We Cope

As I came around the corner I saw a code cart outside my patent's room.

I had gone to lunch 30 minutes earlier, my patient was fine I thought, they had come in with lower abdominal /pelvic pain, a report of constipation. I thought- urinary retention and placed a foley catheter that drained about 250cc. 

Well. that's not it. 

I started an IV, drew labs, medicated per protocol.  The doctors were backed up so the labs came back first.  When the doctor saw the patient and saw normal labs, he ordered at CT scan.  The scan had been done and we waited for the results.  The patient was slightly more comfortable, able to fall asleep, but easily awakened.  One of our bright, young nurses, Kellie, asked if I wanted to be relieved for lunch, and I was ready.  So I gave report on my 4 patients and away I went.

While I was gone the CT report came back for acute appendicitis. Kellie got an order for an antibiotic and started administering it and preparing the patient for the OR.  She was getting ready to do an EKG, she had just told the patient they had beautiful blue eyes which pleased them, when the patient started having difficulty breathing.  She called for help, a code cart and help was there in seconds, the family led just outside the room so everyone could fit.

When I rounded the corner and got to the room CPR was in process.  There were 2 ED doctors, 4 nurses and medic and a tech.  I applied defib pads.

After about 20-30 minutes of CPR, medications, and multiple defibrillations, the patient was pronounced.

So many things run through your mind, mostly, did I miss something. 

We cleaned up the patient, moved them to another room, and brought the family back in.  They had watched the code and the doctor had spoken to them.  They were in shock, hell, I was in shock and I live with this every day. 

What can you say?

I expressed my condolences, I told them to take their time and tell me if they needed anything, and I went back to work.

I WENT BACK TO WORK!

What kind of a twisted job is this?  I went back to work?  After that?

Yes, it's what we do. What else can we do?

I spoke with Steve, my partner that day, about what happened, he said Kellie did everything right.  I spoke with Kellie about it, she seemed to be OK, considering.  I worry about the young nurses.  I mean, it affected me, and I was doing this when they were 5 years old.  I'll speak with her again in a day or two.

Cassie walked over from convenient care to make sure I was OK, Cassie and I have been working together the last few months on the union organizing thing.  As I was worried about Kellie, Cassie was worried about me.  I guess that's how we cope, how we go back for more.

There are no good answers, for the family or for us.  It does affect us, and it's important to recognize that it does.  These things happen often in the hospital, even more often perhaps, in the ED.  They happen too in the field, to our EMS brothers and sisters. 

We cope.

We have to.

If we don't cope, we don't last.

If we don't last, we're not there for the next patient.

To cope, to last, requires us to understand that we are not super human

But we are not alone.

We lean on each other, we gain strength from each other, we are stronger together than alone, we are a family.

And we keep moving.