal, hardass self. Perhaps I should have the Unit Educator do some drills or something so I don't jump whenever the trigger is pulled, so to speak.

I hope.


Spyder said...

Hang in there! You're much braver than I am. They prick my finger & I hear the ocean.

Indy said...

OHHHHH- you shuda done called a Rapid Response!!!!!!!! You know how to do that, dontcha?

bobbie said...

Heather ~ even after 20+ years in ICU, I still did silly things...

Like the time I was at a pts. bedside, & he went flat line. I raced out to the desk (where sat a plethora of nurses and residents), picked up the phone, screamed "Code Blue...", then rushed back into the room...

I still blush when I think of that... and yes, the pt. made it.

So please don't be too hard on yourself. Adrenaline does funny things to you sometimes...

To cheer you up, there are more new Seamus pix up...

Breathe ~

Heather said...

I did call a Rapid Response, butthole. One of the ICU nurses that responded remembered that this same patient did the same thing on her last week.