Breathe Me
I did chest compressions for the first time. I lost my first patient.
Man, that was hard.
The adrenaline rush of being in the middle of a code is like nothing else. The way the floor falls out from beneath right as you realize that you’re about to pull the code bell is…well, we call it a “shit-your-pants-moment”.
I was asked what it was like. It’s like no other moment I’ve experienced. I’ve been on the outside of many, many codes before. In the doorway looking in. This time, I was on the inside looking out. Not trying to sound dramatic or anything- but it’s true. You’re in this small room looking at your patient, looking at the monitor, looking at your supplies and seeing this kid turn gray and hearing the alarms sounding off. The code bell goes off and in an instant there are 20 people piled into your room and spilling into the hallway- not to mention the passersby stopping to rubberneck.
It’s like a TV show that I should be watching at home. The attending and I make eye contact and I hear them say to push another 120ml of normal saline bolus. I grab the full syringe, lock in, and push. Then it’s time to draw up more, switch out and keep going. I stood there next to my preceptor alternating between my fluids and her epinephrine doses. I did my first round of chest compressions and brought pressures back up to an acceptable level where we could feel a pulse again.
It didn’t last.
I take comfort in the fact that we were able to save this patient long enough for the family to get there. It was a long time coming.
It’s surreal. I can hear the screaming exactly like a remembered movie and, yet, it’s so distant that I can’t recall it at all- like a nearly forgotten dream.
Going home was weird. I’m standing in an elevator with other people talking about their night, someone else on the phone, someone else looking at me as if they cant tell if I have bad attitude or if I’ve had a bad night. And I’m sitting here typing this thinking how crazy it must have looked to see me- the youngest in the room with big glasses and, most likely, panicked eyes- bent over a small bed looking like a kid trying to save a kid.
It’s crazy, but this is still where I want to work. This is not the normal day to have your patient go. More people get better than don’t. I have a renewed strength and want to be an amazing nurse. My preceptor is amazing. I want to be just like her when I grow up.
That’s all for tonight.
I remember a similar surreal moment long ago in my career as a pharmacy tech–I worked in the IV room at a pediatric hospital. One particular week a kid had gone on hemodialysate, and it was a pain in the rear to make. It was constantly being changed, and the kid was blasting through the stuff. One day I went home from work, and when I came back the next morning the kid had died. While I was at home playing with my own child, someone’s baby died. The juxtaposition was not lost on me. I took that lesson, and I’ve held it close to my chest. It’s served me well in the life-death situations I’ve been a part of throughout nursing school and my externship.
I really enjoyed reading this post. It is something I think about a lot. I am not sure what I would do in a situation like this. I have done scenarios and practiced on robots, but I have no clue how I will react in the flesh of it all. And when it is my time, I’ll be “the youngest in the room with big glasses and, most likely, panicked eyes- bent over a small bed looking like a kid trying to save a kid.” Granted I am 6 ft. 3 so I’ll be bent a little more than others.
It’s a very surreal experience isn’t it? No amount of code blue simulations can prepare you for your first one. I’m thankful for you that you experienced it as a student, where you had a preceptor by your side and peers/professors to help you debrief. That is a gift to take advantage of!
You will be an incredible PICU nurse, I have no doubt!
I think we all remember our first patient we lost. AND we all remember the fist one lost to a code.
Hang in there, don’t let the feeling discourage you -but don’t forget the feeling either. That feeling will help you and your future patients stay out of harms way.
Stay strong.