Code Blue

I didn’t see it coming but I guess it’s one of those things that you don’t.   

The day started out fine, I woke up on time, dressed in my favorite scrubs and even my knee felt wonderful. Everyone seemed in a good mood, laughing, joking, soothing the patients into their early morning dialysis induced sleep.

We’ve had a slew of new patients, new-to-dialysis patients which is never bad, just time consuming. Our newest one was running first shift and had come in via wheelchair, even before we took out his catheter and set him in our vinyl lounge chair, i could tell he was not feeling well. Pale and sickly which again is not all that uncommon for new dialysis patients.

I didn’t have time to read his H & P and really did feel a pressing need to, I honestly didn’t even know his first name I simply glanced his way and smiled that smile I put on when people are new, I try to soothe and make them feel welcome in this place oh so unwelcome.

He wasn’t my patient today.

At 0717 in the midst of our morning report I heard that sound that makes us all jump, he stated he didn’t feel well and before anyone could respond in any matter he was out, eyes in the back of his head out.

I watched him as he took a breath and then nothing, the nurse bent over his head asking if he was okay, the other two techs returning his blood and holding his feet up above his head. I scrambled around to see what I could do, grabbing a nasal cannula when the nurse yelled, “okay 911”.

I called a code blue, lights and sirens to the medical building where we were as he was hauled to the ground. I rounded the desk again as CPR was started, I found my place at his head, being tossed the ambu bag, I’ve always wondered if I could do this under pressure. The previous codes we’ve had, I’ve always done compressions. I placed the mask over his face, made a “C” with my fingers and gave him two breaths, his cheeks puffing out as if he were a chipmunk gathering his winter store.

I felt this thing in my chest, it felt round and fiery and I could feel it spread up my throat and burst throughout my entire body, I cherished the feeling as adrenaline pulsed through out me. As I bagged him I stared into his eyes and saw nothing, no spark, his agonal breathing not providing the oxygen he needed.He was a full code at 70 something years old. I don’t blame the family, but part of me wondered if we were just abusing this poor man as I heard the cartilage in his ribs crack during compressions. We worked on him for twenty minutes before he was whisked away.

We comforted the patients who seemed to ignore what was happening, probably the best course of action really. Then we comforted ourselves.In outpatient dialysis, we hope we don’t see a lot of codes and really in relation to other parts of the medical field we have far less. So when one comes it takes us by surprise, a moment where we all have a to take a breath and try to reason what happened, to tell ourselves we tried the best we could.

He died at the hospital and we all kind of dealt with it in our own way. The nurse cried, me and another tech laughed which made me feel bad but I realize that when in stress emotions cross boundaries and thats the only way I can make it okay.He wasn’t my first code, but he was the first one that died. Yes, our patients die, but usually not so dramatically or starting within our clinic walls.

I guess I could say that he was my validation for trying so hard to get into nursing school. Because I know I can do this, I can be a great nurse, a great healthcare provider.

I also realize that we cannot save everyone but we can try and at the end of the night I can live with it.

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~ by Kim on March 22, 2008.

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