Friday the 13th

Okay, anyone that works in an ER or area like that knows that we are a superstitous lot. You never erase the last name on the board, you NEVER say "it's quite in here", in fact we get worried and call it the "q" word, lots of things like that. In my unit, in fact lots of people at this hospital (we have around 700 beds) they know me as the"angel". I have never done anything to cause it, it's just there are some people that seem to be the one that is there when things go badly. I'm always cautious about it lest people misunderstand.

Today, I was charge. We have a 20 bed unit, I had two patients (our normal load per nurse). The charge nurse is also lead on the code team for the hospital. Everything was somewhat decent this morning, I even got LUNCH!! Then, well, CODE BLUE so I ran to it. Took awhile to deal with it, transferred the pt to another unit, went back to mine. While I was out they filled my empty bed with a "great charge nurse patient." Pt in their 30's had some heart valve issues, just here to be watched a little closer. You know, just in case. While I was gone they even bathed her (my unit is awesome - I will brag on them anytime, anyplace). So anyway..... my perfect charge nurse patient didn't understand the rules, my rules...... she came down on 1.5 liters O2, decompensated over about 30-45 minutes, was intubated, PEA (ran a code), we placed an art line, neo, dopamine, NS bolus, then the big one, a balloon pump!

I'm still in shock. One of the nurses today is an instructor, she and I reviewed what had happened. Had I missed something? Should I have intubated sooner? We intubated before she gave out, I had drugs being mixed from pharmacy before I had orders so when the doc called back I could be ready right then, I was trying to beat the bad stuff..... I even had the crash cart next to her room to ward off the evil spirits..... No one felt like I missed anything and I really don't either. It's just reviewing how fast our patients can go bad. Had she remained on the floor I really think she would have died. Those nurses are good, but it happened too fast for them to be able to do everything we did. Again, and none of them will read this, well one will, the nurses around me were doing all the work, I was directing some and pacing a lot (phone calls to docs), running and fetching, scribbling notes so I could remember what in the heck happened.

I left work at 8:50, I was supposed to be off at 7p. The patient was stable when I left, the other code patient was alive as well. Maybe it wasn't a bad day after all.