Code Blue

Someone asked me if I had experienced a code blue before….

Why yes I sure have, and I will never forget the only code I have called myself instead of having a Dr. tell me to call it so we can react quickly.

P255.  The room in the corner that was so big.  There was so much room in there and there needed to be.  Two IV poles, 3 pumps, 10 chambers, one PCA pump, a foley, and a fecal management system.

2100-went in to hang TPN, lipids, and restring some tubing, pt resting comfortably
2200-went in to check on pt, noticed blood in tissues, he says, "oh I'm fine its just a little blood coming out when I spit" assess pt, look in his mouth: lots of blood.  look up nose: lots of blood.  look into tissues: clots of blood.
page Dr. on call-he comes, assess pt, looks at me in the hall and says "I have a bad feeling, I am glad I am off at 10.  When I think someone is going to die they usually do."  Great, thanks for the encouragement that I now have to be afraid each time I walk in the room
2230-PA on call for night asks for report, I tell her, she orders some meds after calling the fellow and tells me, "Watch him closely I don't have a good feeling about this"
fast forward
0400-hung vancomycin, pt resting comfortably
0445-go in to hang cef, blood all over the pt chest and back of bed, call Darryl (another RN) and say I need your help cleaning pt up.  VS: O2 sat 88%, HR 145, BP 90/50's, RR 14, pt states he feels fine.  Page PA on call and Rapid Response and PA shows up, Rapid will come if the status changes
0500-started drawing labs anticipating a code situation, and the PA looks at me and says I think we need to call it…I start to get dizzy because as I'm drawing blood its clotting immediately, blood is flowing into the rectal tube, clots are being spit up, I think DIC and I am going to be covered in blood by the patient I call grandpa and have a close relationship with.
0505-Darryl takes over because I need to sit, I am ready to faint
0510-I walk into hall and walk back in and hear grab a venti mask, o2 sat 68%
I immediately pull the code and call it in so they can call overhead, I can't lose him.

Pt is transferred to ICU, I tell him I will see him in a few days when he comes back to our floor, he's tough and he will just need a little extra support but will be back in no time.

I can't sleep.  I am tossing and turning.  I look at my phone, text from the Nursing Assistant telling me pt has decided to be DNR/DNI and is enrolling in hospice and coming back to the floor.

I prayed that P255 was taken by another patient already.  I cannot watch him die.  I have been with him since he was diagnosed, a healthy, fit man otherwise.  No luck, he is back in P255 and I have two days left to work.  Selfish….maybe.  However, unless you have watched someone close to you die, you do not have any clue how it pulls at your heart and you just want it to end.

I watched many people die on P2, but three have captured my heart.  They suffered.  It was a long battle.  It was scary.

I came back to work scared, hurt, quiet.  I talked with him during the brief moments of alertness.  On my third day I had to say goodbye.  I knew when I came back in 5 days he would be gone.  Vitals were in the hole and it wasn't going to be long.  He didn't wake up for many people, but he woke up for me. He kissed me on the cheek, squeezed my hand, and said thank you granddaughter.

He died a few hours after.

Code blue…its not the end, its the beginning.  It either starts a journey to recovery, or starts a new life.  For my pt, it started a new life.  A life where he was not suffering.  For me, it started a journey to recovery.  A journey that now teaches me that death is a struggle for me and is one of my weaknesses.

Life is a box of chocolates, you never know what you're gunna get

Life sure is testing my strength this week.  Everyone thinks that I am such a strong person, however they do not know that us strong people are quite the weak links at times.

I spent my whole drive home crying.  Crying because life is not fair.  Why are some of us so blessed and others are not?  Why do some get chance after chance and continue to mess up and others never get a second chance?

I sat next to a chaplain today at orientation.  However, it was not any chaplain.  It was the Henry Ford chaplain who helped me after L died.  He recognized me right away and thought I left HF because of L.  Kind of in a way I did.  But it was more than L.  It was L, M, and A.  Ironically, L's wife called today and asked me to come help her spread his ashes that he had mentioned to her he wanted me there.  He did not want any funeral or service, so I feel more than honored that he wanted his "granddaughter" there.  Numerous times he let me know that I was going to be his only granddaughter because his daughter was never going to have kids.  It still hurts 2 months later thinking of that day he told me goodbye.  I was sad from this point on.  I shouldn't be sad, I should be happy because death of someone means no pain, it means peace.

Seeing a camper go downhill in front of me….watching the doctors all congregated in the room trying to help.  That is going to be a huge task for me as I take care of these kids I know.  I have an emotional connection to them and I am going to have to put that aside

News of a camper facing a hurdle that could have possible been a huge hurdle and a game changer.  I thank God that he had different plans.

News of a camper becoming hospice stung like a bee.  We became close this year at camp as I spent every morning sitting with her while her companion went to breakfast.  We shared secrets, no worries I won't tell, and we built trust.  She asked me at camp if she was going to die since I was a nurse and nurses are supposed to know everything.  I told her the truth, "I did not know, but if you do I pray that you are at peace with your life you lived."  Never ever tell a patient they are not going to die.  You NEVER know.  Empty promises as a nurse are the worst mistake.

Then finally, news that one of my girls whom I have watched grow up in the fashion show has hours to live.  WHY?!?!  She is only 9.  She has lived 1/3 of the time I have.  Why can't that be me so she can drive a car, vote, or graduate from college?  Why am I so lucky?

I am lucky because God has a plan.  I shouldn't cry because others are unlucky.  I should celebrate life, and keep touching others lives.  I have already talked to two other camp directors.  This is the push I need to achieve something on my bucket list.  I want to attend all the camps in the US.  This year I will attend Arkansas in June, Ohio in July, and Michigan in August.  I will help more children.  I will give them comfort and help them live like children for a week.

Sometimes you need sadness to bring happiness.  You need bad to bring good.  Do something today to make someone else's life better.  Set a goal and achieve it.  When life hands you a box of chocolates, don't be picky…embrace it all and make do with what you got.    

The past is so easy to remember, the future is so hard to welcome

As I left Henry Ford I was happy.  A month later I am feeling a mix of emotions:

I am sad.  I miss my friends, I miss the familiar.  As a float nurse I get to learn a lot more than I ever expected.  I will know about so many diseases in a year instead of only cancer.  However, this is harder than I thought.

Where is Darryl, Crystal, Gina, Ashley or Chelsea when I need them?  They aren't behind me, they aren't down the hall.  These other nurses do not know how to read me.  They do not know when I am really thinking, "Shit is going bad quick…and I need help."  They do not know when I am thinking, "What the hell is this doctor thinking?"

I miss Matt.  I hated him on that first day of practicum and wanted to quit nursing school, only being 3 weeks away from graduation.  By the end, I loved him as a teacher and appreciated him keeping me for 2 hours past my 12 hour shift to teach me in the break room about stuff I did not learn yet.  I learned so much from him and can give him all the credit for molding me into a good nurse.  Most of my habits were learned from him, and they help me with my time management and ability to anticipate.

I miss Stella.  I will always remember my first preceptor as a RN.  She was my big sister I never had.  

Now I have a new preceptor on each unit.  Some are great.  Others are not.  However, we are not all good teachers and we are not all great learners.  I cannot be bias to Stella and Matt because they were great because you do not come across rainbows and butterflies your whole life.

A baby is life's greatest treasure.  I love grabbing a baby at 2 am and cuddling them and and feeding them.  I didn't hate dealing with adults, but let me tell you, feeding a baby at 2 am is much more happier to me than getting manhandled and strangled by a confused patient.

I haven't had to put a patient in a body bag in over a month.  Thats the longest I have went in over a year.  100% of my patients get discharged pretty healthy.  As a younger nurse, this is imperative to my success.  Starting off around so much death was beginning to ruin my perspective and attitude.  It has now been rejuvenated.

I work with a team.  Day shift does not leave anything for night shift to do.  WHAT?!?!  Yes, I said it.  It is not night shifts job or day shifts job to do a certain intervention.  It is EVERYONES job to do EVERYTHING and every patient is YOUR patient.  Amazing that there is that culture.  We eat lunch as a family at 1 am in the lunch room.  Everyone gives an update on their life, and this is time for many to share things that we understand.  It has fostered so much confidence in trusting those around me.

I miss Henry Ford.  I miss the Interns, I miss the Residents, I miss my friends, I miss my confidence.

I will be successful at CHM, as time will pass.  I will make more new friends, I will understand these doctors, I will gain confidence.  

Do not forget the past, remember it has made you what you are today.