You never forget

Sometimes when I would look at her I remember how hard I did those compressions.  Sometimes I canfeel the way her cartilage cracked under my knuckles and sometimes when I look into her eyes I see those unseeing eyes, the glassed over look and I remember.

It haunts me. 

More then a bad dream, it lingers until it ignites with a simple glance across the room.

It was about four years ago, I even remember what I was wearing, blue scrub pants and a red scrub top. I remember everything about those ten minutes.

I was standing in my area, what we lovingly refer to as pods, I had my lab coat opened and was documenting half hour blood pressures.  I was listening to a patient tell me about their new grandson.  Things were relatively quiet in my area, the roll had only begun on the other side of the room. 

As my patient continued to talk I heard in the background the tech standing a patient up after dialysis to take a standing blood pressure, her sites were already done bleeding and she was ready to go.  Her daughter was there waiting to take her home, everything was going as planned.

I was thinking about the weekend, to be honest, and about the plans I had to go to the lake with a few co-workers, selfish things for selfish teenagers.

The sound of a head hitting concrete is a sound that you will never forget, the sound of a daughter’s scream whose mother just hit the floor.

It’s that scream that wakes me in the middle of the night sweating through my pajamas.

Looking back I don’t really know why I took off my lab coat as I ran, I just did.  The Nurse Practitioner was at her head as she continued to seize, she grabbed my coat and placed it around her head as I slid to my knees and felt for a pulse. 

Blood was pouring from her mouth as she had bitten her tongue, her jaw was locked and the NP had her fingers in her mouth.  I couldn’t feel a pulse and looked at the NP, then at the patient sitting behind her, coupled to the machine, he sat there, staring towards the wall.  It is a look they all get when the reality before them is pushed away. 

A code was called and the crash cart clatters to the floor as ambu bags and the suction come out.  I didn’t have gloves on, her blood was on my hands, my face was red and I begun chest compressions.

My co-worker crouched beside me, she had just called 911, the ambu bag was in her hands.  I continued my cycles as Nurse R walked up, she landed on her knees beside me, her hand on my shoulder as she counted compressions with me.  The people at the head of the patient couldn’t get a good seal.  The frustration of the moment overwhelmed us.

Her daughter was screaming, it was horrific.  Another tech rounded the corner and tried to take her out of the unit, she started to fight and scream and she hit him and then she screamed we weren’t helping her mother.

I can’t say I blame her, watching your mother coding can’t be easy, watching some kid do compressions on her while people bark orders.  Watching your mother’s stomach fill with air from improper bag placement must be horrible.  I don’t blame her.

I watched my hands as I compressed her chest, Nurse R asked me if I need a break, it’s my sixth cycle and nothing is working.  I didn’t notice the IV line the other nurse put in, the bag of saline being pushed into her veins.  I just watched my hands, feeling the muscles in my arms and shoulders scream, my thighs were on fire from the pressure.

It seemed like forever before the “woo-woos” take over my hearing.  The firemen and paramedics come in and take over, I am pushed out of the way, a prettier EMT takes my place as I pant, greatful for a break. 

They ask why we hadn’t put on the AED yet.

I placed my hands on my hips, dried blood on my thumbs.  I watched as they got a good seal on the bag, as her body pinked and and waited as she rised from that place.  I watched as she contorted her body, tried to take off the mask, tried to take off her shoes.  Disorientated, from what I understand now.

I looked at her daughter, the screaming caused a nose bleed, she had been handed a kleenex somewhere along the line.  She also had hit a fireman, before he sat her down in a chair and threatened to have her arrested.  I still don’t blame her.

She was loaded up and taken to the hospital. 

She was my first code.  I broke one of her ribs and cried for ten minutes in the coat room with one of the other techs.

I’ve learned things from that day.  I know what I did wrong, I know we were slow at putting on the AED.  There was a reason why Nurse R was counting compressions with me.  Too fast, too slow, there was a reason why we didn’t get proper seal on the bag. 

It was a clusterfuck.  But she made it, she’s still alive, I don’t like to say I learned how to do CPR on a real patient, I wish I did everything right.

I left her in California but I took that experience with me and I will always remember.

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~ by Kim on September 15, 2008.

2 Responses to “You never forget”

  1. I would rather have a cracked ribbed body than a dead body. You did good. Starting compressions right away is better than just standing there and not doing anything.

  2. I get what you mean about not blaming the daughter ..but … somewhere ..we should, as adults, understand that screaming makes chaos worse, not better.

    Last year, my husband was in the ER …and decompensating quickly … it was the start of a 45 day stay in the hospital … and at that point of the stay, we were in for a literal battle for his life. Things were very critical as they waited for a decision for a regular bed or ICU bed …

    The woman who was with the patient next door kept screaming for them to do something for her father. I don’t know the details ..nor will I ever know .. but I do know that they had to listen to my husband’s breathing 4 or 5 extra times because they’d have to do it around her screaming … they couldn’t hear because his breathing was so bad .. it couldn’t be heard. She was screaming so loud!

    Her panic interferred with the care of my husband …

    and even if you don’t realize it, the fact that you were aware of her screaming …meant that you were focusing some of your energy on compassion for her, and you needed 110% for her mother.

    We, as family and loved ones have got to keep our balance so that they can get the best care possible.

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