I was relieved today when I got my assignment; it was the hospital closest to my home. A snowstorm was expected here in Chicago, and I was glad to know that when I came out to a "winter wonderland" I'd have only a short drive home.
As my day wound down, I was closely watching one of my patients, who showed signs of instability. My other patient (we do dialysis on two patients at once in the "acute room") was stable-- or so I thought. With no warning, his eyes glazed over, his blood pressure dropped precipitously and his breathing stopped.
My mind raced, remembering what we'd been told to do in this scenario. I opened up the saline line he was attached to and poured saline into him and shouted to the other nurse in the room to call a code. She got on the phone and called it while the respiratory therapist, who miraculously happened to be in the room because we'd called him because the other three patients in the room kept having respiratory alarms, and my friend Jojo, a very, very experienced dialysis nurse was also miraculously in the room. The respiratory therapist started CPR while Jojo and I set about returning his blood and disconnecting him from the dialysis machine. The crash team was there nearly instantly, along with the house doctor. They "bagged" the patient-- put a vent bag on him, continued the CPR and gave him epinephrine.
Several minutes later, he was breathing on his own and his blood pressure was normal.
My heart was racing a thousand miles an hour. I still had my other patient to take care of, and needed to make sure all my ducks were in a row with documentation.
My patient was taken to the HAU (High Acuity Unit, which is what we call the ICU now), where he'd been taken out of only a day or so before. Obviously he was taken out too soon.
I had to call the patient's nephrologist, which wasn't so bad-- and then my boss. I didn't know until after I called her, but Jojo had had a patient code as well this week. His patient didn't make it.
At the end of it, I still had to go find my patient in the HAU and flush his dialysis ports with saline and dwell a med that keeps them from clotting. I kept my cool and did my job.
After I got everything documented, charted, cleaned and put away, I grabbed the form I need to fill out for the company and headed out the door. I stopped at Trader Joe's on the way home and grabbed something for dinner and some wine. I'm enjoying a much-needed glass right now. It all ended well. My patient's still alive.
1. Absolutely Sweet Marie- Bob Dylan
2. Accidents Will Happen- Elvis Costello & the Attractions
3. Ace of Spades- Motörhead
4. Across the River- Bruce Hornsby and the Range
5. Across the Universe- The Beatles
6. Adam Raised a Cain- Bruce Springsteen
7. Add It Up- The Violent Femmes
8. Adult Books- X
9. AEIOU Sometimes Y- EBN-OZN
10. After the Gold Rush- Neil Young
1. Jason and the Scorchers do a great cover of this one.
2. Still miss the angry Elvis Costello
3. Motörhead singing about the death card
4. Love this song, about a woman having to admit defeat-- temporarily
5. This is the version from the "Let It Be Naked" version, where Phil Spector's silly strings and heavenly choruses that were added without the Beatles got taken out.
6. A blistering song from the great "Darkness On the Edge of Town" album.
7. Even frat boys discovering this song couldn't ruin it for me.
8. Just replaced my copy of "The Unheard Music," the great documentary about X. It's one of those things you lend out and never get back because it gets lent out again.
9. Love this synthy, quirkly one-hit wonder from the eighties.
10. The band "Prelude" had a one-hit wonder with a cover of this song, in 1974