The Code

Someone was shrieking, "Oh no. Oh my God. Call a code." The nurse wouldn't stop screaming. She didn't need to scream anymore, she had our full attention, but she couldn't stop.

I hate code blues. I ran as fast as I could into the room to see if it was really necessary. Last week I cancelled a code that a manager called because the patient only fainted. Codes are for people who aren't breathing or are in cardiac arrest, not for people who just need to lie on the floor for a couple of minutes.

This patient didn't need a code because she was dead, but it is our policy to try and revive even dead people. While the nurse wailed, sobbed and screamed, the rest of us grabbed the crash cart and got busy. Given how dead the patient was, it seemed more like an opportunity to practice our code skills. I wasn't nervous for once because I knew that nothing we did would matter. It was just a practice session.

One nurse spoke sharply to the wailing nurse and told her to stop it. The nurse left the room, sat at the nursing station and continued to cry. The patient had arrived from the ER about an hour earlier and she was the only one who knew anything about the patient. She was unable to answer any questions about the patient, so the doctors just took the chart and tried to figure out for themselves what was going on, other than the obvious fact that the patient was dead.

They worked on her for 45 minutes and got enough of a heartbeat that they could transfer her to CCU, but she was still dead. She was just a grayish empty shell staring off into space. She was finally pronounced dead in CCU.

The patient had been diagnosed with a critical electrolyte imbalance in the ER. Treatment was started to correct the imbalance and she was transferred to our floor. Considering that hearts have a tendency to stop when electrolytes are this far off, it would have been a better choice to send her to a floor that has cardiac monitoring. That way, if she did go into cardiac arrest, they would know about it in time to do something. On our floor, the patient had an opportunity to get good and dead before we noticed. I hate it when people die because we screwed up.

The most unusual thing about the code was the nurse's reaction. Everyone on the floor could hear her sobbing. Some of the nurses were complaining about her unprofessional behavior. Granted, we need to stay calm and cool-headed in a crisis, but it was refreshing to see someone who cared enough to cry. The rest of us are so desensitized that we feel nothing. It must be nice to feel something, anything.