TurboNurse

So yesterday at work, I had the (not so) pleasure of being involved in my first ever code in the neonatal world.

I have to start from the beginning of my week.  Thursday when I worked was my first time being first admit.  What that means is that my preceptor and I were up to get the first baby admitted to our unit.  We ended up getting a 24 weeker (micropreemie).  While it was a critical admission, it all went very smoothly.  We were super busy but that is to be expected on an admit.

Yesterday, Friday, we get this transfer from another part of the state to do a proceedure that only the hospital I work at does in our state.

This was a messy transfer.  If I hadn't seen the EKG tracing on our monitor and if the baby had not been intubated, I would have thought the baby already dead.  As soon as the baby came out of the transport incubator, I had to stop myself from gasping.  It was just terrible.  Baby was blue all over.  I've seen cyanosis before but NEVER this profound.

As soon as we got the baby hooked up to the monitor, we all knew it was just a matter of time before we start coding.

We went on with our admission assessment and did what we had to do until it was time to start the code.

Even though we never wish to have this happen to us, I was at the same time amazed at how adrenaline-free the whole thing was.  My preceptor put it beautifully.  In the adult ICU world (where I came from) it seems that everyone is just waiting for a code to happen.  People get excited and let the adrenaline take over.  It's the complete opposite in the neonatal world.

We, yes myself included, were calm the whole time.  There was no yelling, no running.  Everyone just kept very cool and calm and collected.  I knew there was a reason I was called to the neonatal world.

When the code started for the first time, I didn't even realize they had officially started.  Just a few minutes before it happened, we opened the crash cart and got our meds ready.  It definately wasn't what I expected.  It was much better.

Since this was my first time experiencing this, my role the first two times was recorder.  It was the perfect place for me to be because my job as a recorder was to watch and record everything that hapened, when it happened.  The third time we coded the baby, I got to push the meds while me preceptor recorded for me.

The attending called it during our last code so we stopped, much to everyone's relief.

This was such a messy, ugly situation.  When my preceptor and I were talking about it after, she told me that they haven't had a code that bad/messy in 4-5 years.  I guess when it's Friday the 13th, it's really Friday the 13th!

I now also understand why we allow people at the bedside when this happens.  It seems that when the family can see that we really are doing everything we can for their baby or loved one, they begin to understand really what is going on.

When I was in school and even when I was a tech, I used to cringe when the family was at the bedside when we coded a patient but now, as a nurse, I totally appreciate and encourage family to be at the bedside.

On the emotional side of things, I was devastated.  Not as devastated as the family of the child was, by any means.  It was very difficult for me.  Even before we started to code the baby, I was having to hold back tears and just concentrate on the job at hand.

When it was finally over, I had to step out of the pod while they handed the baby to family and just let a little bit of it out.  I just put myself up against the wall and let some tears start to flow.

While that whole sitation was hard, what was even harder than that was having to go back to my other two patients, whom I haven't seen in almost 4 hours at this point, and carry on like nothing happened.  I had a lot of work to catch up on as far as charting goes because I had to chart on my two patients I started the day out with and then chart on my third one, the transport.

Once I finally made it out of work (only 30 minutes after shift end.....not too bad!) I got to my car and just allowed myself time to cry.  I let it all out and just put my head on my steering wheel and bawled my eyes out for a good 10 minutes.  Then I decided that I needed to go home so I gathered myself up again to make it home safely.

I got home and was OK until I saw my husband.  He asked me what was wrong and all I could do was bawl again, in his arms.  Bless his heart.  I don't know what I would do without him.  I have my own way of dealing with things and he let me deal how I needed to all while being available for me to talk to but not in my way.

I can also now see why so many new nurses quit the job within the first year.  If you go into nursing thinking it's all going to be passing meds and wiping butts, you are wrong!  Nursing is so much more than that.  Immensely more than that.  Nursing is treating the whole person, and in more cases than not, the whole family.

The thought did cross my mind about throwing in the towel.  It crossed only briefly before I told myself that is the wrong answer.  I got into this job because of my love of people, medicine, and (w)holistic healing. 

This was the dirty side of nursing.  We deal with life and death all day every day we are at work, especially in the critical care areas.  We are the eyes and ears for the doctors since we are at the bedside a lot more than they are.  We are NOT the doctors handmaidens.  We ARE the doctors TEAMMATES. 

I've said this many times.  As nurses, we have the ability to see humanity in it's lowest and hardest times.  It's worst.  But we all love what we do and come back for more.

It's amazing the impact we can have on a human life.  I absolutely LOVE what I do and couldn't imagine doing anything different.  My heart is in nursing and that is where I am going to stay.

While I'm ever so thankful to have this day off, if I did have to work today, I would have gone in with a smile because today is a new day.  It's a new opportunity to help these young lives go on.  Today will never be yesterday or tomorrow.  It's all about now and being the best we can be in this exact moment.  Nobody knows what the future will bring and the past is the past.  We learn as we go but our focus really needs to be on the NOW.  For if we focus our energy on the present, this is when we are our best and ready to do our best work ever.