What do I normally do when someone from work asks me to come in and fill a hole? Normally I don't answer and choose to ignore the phone call, reminding myself that it is my day off and I deserve to rest. Hey I graduate this week and I need all the rest I can get. I have to be able to party hardy after 5 years in college. So when I actually called my boss back and said that I would work from 3 to 7pm, it surprised me. What made today any different from any other day...? I needed the money. I have to buy a couch for my new apartment. 4 hours of work is no big deal and I figured it would be a quiet evening full of playing waitress.
How wrong was I....
I bumbed a ride from one of my roommies and had her drop me off and went into work like any normal day. I figured out who was going to be working with me and got my assignments. Joy I got the back half of the hallway. That meant 8 patients. I started taking my vital signs and only got one done when I heard "we need some help in here." Two nurses just coming on came out into the hallway and asked what was needed. "Lots of towels." So I go into the room to find one of the nurses in the bathroom with the patient, blood splattered everywhere, Janet (the other tech) standing outside the bathroom door, the Foley catheter still attached to the bed and the end of it laying on the floor with the balloon still inflated, the IV pole outside the bathroom door with the normal saline infusing onto the floor.
I've seen worse situations, but let's understand something. It looked like someone had been murdered in the bathroom. Blood is everywhere. All over the floor, the walls, the toilet, the patient. And everything that was attached to the patient in now unattached. The IVs and Foley were pulled out when the patient got up to go to the bathroom. So I let the nurses deal with the patient and do what I do, clean up the mess in the room. I throw away the Foley bag and catheter part (balloon and all) and the IV catheters that are covered in blood.
The patient by this point has now been bleeding out of his arms for several minutes and by the looks of one of Iv sites, out of an artery. IVs go into veins not arteries, that's why they are called intravenous catheters.... Arteries spurt blood, veins don't. So arterial blood is spraying the walls of the bathroom and if we try to get the patient up, us too. We had spent maybe 2 minutes in the room and the patient slumps over and is now unresponsive. This is the beginning of a crazy day.
I'm pulling code lights while another nurse goes to have the code team paged. Nurses from other wings are running to our aid. Immediately we have an attending, 4 residents, all 5 nurses form our wing, 2 from west, myself, the other tech, and another tech from east. You have to realize that this patient is in a semiprivate room, with a roommate. I push the roommate up next to the window, begin throwing stuff off the bed to clear it so we can move the patient. Hooking the ambu bag up to 11 liters of oxygen. We used a tourniquet to cut off the blood supply to the artery that was spewing blood everywhere, so that we wouldn't get caught in the face.
While I was doing everything at once, three males - a doctor, tech, and nurse grab the patient, who is now not breathing and shouts to me to move the bed closer. I unlock the wheels and push the bed towards them and lock it back as they flop- yes flop- the patient onto the bed. I was afraid that he would bounce off the bed and onto the floor.
People are starting to come into the room and it's getting crowded. The only thing I thought to do was get out of the way. So I ended up pushing chairs, trashcans out of my way so I could get around the bed and get out. The code light is still blaring- baaaa dooo baaaa dooo. Most annoying sound ever. By the time I climb out of the room over legs, trash cans, sheets, feet, and people there are at least 15 more doctors (attendings, residents, interns), 4 or 5 pharmacy techs and pharmacists, the rapid response team (3 nurses), and other random nurses who are with the patient's team of doctors. Must have been 30 or more people, plus two code carts. I don't know why we needed two, but we had them both.
All I know is that when someone shouted for suction set up I ran to get the suction set up as another nurse ran to get it. I handed it all to her and went to find the wall set up. It was intense and a blur. I ran into other patients rooms looking for oxygen wall adapters and ran back out. I'm sure they thought that I was completely crazy. Oh well. I got the doctors what they needed. I was shaking so bad from the adrenaline by this time that I couldn't even help draw up saline flushes.
No telling how many calories I burned today. This was all within the first 40 minutes of me being at work.
We ran to and from the supply room many many times today getting, face masks, and anything that was needed. We called housekeeping to ask for red bags and got 8. We didn't need 8 but now we have them if we need them. The chaplain was also called so that we could keep the family busy while we worked on the patient. That helped a lot.
When they said we have a pulse but no blood pressure it was a good sign. Packed red blood cells and fresh frozen plasma were ordered, new IVs placed, an ET tube was also placed after several tense minutes. Although they paged anesthesia just in case.... when they showed up with the fluoroscope, I heard someone yell, "We have back up, the Calvary is here!"
Finally after 40 minutes the patient was stable enough to move to the PACU. But my job was far from over. A resident ran to catch the elevator and hold it while I stood outside the room with a biohazard bag and caught all the crap that the doctors had in their hands. We finally heard the resident shout that she had the elevator and I yelled to the docs in the room with the patient "they have the elevator..." And the patient was whisked away.
If only I could have gone home after that. I got to assess the damage inside the room. Blood everywhere, things tossed on the floor. ET tubes that didn't work laying on the floor. It was a murder scene. Like one of those murder movies where no one survives, and you find a person laying in the bathroom in a puddle of blood. They were taking a crap and then ax to the head. It was crazy.
If I had to have a code, I guess that was the best kind to have... Not that anyone wishes for a code. I think that if my boss calls me tomorrow and asks me to work, I just may say "hell no I won't go."
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