Tag Archives: code blue

i hate asystole

14 Jan

epi epi epi

It is official, I have decided that I hate asystole or PEA codes.  Since my new nursling days that is almost 3 years ago today (I am still a nursling <3), I have been directly involved in a total of 4  code blues. I am not including respiratory distress with intubation etc because luckily in those situations intervention preceded cardiac arrest.

3 out of the 4 pulseless codes have been aystole or PEA and those 3 patients died. The only 1 that lived was the shockable ventricular fibrillation: so that is the kind of code I liked best, if “liking” a code were possible.

I am still feeling yucky about the last asystole code. The whole thing keeps playing over in my mind and I keep thinking of how it could have been better. I also can not stop thinking about: this code blue seemed different, maybe because it did not happen on my floor where I work. I was going over to a medical floor to pick the patient up to transfer to telemetry. I  had the feeling that something was not right because the nurse called me in a panic, requesting me to hurry and pick up the patient. While I was en-route 3/4 of the way there I heard the code blue announced to the very place I moving towards and I guessed that it was the patient I was supposed to be picking up.

I walked into the room and the medical nurses were doing chest compressions and nothing else. I am not trying to describe anything negative about the medical floor, I am just trying to express that the other code blues that I have been around on the telemetry floor where I work: the nurses just start working as if being moved by some invisible robotic arm. In fact the other codes on the tele floor that I have seen looks more like:  the defibrillator is hooked up, someone is ventilating till the RT gets there, CPR is performed, someone is checking the line, someone is getting the chart, someone is getting the doppler, someone is calling for an IV pump just in case, someone is recording, someone is printing out the morning labs. It helps that I work on a pretty big floor so there are lots of “someones” around to help. <giggle> And all these someones seem to just announce what they are doing without anyone asking or telling them what to do.  The nurse is telling everyone what is going on and then he/she repeats it all again when the doctor and the ICU nurse arrives.

All I can say is that I would rather see v fib on the monitor than asystole any day. This code was just lifeless, and actually I wonder how long the patient was dead before CPR was started. The latter part depresses me too.

So it makes me think about: I like to bitch and complain about the circus arena that I work in on telemetry. But here is an example of: I wished that patient was coding in my own area called telemetry. I am not intending to claim that the outcome would have been different for the patient, that patient was dead. I am just forming an early opinion that there might be a difference in atmosphere. The outcome for my emotions would be different. I bet I would of felt less hopeless afterwards.

And for me, for my sake who is going to lick my wounds and give me some understanding?

I started this blog in the summer of 2007 when my first patient died in a code 2 weeks off of my orientation. I was sad. It helped me to write my experiences and it still serves the purpose. I feel comforted reading medical and nurse blogs because it helps me to feel not so alone in this thing that we love to do: healthcare.

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My Embrangled Day

21 Mar

Yes embrangled is a word. (you can look it up I am actually to lazy right now to post the link even though my spell checker does not believe me).

One  code blue.

One Respiratory distress.

One acute seizure.

One performance evaluation that did not end in a pay raise due to an administrative policy.

One transfer that never came because the patient walked out AMA.

One discharge that could not understand his medications after an hour of teaching.

One admission who was needing a cigarette.

Ending in one nurse crying in her car when it was all over.

All right I still love my job but….wow…this is insanity.