88 minutes  

absolutelynormal 57F
6016 posts
3/31/2006 9:08 pm

Last Read:
8/30/2006 4:12 pm

88 minutes

I had been out of nursing school for about six months. I was working in the cardiac intensive care unit at the time. I'd been to the advanced cardiac life support class, I had my card that said I could provide that service if need be. Some one from the unit answered all the codes. They called one in the ER. I went.

I came around the corner and just said where to the unit clerk and she pointed to where I should be. It was a curtained room with the drape pulled shut, almost. As I got closer I could see an enormous belly. It looked young and female. It also appeared to be very pregnant. My heart did flip flops.

The doctor saw the look on my face and told me she's not pregnant, she delivered five days ago. I ask what they want me to do, each person on a code team has a job. Some places you know your role before you get there, other places you're assigned when you get to the scene.
The doctor asks me if I will take over chest compressions. I look at her chest, see where his hands are placed and realize that he has his hands turned length wise on her sternum. Her breasts are engorged and his hands won't fit. Neither will mine.

He asks me to hold the compressions to see if we have anything on the monitor screen. We don't. Contrary to what you see on TV or the movies, I have yet to go to a code where someone is saying one-one thousand, two one thousand and so forth when doing chest compressions.

She was intubated before I got there. Someone is breathing for her using an ambu-bag. It's kinda like a rubber football, you squeeze the air out and into the lungs and when you let go it re- inflates itself. Another person is giving IV medications to try to get her heart started. There is someone writing down everything that is going on. It's controlled chaos.

I'm short, someone gets me stepstool to stand on to give me better leverage. My compressions are effective, you can feel a pulse each time I push down on her sternum. It's hard work, soon I am sweating. I look down at her face. It's young like mine is. Her blue eyes are open, yet they see nothing.

I ask what happened. The doctor tells the tale. "She had a csection 5 days ago. Went home 2 days ago. She had a fever when she was discharged, they put her on antibiotics. Progressive shortness of breath today. Her oxygen saturation was 93 when she came in" he says. Not a normal sat for a 25 year old nonsmoker, non asthmatic patient. "We started her on oxygen at 2 liters. her sat didn't come up. We gave her a breathing treatment, didn't help. Switched to O2 by mask, getting worse now. I finally decided to intubate her. I lowered the head of the bed and snapped the blade onto the laryngoscope and she screamed and went flat line."

She's still flat line. We work and work. This is a new mom. Her baby needs her. At this point though, it won't be his mom he'll get back if we're able to get her heart to start. She'll have brain damage even at that point. Still we refuse to give up. We've been in this tiny ER exam room for 50 minutes. We've emptied 2 crash carts of their medications.

I look around the room. The most respected doctors in the hospital are there even though it's 2 am. One that I have the utmost faith in, I've seen him work miracles, perhaps he can now. He's young and smart, just out of med school. They all agree that there is no reason for this young woman to be here. Her white blood cell count is elevated but not a whole lot. She's had a fever but low grade. She doesn't have pneumonia. Her blood pressure wasn't elevated when she came in and she didn't have a seizure.

We all cried that night. You rarely see doctors cry. The doctor I had so much faith in is a lung specialist, his wife had given birth about a week before this young lady did. I was only 2 years older than she was at the time. It was devastating for me. I went home and held my babies although I could hardly call them babies by then. I cried and cried. My husband knew what happened but I didn't want my kids to know that a young mom had died.

They did a post mortem on her the next day. She died of septic shock. She had a bladder full of pus, pus from there all the way to her kidneys. She hadn't wanted to leave the hospital. Her insurance wouldn't allow her to stay. She was sick and she knew it. She had called the doctor multiple times complaining of pain and they told her it was normal to hurt after a caesarean section. They called in more potent pain meds for her. She slept most of the day before she became short of breath.

I try to put myself in her shoes. I wonder how bad she felt. I wonder if she knew how sick she was. I wonder if she was terrified of leaving her baby.

We all heard her husband scream when they told him she was dead. He was alone. Her parents had the baby at their house. He wasn't from here. He came in to see her. He wanted us to remove all the paraphernalia that we inserted to try to save her. We couldn't. She was a coroner's case. It all had to be left in.

I had to go back to my world. The ER was not my world back then. My world was the elderly patients with heart problems. I wasn't there when her parents arrived. I wasn't there when her husband let her "hold" the baby one last time.

88 minutes, the longest code I've ever worked and I've been doing this for 19 years. 88 minutes of knowing it was futile. 88 minutes of knowing a young husband would be a widower. 88 minutes of knowing a baby would be motherless. 88 minutes of helplessness.

qship52 64M

3/31/2006 9:39 pm

My heart goes out to you - and that family. I had occasion to spend the night in an emergency room recently with my daughter, and I want to expression my appreciation for all the hospital staff that works an ER - you are all wonderful.

absolutelynormal replies on 3/31/2006 9:55 pm:
Thanks Gship, I hope your daughter is recovering nicely

mangomamiCT 43F

3/31/2006 9:44 pm

I send up a prayer for that child wherever they might be today ........

absolutelynormal replies on 3/31/2006 10:39 pm:
Yeah, me too. Assuming all is OK with his health, he should be 18. I know his dad remarried not long after mom died, raising some eyebrows. The people that were talking were not there the night she expired.

womanoirish 55F

3/31/2006 9:53 pm

This is so sad.
Fortunately, California now has a law that states that neither a woman nor her newborn can be discharged if the mother and her physician feel it is not time for her to go home. Essentially, the health plan cannot dictate the hospital length of stay. Unfortunately, unnecessary deaths like the one you describe and deaths of newborns happened before that law was passed.

I've worked on the business side of medicine for many years and it's sickening to me the extent health insurance companies will go to make a buck.

absolutelynormal 57F
6563 posts
3/31/2006 9:57 pm

Yeah WOI, I too am glad that they've passed laws that keep this from happening. The family sued and won millions, and they should have.

Helper874 46M

3/31/2006 10:11 pm

Wow Mac. I have been to codes before. But never one that long. I could sense the desperation and dispair. Must be tough to re-live. Thank you for sharing....Hugs.

absolutelynormal replies on 3/31/2006 10:22 pm:
Extenuating circumstances. Most codes are over quickly, especially once the patient has gone flat line. Your odds are like 10,000 to one to come back to the same quality of life you had before your heart stopped. I'm having DNR (do not resuscitate) tattoo'd on my chest. I'm an emotional person, but my job doesn't allow for it.

2943 posts
3/31/2006 10:13 pm

Wow...I am speechless in a numb kind of way. You know, I don't know how you people do it on a day to day basis...it must be hell sometimes especially when this happens. I am asuming you are a nurse...and I know you are a special person. I thank you for all that you do...sometimes there's nothing more you can do. It's so unfortunate that people have to live without insurance, or limits.
This country is way behind on making sure it's people are cared for and given the opportunity to stay healthy. It's just plain sad and I feel for that girls family, husband and baby she will never get to love. So very sad...........


absolutelynormal replies on 3/31/2006 10:41 pm:
Yeah, I'm a nurse. I would agree with everything you said in regard to healthcare in this country.

FriendlybutKinky 50M

3/31/2006 10:41 pm

Thank you for trying so hard. Even when you knew it was not going well. Thanks for never giving up. Thanks for picking up and moving on, even when you were to sad to do so.

I have had my share of death, the feeling is so very helpless. The best we can do to honor the dead is to live and love well.


absolutelynormal replies on 3/31/2006 10:46 pm:
Thanks and peace be unto you too, FBK Mac

trillionman 56M

4/1/2006 7:24 am

I still don't know how you can deal with that sort of thing every day.I could not. That is why I say you are a very special person.

absolutelynormal replies on 4/1/2006 8:44 am:
Fortunately I don't have to deal with it everyday. Most of the people that come to the ER don't actually need emergency help. Real emergencies account for I'd say 10% of the people we see. Most patients could be well taken care of in a doctor's office. Most do not have insurance, doctor's offices want money up front inf you don't have health insurance> In the US if a hospital receives government funding (think medicaid, medicare) that hospital cannot turn anyone away.

ProtonicMan 49M

4/1/2006 11:49 am

Hugs. Hugs. Hugs.


absolutelynormal replies on 4/2/2006 7:51 am:
I'll take all of them, thank you TJ Wendy

4206 posts
4/2/2006 10:11 pm

so sad...you are truly a remarkable woman to deal with pain...and sometimes sorrow...on a daily basis...my heartfelt thanks go out to those of you who tend to those in need...smooches...QueenB

Come on over...let's play in my Castle! The hide and seek is awesome!


absolutelynormal replies on 4/2/2006 11:06 pm:
Thank you Queenbeev. I'd like to say again that this is not something that happens in most ER's daily. 20 something year olds don't usually die. I've been in on 100's of codes, she was the youngest adult I've had die.

keithcancook 61M
17930 posts
4/5/2006 12:05 am

She will not be forgotten. You have seen to that...

Blog On!

absolutelynormal replies on 4/5/2006 12:07 am:
I don't recall her name, but as you say, she will never, ever be forgotten. Thanks for visiting, Keith, Mac

Babel__Fish 46F

4/5/2006 6:27 am

Great writing.


absolutelynormal replies on 4/5/2006 6:34 am:
Thanks Babel, hope your foot/ankle is feeling better

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