Time of Death

I can’t believe how long it has been since my last blog post. I wish I was sorry, but honestly I just haven’t felt the need to blog. This blog hold such a place in my heart, and I love looking back on it. But I do feel like my life has shifted. I will continue to blog as I fell lead, after all this is for leisure. No reason to make it stressful.

Code blues. Something often glamorized by medical shows. But I would consider them one of the toughest parts of my job.

It starts at the beginning of the day, when you look at the assignment board and your name is in the code team box. It is a day that you make sure you have a radio, and you eat your lunch in the break room and not the cafeteria. You could be called at any point of the day, have to drop what you are doing and be in a that room.

Sometimes, you are lucky and EMS calls in with CPR in progress. You have time to prep the room, and people have a chance to gather and delineate roles. Then you wait. There is a thickness of anticipation in the air. I told a doctor this week that it was like in Lord of the Rings: The Two Towers and the Battle of Helms Deep. When the men are watching the Uruk-hai march in, and you can sense the tension. But then the lone arrow sets off, and it is go time.

The room buzzes once the patient arrives. EMS yelling report so everyone can hear. Compression management being handed over to the hospital staff. Everyone knows their role, and we get to work. Compressions for two minutes. Pulse check. Medications. Shock depending on the heart rhythm. Start all over again.

The goal is ROSC, or return of spontaneous circulation. As you continue everyones thinking what else can we do. Are we missing something? There comes a point where you have thought of everything, you have thrown the whole code cart at them, and there is still no ROSC.

After every possible thing is tried, the doctor will typically tell the room one more round of compressions, and opens the floor if anyone has any ideas. This is when the feeling starts to sink in. They aren’t going to make it. Modern medicine won’t defy death today. The round of compressions ends and the doctor asks for the time. As the recorder you tell the time and the doctor calls it.

Your heart sinks. The room goes silent for a second, but then it is time to clean up the room so the family can come and say goodbyes. As a nurse, you get to take a few deep breaths and go to see your next patient. The world doesn’t stop as much as you would like it to.

It is hard. You don’t have time to process. You have to put your feelings in a box and move on with your day. You will sit at the nurses station and hear the hysterical cries of the family. But it isn’t until the drive home that you get to process the loss of life.

People may think that we are cold because don’t show emotion in that room. We have a job to do. Let me tell you it sucks when we can’t defy death. The very reason I became a nurse was because I want to help people. When people die it can feel like the ultimate failure. I am learning that we don’t get to choose who lives and who dies, we can only try our best to save everyone.

I will cry my tears on the way home, at church or with my friends. I will talk to my therapist about how to better cope in the moment and when I have a chance to breath. I will continue to go over what happened and if I can do better next time. I never want death to be something that I become numb to. I want to acknowledge the life altering things that occur every day in the ER both big and small.