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.