This isn't a particularly pleasant post to write, but I think it is an experience that I can share with other student nurses that will offer them reassurance and support. My first time happened on Tuesday. It was before handover started and one of the night staff put a call out for a cardiac arrest.
I've doubted my ability to cope in a situation like that. I'd assumed it would send me into a frenzy and I would panic and not be able to be involved. But, my reaction was to go to the patient and be involved in the resuscitation attempt. Within moments of the call there was a full team assembled, the crash trolly was collected, oxygen was on the patient and his airway controlled, compressions were commenced and blood gases were being taken. The assistant practitioner was drawing curtains around other patients - it didn't really dawn on me until afterwards just how important that was in protecting the patient who was being treated, and the other patient's in the bay. It highlighted the importance of respecting privacy and dignity at all times.
For the first few seconds I stood and observed, before rotating in to do compressions. It was an experience that will be valued in my learning. It was not like performing them on the resus-dolls used it training. It was a real chest, with skin and bones. All sensation and feeling is different and although it feels brutal it is important to make compressions count. It is important to do it right. I rotated in for a full cycle. The site practitioner commented the rhythm was good, and that was supportive and reassuring for a first time. For the timing of that cycle I didn't seem to think, just focus. Watching other people do compressions was surreal. Four cycles of CPR were completed before the medical registrar in-charge of the resus attempt ended resus. The patient was elderly, had several co-morbidities and had no output for the entirety of the cycles. It was a decision that had collective agreement from all the team. As we stopped there was no sudden dispersal of staff, people removed the cannulas, and airways, his eyes were closed and his pyjama top was buttoned up. The emphasis on maintaining his dignity in death as it would be in life was encouraging, and provided the realisation of just how much people can care. Nurses particularly as filled with such kindness, and it is inspiring to watch it unfold. The patient was taken to a side room for his family to have privacy and time on their arrival.
It was somewhat overwhelming, and probably the most difficult part of the resuscitation attempt for it to be stopped. But the decision was the right one, made by an educated professional who could utilise her clinical judgement to know there would be no output and the patient had unfortunately died. The hard part was knowing he was someone to someone, or maybe many people. He was part of people's worlds. But, there is comfort in knowing there was such intense efforts to try and save this man. Every single member of the team had their sole focus on him. Observing a crash team in action appears like an assembled chaos, it's a mayhem that's entirely co-ordinated. People move so fast to try and save, and preserve a life and no measure is compromised. It is a team of professionals that know exactly what they are doing and are working together as a collective.
Having returned to placement for a last block of hub before finishing second year I'm back training on a male surgical ward. It is a particularly organised, well managed ward and it has a lot of big windows (a must when you have a panic disorder, like me!) and for many reasons the placement suits a lot of my needs, but I still struggle with going back. Monday had proved to be a difficult day for me, running on nervous energy and a constant 'on-edge' feeling left me drained and exhausted by the end of my shift, and I had a horrible panic attack that woke me up. I almost didn't go back on Tuesday, I spent twenty minutes stood outside the ED entrance working myself up to go inside and I convinced myself I needed to quit, I couldn't do this, I couldn't cope with the pressure and the environment, it was all too much. But the events that occurred that morning built my confidence. What I say, I say carefully and with hope that it is not interpreted wrong. It was deeply saddening this happened, and I am aware that a life was lost, and he was someones someone. But, it was an experience that has encouraged, educated and inspired me. It has provided invaluable lessons and learning. It is only through experience we gather ability to prepare, and it is through experience that we learn.
It was a daunting and saddening experience at once, and it was educating on all area's of patient care - not just the actual provision of CPR, but the staff who worked to ensure privacy and those who ran to to collect clinical equipment. It was enlightening as to how a team works under the hardest of pressures and it was inspiring to see a collective effort filled with determination and such trying. I didn't expect myself to be able to get involved, and it would have been fine to have not, to have just observed or to have taken time away. Not everyone can cope. I was fully supported by my mentor who offered me some time out afterwards, but I didn't need it. I debriefed with my mentor a couple of days after the event, and it helped to understand and reflect on the event. My advice to other students would be to involved yourself if you can, but if you can't do not beat yourself up. Everything is in your own time.
-Loola.
I've doubted my ability to cope in a situation like that. I'd assumed it would send me into a frenzy and I would panic and not be able to be involved. But, my reaction was to go to the patient and be involved in the resuscitation attempt. Within moments of the call there was a full team assembled, the crash trolly was collected, oxygen was on the patient and his airway controlled, compressions were commenced and blood gases were being taken. The assistant practitioner was drawing curtains around other patients - it didn't really dawn on me until afterwards just how important that was in protecting the patient who was being treated, and the other patient's in the bay. It highlighted the importance of respecting privacy and dignity at all times.
For the first few seconds I stood and observed, before rotating in to do compressions. It was an experience that will be valued in my learning. It was not like performing them on the resus-dolls used it training. It was a real chest, with skin and bones. All sensation and feeling is different and although it feels brutal it is important to make compressions count. It is important to do it right. I rotated in for a full cycle. The site practitioner commented the rhythm was good, and that was supportive and reassuring for a first time. For the timing of that cycle I didn't seem to think, just focus. Watching other people do compressions was surreal. Four cycles of CPR were completed before the medical registrar in-charge of the resus attempt ended resus. The patient was elderly, had several co-morbidities and had no output for the entirety of the cycles. It was a decision that had collective agreement from all the team. As we stopped there was no sudden dispersal of staff, people removed the cannulas, and airways, his eyes were closed and his pyjama top was buttoned up. The emphasis on maintaining his dignity in death as it would be in life was encouraging, and provided the realisation of just how much people can care. Nurses particularly as filled with such kindness, and it is inspiring to watch it unfold. The patient was taken to a side room for his family to have privacy and time on their arrival.
It was somewhat overwhelming, and probably the most difficult part of the resuscitation attempt for it to be stopped. But the decision was the right one, made by an educated professional who could utilise her clinical judgement to know there would be no output and the patient had unfortunately died. The hard part was knowing he was someone to someone, or maybe many people. He was part of people's worlds. But, there is comfort in knowing there was such intense efforts to try and save this man. Every single member of the team had their sole focus on him. Observing a crash team in action appears like an assembled chaos, it's a mayhem that's entirely co-ordinated. People move so fast to try and save, and preserve a life and no measure is compromised. It is a team of professionals that know exactly what they are doing and are working together as a collective.
Having returned to placement for a last block of hub before finishing second year I'm back training on a male surgical ward. It is a particularly organised, well managed ward and it has a lot of big windows (a must when you have a panic disorder, like me!) and for many reasons the placement suits a lot of my needs, but I still struggle with going back. Monday had proved to be a difficult day for me, running on nervous energy and a constant 'on-edge' feeling left me drained and exhausted by the end of my shift, and I had a horrible panic attack that woke me up. I almost didn't go back on Tuesday, I spent twenty minutes stood outside the ED entrance working myself up to go inside and I convinced myself I needed to quit, I couldn't do this, I couldn't cope with the pressure and the environment, it was all too much. But the events that occurred that morning built my confidence. What I say, I say carefully and with hope that it is not interpreted wrong. It was deeply saddening this happened, and I am aware that a life was lost, and he was someones someone. But, it was an experience that has encouraged, educated and inspired me. It has provided invaluable lessons and learning. It is only through experience we gather ability to prepare, and it is through experience that we learn.
It was a daunting and saddening experience at once, and it was educating on all area's of patient care - not just the actual provision of CPR, but the staff who worked to ensure privacy and those who ran to to collect clinical equipment. It was enlightening as to how a team works under the hardest of pressures and it was inspiring to see a collective effort filled with determination and such trying. I didn't expect myself to be able to get involved, and it would have been fine to have not, to have just observed or to have taken time away. Not everyone can cope. I was fully supported by my mentor who offered me some time out afterwards, but I didn't need it. I debriefed with my mentor a couple of days after the event, and it helped to understand and reflect on the event. My advice to other students would be to involved yourself if you can, but if you can't do not beat yourself up. Everything is in your own time.
-Loola.