Wednesday, September 9, 2009

Full Code

Today was our first day with a patient of our own. We doubled up into pairs, since these patients are WAAAAY more complex than last semester. For example, most people last semester could...like...TALK. And breathe on their own.
Ms. E (SO not her real name) reminded me of my Grandmama- tiny, frail and old as rocks. She had what the docs called "alphabet soup"- you name it, she had it: Type 1 diabeetus, CHF, VDRF (vent-dependent resp. fail), COPD, previous history of CVA, seizure disorder, previous GI bleed, liver failure with jaundice, previous UTI, et cet. Oh and ALL FOR STAGES of pressure ulcer, on various parts of her body. Essentially, Ms. E was a mess. A MRSA-positive mess.
Still, she would grin at us as we assessed her, occasionally pointing imperiously to her trach for us to suction it. Then she'd wink. It was kind of a riot. She had just had one leg amputated above the knee, due to gangrene, and I'm pretty sure the other one is going to have to come off soon, if her nursing home doesnt learn how to treat bedsores.
Ms. E was a full code, due to her family wanting to give her "all the chances they could".
Her roommate was ALSO a full code, with agonal breathing on another vent. Both alarms were constantly going off as the two women shifted their heads, or coughed. That's why, since the curtains were pulled around the other bed, I didn't realize that the OTHER alarm was going off. Ms. E's roommate had pulled off her vent, satting in the 40s. I heard ANOTHER alarm go off, with a different tone (the BP alarm) and checked, and then suddenly the room was FULL of people.

"Quick! Grab the AMBU bag, and bag her!" A nurse yelled, so I grabbed the bag, attached it, and began bagging...against very little resistance. It took a minute for my instructor to run into the room...she blinked, and said "What's going on?" I explained that I didn't know that the vent alarm was going off, and so this all was probably my fault.
Everyone laughed. "It's not even your PATIENT, and it's your first day! How were you supposed to know which alarms were for which patient? Next time just run around and check ALL the patients in a room."

She stabilized, and all was well...but I will NEVER let that happen again.

1 comment:

Nursing Anatomy said...

Wow, that's a crazy experience for your first day! But, despite the fact that the other lady wasn't your patient, you managed to think on your feet and jump into action. I only wish my first day at clinical is that exciting/life altering!