Very First Code

Last night has been the busiest so far. Although 3 of my 12 beds were empty, the events of the night kept me more than busy. Being busy is relative...my new job still can't compete with the amount of running, lifting, turning, pushing, and sweating that I had to do in long term care.

We've lost quite a few folks lately. I'm finding that in intesive care, and perhaps in all areas of medicine and surgery, you see lots of the same: respiratory failure, renal failure, MRSA, HIV, diabetic ketoacidosis, overdose. Perhaps part of becoming a strong nurse/doctor/respiratory therapist/PA is being subjected to the same diagnoses, and in turn, similar prognoses, drugs, complications. I find myself writing down things I'm not familiar with...mostly treatments and drugs. Last night, I became familiar with atropine and epinephrine.

Mr. A had come in two days earlier for only God knows what. I never could get my hands on his chart. Either the nurse had it, or it was nowhere to be found. You could tell he was sick just by looking at him: xanthoderma, anxious, restless, distended abdomen, not to mention the bloody stools that I helped clean up. He just had the look. His nurse, Tina, called his coding a few hours before he went into asystole. Once the code was announced, herds of people from all over the hospital came to pitch in. Respiratory, nurses, the resident, the doctor, and little ole me! Can you imagine 15+ people in a tiny room, moving around like ants in an ant farm? That's what it was like.

The nurses and therapists took turns performing CPR, and Tina prepared the atropine and epi. One round of drugs after another were administered, and Mr. A toggled between V fib. and asystole, his body bouncing off the table with every compression. The nurse mentioned that he could feel the ribs cracking beneath his hands. After four rounds of medications and no change in cardiac rhythm, the doctor called it.

Codes are nothing like television makes them out to be. There was no yelling, no passionate plea for Mr. A to pull through. On the contrary, there was laughter, idle chit chat, and smiling. Immediately after pronouncing him, everyone left as quickly as they arrived. Tina, myself, and the other nurses on the unit were left behind to clean up the mess. Overall, I think I did well for my first code. I didn't cry when Mr. A passed, and I didn't run out of the room when, while assisting the nurse with removing the backboard, a melodious sound of air escaped from his throat. I did, however, learn that Mr. A died a lonely man, estranged from his family, and befriended by a certain "colleague" who was his power of attorney.

Only two weeks on the job, and so many lessons have been learned. This is the kind of stuff I need to see and experience before the end of the year.