Code Blue on the floor: a lot like a Code Blue in the Emergency Department, except we have to run to the elevators, take a ponderously slow ride up to whatever floor they’re doing compressions, and then run some more down some endlessly long corridors till we find a room full of telemetry nurses looking out expectantly the doc and me and the ICU nurse (who flew down three fights and turned an ankle in the process.)
The patient, of course, is already dead. We just haven’t decided yet to make it official. This is one of health care’s best kept secrets: once a patient has gone VSA he is, for all intents and purposes, dead. Chances of bringing him back are minuscule — and yet not tiny enough to give up all hope of resuscitation. Once even I shook the hand of a woman leaving the hospital who coded on the ambulance gurney while I was triaging her the week before. So we continue. I pull out the drugs, and direct traffic, while the ICU nurse pushes epinephrine and atropine. The ICU Respiratory Therapist manages the airway. One of the tele nurses is assigned documentation, and there’s a short rotation of three nurses for chest compressions. The doc yells at one of them: harder! faster!
After the second round of drugs, it’s becoming clear the effort is futile, and we settle into the routine. Nurses doing compressions change every two minutes. Epi every three. When we briefly pause for the change, the monitor shows asystole. The ICU nurse and I chat. The RT cracks wise with the doc, and the tele nurses giggle at this, We banter back and forth. We joke. Another of health care’s best kept secrets: we chatter like budgerigars during codes. Then, through a crack in the privacy curtain, I see just this: two fidgeting hands clasped across a flannel covered belly.
Shit. There’s a patient in the next bed. I make frantic hand signals. I finally get everyone to shut up. A couple of minutes later, the doc pronounces. The room is silent. I can only imagine what he guy in the next bed is thinking.
And this isn’t the first time this has happened in my experience. I can remember a few occasions in the Emergency department where the guy in the next bed was a child who for various reasons couldn’t be moved.
So what do we do about the patient in the next bed, apart from shutting up?
Those Emergency Blues 
#1 by ellen-ottawa on Tuesday 13 March 2012 - 1430
cut yourselves some slack…. the adult patient can realize that you are human beings doing a tough stressful job…. of course you don’t want that side to show to patients, but they need to cut the medical profession a bit of slack too…. and I speak as a member of the public…..
#2 by Zarena on Tuesday 13 March 2012 - 1808
Actually you would hope the public would grant you some slack, but more often then not they are the first to complain. If the guy in the next baed took offense to anything said he could have put in a complaint not just with your employer, but with your professional association or college ( as is the case with doctors and nures). And good luck fighting them cause you are guilty by default and in the very least will be required to take a communication course if you don’t lose you license to practice entirely. This story is another reminder why we have to keep our mouths shut and realize that we are held to a higher standard.
#3 by jenjilks on Friday 16 March 2012 - 0722
Confess your sins, explain to the patient, talk about the love of humanity that demands you understand the reality about life and death (life is a hotel; we check in and check out), and requires that all professionals relieve this stress.