Code

My first call night back at UNMC was... ? ...hard to describe. The afternoon had been excruciatingly busy, so I was gearing up to get slaughtered with new patients. However, we must have soaked up all of the sick people of Omaha during the day because we admitted less than the average number of new patients. As good as that was, cross-covering on other resident's patients was especially busy, and my code pager went off more than anyone would ever want. Once is too many times, and twice is painful. Trust me, I would much rather do an admission than go to a code.

Heading down the stairs after checking an EKG of a chest pain patient, I heard the dreaded and distinctive "beep!-beep!-beep!" of the code pager on my hip. My personal pager is set to vibrate, so I nearly fell down the stairs with this terrible sound. The pager gave the room number, and it happened to be on the opposite end of the hospital. When I say opposite end, I mean 0.25 miles away. As I changed my direction and headed to the room, I quickly scanned the list of our patients in my pocket and hoped that I wouldn't find a matching room number. No match. Whew! It wasn't one of our patients.

To my surprise I was the first one in a long white coat to arrive. My worst nightmare! How could I be the first one if I was nearly as far away as physically possible. In that split second I prepared myself to run the code. My worst worst nightmare!! Instead, one of the nurses that had gathered in the hall outside the room intercepted me and said, "I think he's already passed." (Hello! That's why you called the code blue!) "What's his code status?" I asked instead of sarcastic remark that first came to my mind. "He and his family decided to be DNR/DNI about 30 minutes ago." I prayed that this was documented somewhere. The patient's room was filled with family gathered respectfully around the bed. Who was I to charge in there, expose their family member, and begin pounding on his chest against all of their wishes simply to appease some malpractice lawyer? This quickly became my worst worst worst nightmare!!! Thankfully, before I had time to respond, my supervisor and the patient's primary doctor arrived. The primary doc took over (as they should), and the rest of us left out of respect for the patient and family. Big sigh of relief.

This was in contrast to the "beep!-beep!-beep!" that sounded a few hours later at 3:00AM. It first came across as an "RRT." This stands for "Rapid Response Team" and is intended to get help to a patient who is in trouble but isn't in a code situation... yet. As my supervisor and I arrived at the elevators the "beep!-beep!-beep!" sounded again. Same room. Now a code blue. The room was already filled with nurses, support staff, and all of the contents of the crash cart. This was the real deal. An hour later, it was over. All over. I walked away by myself so I could gather my thoughts of what that night had held. Thankfully, the other residents would be arriving shortly and this night would be done.