Any nurses or medical professionals around?

[HannahP 119]

I just saw a guy die of a busted carotid. He'd apparently been up and walking the unit, talking, making plans to go home, etc. We rushed in after he put on his call light and he started banging noisily on his bed. It took him about three minutes from the time we got there to lose consciousness as he bled out (in a hospital surrounded by medical professionals who could do nothing to help him). Five to die. He was staring at us the entire time. We couldn't do anything. The carotid cart was mis-stocked and we didn't even have any blankets, let alone the ativan/fent that they usually push?

I've worked codes, rapid responses, had to make very important decisions as POA of my dying mom. Hell, I've held a very dead baby (SIDS) in my arms, and rushed him back to start a futile code. Never seen a guy who knew he was dying as we watched him die until today.

[TBoneTX 43,057]

Dear, it was his time. Things happen for a reason, even if it's unclear to us what it is. You're not to blame. You're feeling rattled and shaken right now, and this is extremely natural. This too shall pass.

[NickD 202]

Wife works as a medical interpreter and sees many deaths, touched mostly by little kids. A part of her job, she was touched by a premature baby that somehow managed to survive for two months in ICU, then just suddenly died. It was her job to inform the mother. She can tell me about things like this, but is not permitted to use any names, places, or the people involved.

She is talking about becoming a nurse so at least she can attempt to do anything about it, but has to be emotionless and just translate verbatim. Its a super though job, all I can do is to give her a big hug. But can feel how upset she is.

[Nagishkaw 510]

I remember back in the late 70's, I turned a patient over to get a rectal temp ( I was doing vitals ). When I turned her over, she breathed her last breath and expired. I thought I killed her. I kept thinking over and over, " If I would have left her on her back, she would still be alive "... I suffered terrible guilt for months until someone said just about what TBone said to me. Since then, I've had lots of people pass in my presence. Have even washed them up, dressed them and repositioned them after their passing so they looked 'presentable' to their family members. In some sort of odd way, I reconciled it to myself that it is part of the job even though it is unpleasant . Death is, after all, a part of life and no one will escape it.

The best thing I see from your experience is that the man did not die alone. Your job was done when you gave him the most important element in your field....compassion and comfort.

[TBoneTX 43,057]

I reconciled it to myself that it is part of the job even though it is unpleasant . Death is, after all, a part of life and no one will escape it.

The best thing I see from your experience is that the man did not die alone. Your job was done when you gave him the most important element in your field....compassion and comfort.

Si, man. Remember that no matter how we long for the situation to be otherwise, the mortality rate for human beings remains exactly 100%.

[HannahP 119]

I remember back in the late 70's, I turned a patient over to get a rectal temp ( I was doing vitals ). When I turned her over, she breathed her last breath and expired. I thought I killed her. I kept thinking over and over, " If I would have left her on her back, she would still be alive "... I suffered terrible guilt for months until someone said just about what TBone said to me. Since then, I've had lots of people pass in my presence. Have even washed them up, dressed them and repositioned them after their passing so they looked 'presentable' to their family members. In some sort of odd way, I reconciled it to myself that it is part of the job even though it is unpleasant . Death is, after all, a part of life and no one will escape it.

The best thing I see from your experience is that the man did not die alone. Your job was done when you gave him the most important element in your field....compassion and comfort.

I appreciate what you're saying. And, no, he didn't die alone. But he also died a very prolonged, agonizing death. It's not that we could have saved him but we could have helped him over and that wasn't done, y'know?

What is really bothering me is that the code went very, very, very wrong. The cart wasn't stocked properly and we didn't have blankets or fent/ativan. You had nurses openly bawling in front of the patient as he died.

My grandfather died a horrible end of life death. He had a DNR in place. When they took him off the vent, he wasn't given enough morphine or ativan. It's a little traumatic to watch someone gasping for breath and reaching upwards.

Maybe I was having flash backs from that? This guy did not die in the way that he should have. Neither did my granddad. I am just so sad...his death was absolutely botched by the hospital.

I get that people die. Everyone dies. I've seen very young babies die and people who lived a full, long life die. This just wasn't right.

[Flames9_RN 358]

As a RN on a tele unit been around too many codes for my liking. What can be done is learn by these experiences and ensure the code-carts are properly filled. Some people just get lazy or forget and things get missed and then when you need the equipment,its too late.

[Jay&Hua 0]

Dont know what type protocol your institution is using but where i am at code cart after being used goes to the pharm and stocked,the person that stocks the cart signs off on it and it is locked ( if something goes wrong and an item that is needed is not in there it will fall on the person shoulders that stocked it )it is then checked and signed off on every 24 hours by the charge nurse,i have never been in a situation where there was something missing.

[Flames9_RN 358]

Pretty much the same at our hospital. carts get stocked and signed off, then they get those plastic locks. never come across where the meds where missing, but have come across certain items missing or not working. Tehn the fun begins later--the paperwork!!

[chnst 6]

I just saw a guy die of a busted carotid. He'd apparently been up and walking the unit, talking, making plans to go home, etc. We rushed in after he put on his call light and he started banging noisily on his bed. It took him about three minutes from the time we got there to lose consciousness as he bled out (in a hospital surrounded by medical professionals who could do nothing to help him). Five to die. He was staring at us the entire time. We couldn't do anything. The carotid cart was mis-stocked and we didn't even have any blankets, let alone the ativan/fent that they usually push?

I've worked codes, rapid responses, had to make very important decisions as POA of my dying mom. Hell, I've held a very dead baby (SIDS) in my arms, and rushed him back to start a futile code. Never seen a guy who knew he was dying as we watched him die until today.

Oh man, sorry you had to be there for that. It's one of these things you will never forget in your life and I'm sure these 5 minutes felt like hours. I've been there and the worst feeling is the chaos and the feeling of being totally unprepared for something like this. But hopefully it will be a lesson learned and the code cart is ready next time. No matter how experienced you are this is one of the things that is traumatizing for anyone.

I am hoping for you that there is some kind of remediation for everyone involved where you can talk about it.

I work in OB/NICU and we've had a few pretty bad codes lately and management never addresses things, its not acceptable to talk about it. All of a sudden there is a new read-and-sign or stuff disappears and you're left to your own to make sense of it. That is so different from where I used to work. People have quit because of bad situtations like that or they're scared to death in similar situations.

Well, the good thing is- I learned my lesson fast- we check our code carts on the first tuesday of the month, so I know to schedule myself in for this and the first time I checked the carts most of the suppplies where missing, expired, wrong sized etc. I made a copy of the ACLS algorythm and put it in the top drawer, same for NRP for the baby cart. Also drug dosages- who the heck remembers that stuff in a situation like that (unless you do it every day)? At least you know YOU are prepared if you happen to be in the same situation again. Just know your scope of practice and hospital policies at your facilities regarding intubation etc.

oh and our carts get locked too, but still stuff disappears somehow, there was no lidocaine in one or adult epi in the baby cart etc! You can't ever rely on other people doing it right. The portable suction wasn't charged, oxygen tank was empty.. omg I could go on and on, just make sure you familiarize yourself with the emergency equipment its so important. One of the mom's coded and someone brought the baby cat out... Just such a waste of time if people are not educating themselves.

[Kathryn41 3,205]

I'm sorry, Hannah,

I appreciate how frustrated and even angry you must feel, not at the death,but at the unnecessary suffering that accompanied it. It does sound like this is a situation many in the emergency/critical care field experience, so perhaps you will find a way to turn the unfortunate circumstances surrounding his death into something positive - requesting a review of the procedure used with the cat and emergency carts- setting up a better protocol to ensure what is needed is where it is needed when it is needed, etc. It may not be possible to save the life, but it may be possible to make it easier to bear.

Looking in to the eyes of someone who knows they are dying is a sobering experience and one I know you will never forget. At least, if you are able to help bring about the changes that may make future situations like this less traumatic for the sufferer, then something useful will have come from his death.

Edited February 13, 2011 by Kathryn41