a CODE BLUE like no other

As I am nearing my first year as a nurse <insert smiley here>, I can say that I already have ample experience on life-threatening conditions that requires my super-fast and accurate nursing functions. Code Blue(s) are in nature unexpected; but sometimes when you know a patient so well, you’ll see an stand-by intubation engraved on his forehead.

I came to duty today for a 12hour shift (6pm-6am); it was one of those days when our patients’ census is less than 20, with no code-able patient to note. Seven in the evening came and we received a call from one of the security personnel; saying that a man downstairs identified himself as the driver of one of our patients and is about to get their car, so Mr. Security is confirming the identity of the man. One of my co-staff called Mrs. Star, the wife of our patient Mr. Star who suffered from a stroke; she said that she does not know the man. We all found the incident funny as a car thief identified himself with the guard; one of us even joked that maybe it was his first time to do a crime!

At around 9pm, my charge nurse entered Mr. Star’s room to check on his IV fluid, he saw Mrs. Star lying while watching TV at the bedside divan, commented on the almost-car-thief incident then left the room. At 9:40pm, the nurse’s call was activated in Mr. Star’s room, one nurse came immediately inside and found Mrs. Star unresponsive on the divan. Yes, it’s the wife, not the patient that we found unresponsive. Measures like sternal rub, vigorous shoulder tapping, etc was done, but she still did not wake up.

Some seconds later, I found myself asking the operator to page the dreaded “ATTENTION CODE BLUE” for a relative, not a patient.

While we were resuscitating Mrs. Star, we learned that the other guy who have been with them throughout their admission was not related to them. No one then can give reliable information about Mrs. Star’s medical history like past ailments, allergies, her drug maintenance, or even to decide whether to intubate her, stop the resuscitation, and the like. With lack of relative consent, we proceeded with intubating her and continued ACLS.

Our resident doctor Dr. Cheeks then got hold of Mrs. Star’s cellular phone and called all the contacts there to ask someone to come to the hospital and decide on the matter. When I thought the situation could not get any worse, almost all that Dr. Cheeks contacted were at Baguio City; almost 10 hours travel from Manila. As we were nearing the 30th minute of resuscitation, Dr. Cheeks finally talked to a son of the couple who was in Quezon City. He was briefed of the situation and promised to come immediately.

The moment was so desperate as no amount of Epinephrine nor chest compression made her heart pump plus we do not have an eligible relative to confide with. The other doctors were as desperate that they even talked to Mr. Star and asked him if his wife has history of a heart problem. Of course no proper response was extracted from him, but it was just the best we can do at the moment.

The code lasted for more than an hour and we failed to revive Mrs. Star. The son came and we could only give him an assurance that we did everything but what happened was just beyond our control. It was sad, stupefying, and unbelievable all at the same time.

Lesson learned here: Never come to duty unprepared; because you will NEVER know.