Last shift I worked, I came in to get report. J had recieved a new pt, who honestly, looking from the door looked like the foot was on the bannana peel. I asked her "why's he here and not in ICU?". "Oh, well they will have a room for him when the relief gets here...". "Ok, I tell her, I'll get report on the rest of my patient's from the other nurse and by that time the ICU nurse will be ready for report...no need in giving report to me...and me giving a 2nd hand report to ICU is there?" "Uh, OK she agreed (relunctantly because she really wanted to just leave and go home). She had had a long day. I had given report to her in ICU that morning and she had transferred patient's out and they had floated her to tele and given her a butt-load of admits. She looked like she had been basically run through the ringer.
Half-way through my report, J interrupts to tell me that the Powers-That-Be had decided to leave the patient in Tele because "he is doing better" (!). I asked her, if any of them had stepped out of their ivory office to take a peek at the man, because he doesn't look too good. She assured me that he looked better than he had on arrival, and had on his C-Pap and was resting.
I finished my report, then she starts giving me report on the "Banana Peel" guy, I'm looking in the door and I stop her cold...."Let's just go in the room, so I can be checking him out while you're talking, because to me he doesn't look good". "He's got a foley, and it's draining good, and he got lasix and he had C-pap, he's X-years old, and he seems to have some sort of sleep......."
At this point I interupt her, my stethoscope on his chest...."He ain't breathing!" "Uh, she says, his chest is going up and down.." "Yup...that's the C-pap working...he doesn't have any lung sounds..." I start trying to wake him up, shaking him ... doing sternal rubs...calling his name. Hey, J , was he responsive when you were in here...? "He was talking to me", she says. "Well something ain't right now...he's out of it...is he diabetic (I'm observing the ring of sweat on the bed, feeling the patient's skin which is diaphoretic and pale). "No"...
GET THE CRASH CART NOW.....I call the Supervisor for rapid response team, and call respiratory for rapid response team.
The Supervisor comes in and I let the Powers-that-Be know the situation...IE: He isn't moving any air, but he has a pulse and is sinus rhythem...
By this time respiratory is there and checking the O2 sat...which was to say the least dismal....We hit the button...Code Blue...and the rest of the team arrives. The er Doc tubes the guy, but they cannot get it in position, and bagging him is making him puff up like a puffer frog. The man had two docs working on him trying to get him intubated and an OG To get the air out of his stomach. In between we were getting good sats with bagging, just blowing him up like a puffer frog. Mid-way through he had a seizure (damn that sure isn't a good sign!), they finally got him tubes and over to ICU...where they had to CALL IN THE ICU nurse they had put on call. Didn't save any money there folks.
Last I saw, the guy was still tubed and looking pinker, but sedated...don't know how that will turn out. J stopped on her way out 2 hours late and thanked me for looking at the guy with "new eyes", because to her he looked better, and sometimes appearances can be deceiving.
The rest of my night was pretty good except I had one patient that the family even wanted me to come out of the CODE because their mom had some blood in her spit....hello....that's not life threatening...I'll be there when I'm thru here...saving a life...got it folks??? Later they complained to management that "I wasn't treating them right"....hummmm was it the code when I wouldn't desert my patient to look at spit...or was it me asking them to quit sucking her tonsils out through the yanker because she was gagging and that was putting her in pain (gallstones people!!!) and we had just pulled out the femoral line and there was that little bitty thing about possibly causing her to start bleeding....YOU KNOW talking common sense to the contrary!!!!??? I'm just a bitch I guess. Anyhow, my boss just shook her head...and went to her office..., you just cannot please everybody and GIVE GOOD CARE at the same time!