It was a lazy monday morning in ER. I was not supposed to be in the morning shift but asked to do so since we have 3 staffs scheduled for ACLS training. I don’t have routine checking assignment since I’m not included in the original list of staffs on duty. For this reason, I voluntarily assigned myself in our extension of seven beds, three of it were occupied by our “tenants” or our so called ICU-0’s. Two of them are cases of RTA, a male and a female,who had been with us for quite some time, one for about six months and the other nearly four months now. The third bed was for an old lady with renal failure and severe anemia who, despite of her condition, still manages to smile on us and answers “Alhamdullilah Kuais” (thank God I’m fine) everytime you will ask how she is.
We are four nurses assigned on the extension that day, Nurse Vhie (our ACN), Nurse Oliver (for the male zero), Nurse Berna (for the two female zero) and myself as the floater which means I would handle patients who will occupy the beds in our area once the main ER will be full. But since patients are not that much that day, I only handled exactly two patients, so in between, I helped Nurse Berna for rendering care for the female zeros. At the end of my eight hour shift, I was called to prepare for a home visit since the incoming shift still have routine checking. According to Dr. Saad, its a regular home visit with change of NGT for a bed ridden patient, which has a complaint of SOB as what the relative told him.
We went to the relatives’ private vehicle with our home visit bag and NGT sets. On our way, they were discussing things about the patient’s condition. Though I could not understand much of their conversation (because it was in Arabic), I got some idea about the patient’s case. When we arrived at the patient’s room at the third floor of their building, I noticed immediately that the patient was gasping already…an old NGT at her right nares…unresponsive…extremities were cold… I could not palpate any pulse…my oxymetry could not capture any reading at all neither could I measure the patient’s blood pressure.
Dr.Saad quickly assessed the patient and informed them that we need to urgently bring her to the hospital. The relative called the Red Cresent to come over but it would take time for them to arrive so Dr. Saad started chest compression and asked me if we had an ambu bag which unfortunately we didn’t have since it was supposed to be a regular home visit. I managed to insert a peripheral line but no code meds were available in our kit…what we will do now? no ambu bag…no meds…Dr. Saad continued to do CPR cycle, he rendered air through mouth to mouth using the tissue at the bedside as a barrier…5 minutes…10 minutes…15 minutes…unsuccessful! Relatives crying…me and my doctor were speechless…Red Cresent arrived assessed the patient and confirmed to the family that she’s dead already.
Grief filled the room for the unexpected scenario. We silently left the family in the room and waited outside for someone to drive us back in the hospital. I salute my doctor for what he had done. I just felt sad that the relatives were not able to assess what’s really going on with the patient. At the end of the day, I realized that it was not really a lazy day…and we medical practioners played a vital role in the society. We save lives but only God can give life!
Photo credit: sanjuanems.org
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