Archives: Dress Code

September 2nd Year:

A few weeks ago I was on a week of hospital service, which is always capped off with a Sunday call. On a weekend call, we are required to go into the hospital in the am and round on our patients. After that, if no one is requiring admission to the hospital, you can answer the nursing/patient calls from wherever you would like until someone does come in (which they always do at some point). I, being a little optimistic, decided to dress in my Sunday best. Our church starts at 1:00, and so I figured that I could be done rounding by the time church started and hopefully head straight there.

I guess I forgot to knock on wood.

After I finished rounding at one hospital, I headed over to the other hospital we cover, where the third year resident was finishing up her morning rounds. Upon arriving there, she told me that she was just heading to the ER to do an admission. She'd gotten called about this gentleman earlier in the morning, but since things had been so busy with their existing patients and the ER doc was keeing an eye on this supposedly stable patient, she hadn't been to see him yet. Right before I walked in, she'd gotten a call from the ER saying that this 60-some odd year old man had suddenly deteriorated and had required intubation. They weren't sure what was going on, but an ICU doc had been called as well since things were rapidly going south, and mostly unexplainable. I offered to go over and help her get stuff ready on the patient.

We headed over to the ER and found our patient in his room. I have seen many, many intubated patients, and since most alert people wouldn't tolerate a breathing tube down their throat very well, they are usually heavily sedated. But this man looked different. He looked dead.

I commented as such to the third year after we had finished examining the patient and stepped outside to write the admission orders. We sat down, and within five minutes, were interrupted by the nurse stepping outside of the patient's room. "Um, could someone call a code please? His heart just stopped." "Call a code in room 2!" I spoke loudly, while the third year and I ran back in.

The things that were already were in our favor: He already had a central line (a large centrally placed IV that makes it easier to give hard-hitting drugs) and a breathing tube.

Things that were not in our favor: His heart was flat-lining and he had no pulse.

When someone is flat-lining, you can't actually shock their heart. You have to have at least some electrical activity for that to work. So instead, we started giving the man drugs to re-start things and doing CPR to get said drugs circulating. One of the nurses started doing chest compressions, but looked like she was tiring after a little while (it actually gets exhausting pretty fast). I took over for her while we waited for reinforcements in the manpower department.

"one-and-two-and-three-and..." I counted to myself as I kept my elbows straight and got into the rhythmic pattern of resuscitation. As I thumped away, I had a few thoughts:

1)This poor man's family...I don't see this ending well
2)Thank you, little baby girl, for not sticking out too far and making this task impossible.
3)I am in heels and a Sunday Dress, 8 months pregnant, and doing CPR. My life can be really odd.

That moment in that room is a memory that I think will be glued to my brain forever.

And in case you were wondering, we were able to bring the man back, but only temporarily. He passed away peacefully less than 48 hours later. His rapid descent into acute illness remains somewhat a mystery, but his loving family handled the situation with amazing grace, and let him go when it was obvious the way things were going to go. It can be the hardest but most merciful gift a family can give, I think.

I have more to post here soon--pics from our last pre-baby weekend away and baby showers, so I promise to be back soon. I've been blog-slacking, but am going to improve. I swear. ;)