Don't You Believe Us?

A fellow nurse called me into a room urgently for help with a patient. By the look on his face I knew that I better get my behind in there NOW. When I step into the room, I see the patient looking very toxic, in fact, looking rather cold if you know what I mean. It is at this point that I hear the telemetry system alarming asystole, and I rush off to call a code so the primary nurse could get things started in the room.

While I'm out rushing around calling all staff and getting the equipment in the room, I hear the page operator calling it overhead and I can imagine the frantic and excited residents all over the hospital jump up leaving their coffee behind and rushing to our aid. By the time I get back into the room (maybe 1 minute later) I am surprised to see the patient with his eyes open again. I look at the nurse, and he tells me that the patient came back on their own with no intervention.

At this point I turn my attention to the monitor, as I want to see the event and how it played out. While I'm mousing my way through the screens I hear the footsteps and see the disappointed faces from the various members of the code team as they come running only to be dismissed as the patient had recovered. I could hear some of them mumbling, "The primary team wants to handle it." Or a biting, "Was he really asystolic? A lead probably just popped off and the alarm freaked the nurses out." And my favorite, "He just vagal'd, not a real code."

Excuse me? We are educated nurses, and we know the difference between a slow brady and asystole. We know enough to immediately check leads, but when a patient is looking rather cold and not breathing you tend to skip that step and act immediately for the benefit of the patient.

But, this incident makes me doubt what I saw. Maybe we didn't know what was happening? Maybe we acted too quickly? I'm not sure, but I still feel like we did the right thing. My gut confirmed what the primary nurse saw and we acted quickly and appropriately, no matter what the disgruntled and disappointed residents may think.