I lost a patient today. It's the first time at this hospital. I mean, yeah, I've had patients die here before, but they've been hospice beds. Today, I lost a full code. Actually, I'll be honest. I lost one of both today.
There's nothing like walking into a room and finding your friend unresponsive. He'd had trouble breathing on and off all day. I kept trying to get the doc to order different things. He wasn't interested. I bypassed him and got help from other people. Everything helped temporarily. I watched him so closely all day.
His CK was high from the labs we drew during the code. Maybe he had a heart attack. Maybe it wasn't respiratory. I can't say.
It's a hard lesson, and I'm not even sure what I'm supposed to learn. Should I have called a rapid response earlier and convinced the resident to take him to the ICU? Would that have saved his life? How much of it was out of my hands? How much?
The Solomon of nurses told me I practically ran the code today. It's not true, but looking back, I bet nobody would've guessed it was my first code. They always told me during mock codes that I wouldn't have to worry about pushing meds. Someone with know-how would be pushing. Except in the PICU. In the PICU, they told me to slam everything. So that's what I did. Epi in. Atropine in. Bicarb in...atropine...atropine. "How many atropines?" "We can only give three." And then, "After this bicarb, I'm calling it unless anyone has anything else." And that's when I swore, and somebody thought I stuck myself. It felt like ten minutes, but it was 45.
The guy asked me if it was my first time at the morgue. I told him it was my second time that day, but he wasn't listening. He wasn't asking for an answer. He was asking to fill his own ears.
Another one down to AML today.