Sunday, July 6, 2008

My Second Code Blue

I went into work Thursday night - a night I did not orginally schedule for myself, but our scheduler rearranged my schedule that week. So I was there. I was just starting shift change report when the wife of a patient reported to me and the day nurse that she felt her husband was restless and anxious - could we get him a Xanax. Rather than insisting the day nurse get it - since it was technically still her shift as I hadn't even gotten report yet, I volunteered to get the medication so the patient did not have to wait at least 30 minutes because of shift change.

I brought the Xanax 0.25 mg PO (pill form) into the room. His wife who is also a nurse, sat him up in bed. The patient wasn't saying very much to me. The wife claimed physical therapy worked with him a lot today and he was tired. Yet anxious because he was not going to be discharged until tomorrow. So I give him the pill, he takes a few sips of water - swallows the pill - takes a few more sips of water. I ask him if he got the pill down. He agrees that he did. Within 60 seconds of that, he went unresponsive. His eyes were still open and that threw me a little, but his wife immediately starting mouth to mouth on him really threw me. It wasn't anything like what we learn in ACLS....check for breathing, check for pulse...nope, she just yelled "Something's wrong" & started mouth to mouth. I got the day nurse to come in to assess him and by that time the wife was now doing compressions. I guess she just went into panic mode. I went ahead and called a code blue because obviously there was a change in this patients condition - not that I was sure that he had stopped breathing or that his heart stopped.

The only good thing about a code at shift change is that you get twice as many people showing up - day staff and night staff. The patient's heart had never stopped beating and although he was having difficulty breathing, he never stopped breathing. They ended up intubating him and transferring him to ICU. Kinda weird considering the day nurse had spent all day getting his doctors to clear him for discharge the next day. Guess it is just not meant to be.

I don't believe he choked or aspirated the pill or water we gave him. I think the restlessness and anxiousness were more of a sign that he wasn't feeling right to begin with and that this would have happened regardless of whether I medicated him or not. There's always a doubt though. I felt a little helpless, but am grateful we have a good staff when it comes to codes.

I got a call from that other hospital. I have to call them back tomorrow. I'm pretty much positive they'll offer me the position - which I will accept. I want to see what it's like outside of my comfort zone.

I saw a couple of movies last week....Wanted and Hancock. I enjoyed Wanted = great action flick. Hancock....ehhhh, it's ok, very different.

I have to work the next 4 nights in a row. Hopefully it will be a good week.

Take care everyone!

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