Rapid Response…

The first time I called a rapid response, I had been a nurse for a few months. I was on my own and had a good idea of what I was doing. I had participated in quite a few code blues and rapid responses because after all I was meant to be an ER nurse so I always went to the codes to get the experience…..

This night in particular I had a particularly easy night. My patients were all independent and lovely people who didn’t complain, didn’t ask too much and were very appreciative of everything I did for them. One patient in particular was a special kind of fun patient we laughed as I administered night medications and joked with her about how crazy it was that she was in the hospital bunked up with another patient who was only a few years older than her and God did it make her feel old, she was a very young 60 something, closer to 70 than she cared to acknowledge… You know what I mean when I say a young 60 something… She was full of life, independent and no one would even guess she was anywhere near close to 70 years old….

I was called into the room about an hour after giving her one last ice cream cup and saying goodnight…. She was a completely different person. She had pulled her IV out, blood was all over her bed and down her arm. She was apologizing profusely about the mess she had made, she didn’t know what had gotten into her…She forgot where she was at… Was she going through sun-downers?! I comforted her as I started another IV and tucked her back into bed. As I was getting ready to head out the door, she began throwing the blankets off of her saying she was too hot, she could not even breath. I turned the over head light on and realized her lips were turning purple…

I rolled a vitals machine into the room and sure enough her oxygen saturation had plummeted into the 60’s she was diaphoretic and thrashing all over the bed uncomfortable. I called my charge nurse with the phone I had, not wanting to leave her side and said as calmly as I could… CALL A RAPID RESPONSE ROOM 233-2, I NEED YOU IN HERE NOW…. I went over my ABC’s in my head and thought “Oxygen!! I need some O’s!!!” I placed a non-rebreather on her and boom! By the time my charge nurse came in the pink had returned to her face, her oxygen saturation had climbed to a beautiful 99% and she had stopped thrashing about like a toddler in the middle of the night…. Whew I fixed her! I sheepishly smiled and said “sorry, you can cancel that Rapid Response, I think I got it covered…”

I smiled as I wiped the sweat off her face and told her what a scare she had just given me… something didn’t feel right… something was still wrong… her lips started turning blue and while the monitor read a beautiful 98% she didn’t look like a 98%….she began throwing blankets off and trying to get out of bed, grabbing her chest and breathing as if she had just ran a marathon…. then all of a sudden she was quiet, the monitor started beeping and my heart screamed in my ears as the only thing I could do was yell to anyone who would listen… I NEED SOME HELP IN HERE!!! CODE BLUE! CODE BLUE! Luckily some of the providers who had scampered up for the perceived rapid response where still hanging around outside the room and came in to save us both. I stood back confused,  I fixed her… the non-rebreather was working…until it didn’t.

She ended up intubated and transferred to the unit where she stayed until the next day and was easily extubated and returned to my side of the second floor… She was fine…She survived… She didn’t even remember any of the happenings leading up to that moment… The last thing she remembered was getting a sweet treat from the sweet young nurse who was caring for her…

I learned several things that day. First…ALWAYS let a rapid response play out…. second and most importantly a non-rebreather is a band-aid… you always, always, always have to investigate to understand why you needed it in the first place or you will end up in even more trouble. Trouble that could lead to a patient’s demise. It’s not a fix, but it was a necessary part of her healing process…

A necessary part of my healing process… You see we all have band-aids… tourniquets… non-rebreathers… splints… sutures… all of these things have one thing in common…they are temporary, but without further interventions they don’t fix the problem, only help them heal, prevent further injury or hide the symptoms of the problem until the true fix comes along….

My point is… Sometimes a non-rebreather is necessary…but don’t use it for so long that you forget there is an underlying problem to fix… you will soon find yourself spiraling into your own demise…

Sometimes a band-aid is all you need to help the healing process… but eventually the band-aide has to come off and get thrown in the trash where it belongs…  The scar of the wound will always be there, even after you are healed… but you’re stronger from the pain…stronger from the experience…smarter because of it too…

And the beauty of it all is that next time you know… next time you don’t make that same mistake… You don’t let yourself spiral down into something you aren’t coming back from… and when you inevitably do fall into something that causes you pain, you know exactly how to fix it and that everything will be okay…

I’m okay… I’m healing… my band-aids are off and the scars, while they are still pretty raw and tear open from time to time… are almost completely healed. I’m ready to move forward… I don’t need the band-aids anymore…. I’m ready… to stand tall and say that I fell down… but I survived… I made it… and I’m going to keep making it until the next time I fall… but next time I’ll know how to fall… where to fall… so that the wounds don’t cut so deep, in the same spot… but that’s the beauty of this life… our wounds and scars are what make us who we are…make us beautiful…

Ready…Set…fall… Who’s with me?!

 

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