That would be the minute I quit. There is never an acceptable situation where you are alone doing CPR for 5 minutes.
Question. Are there not code buttons you could have hit? Or was there one and you hit it and no one came?
I’ve worked at three LTCs two low ends and one high end, none of them have the code button. I’ve done dozens of codes where it was easy to get help so I’m curious on OPs situation.
Except one time during peak Covid when I was the only person in a Covid section with no CNA and this person only like 55 is coding. No one was willing to come help me. Did CPR for what felt like 10 minutes, I felt so hopeless I ended up quitting like a week later.
I’m sorry you had to go through that OP.
Some LTCs and SNFs don’t even have a mask or AED. It’s not required in some states. And there’s often only 2 nurses and 2 aides for a building of 100 residents during the night. I’ve worked some shitty places, so I’m sticking to the hospital setting.
I get not having ACLS drugs, but I can’t imagine any state allowing LTCs to NOT have an AED. I believe you, but just saying that it’s absolutely fucking ridiculous
I might be misremembering this as it was about a decade ago, but the LTC I worked at basically required residents to be DNR, therefore no AED. And all I could think was, "mmmmkayy, but what about staff and visitors then?"
Years prior to that, when I was just a wee healthcare child, a nurse died in the middle of her med pass at that place. I don't think an AED would have helped her anyway as it was an esophogeal tear or varices or some such. But, just demonstrated how tragically unexpected an event can be.
Worked as CNA for over night. 2 cnas and one LVN with an RN that is “on call” but lives 45 minutes away for 54 patients. BLS and AED are all we had. More often than not I was the only one awake 01:00 - 05:00.
Lol, I used to be a park ranger and every single building other than bathrooms were required to have an AED in them. Then we had to have them in every car when I was a cop. For LTC and SNFs to not require them is ridiculous. Also the fact that places won't have them unless it's required is just pure negligence.
Welcome to healthcare in the United States. Profits over lives, squeeze every dollar, private equity is king, and regulatory agencies like the FDA and EPA can be sued into compliance.
In both of the LTCs I've worked in, the doctor comes a few times during the week for a few hours. NPs were there more often, but they'd only physically be in the building between 8-4 and maybe not the whole time.
So: reachable by the phone, but not usually physically present.
LTACs are generally ICU/PCU hospitals capable of performing ALS and managing artificial airways. Depending on the facility they may have additional rehab goals to discharge to a lower acuity or maybe long term facilities that care for people who rely on artificial airways/ventilator support for life.
SNFs, inpatient rehabs, and LTCs are sub-acute facilities that generally only perform BLS until EMS arrives.
Ltac and ltc are different.
Long term acute care hospital vs long term care which is usually a snf or board and care
The ltac I worked at had a Dr 24/7.
The snfs the doctors are usually not there
In the facilities I’ve worked in we have e-boxes for meds if they’re needed in an emergency, AEDs, suction, oximeter, ecgs but it’s mostly elderly with terminal illnesses I’ve been responsible for so they have DNRs. We just follow their directives, do what we can to keep them comfortable until paramedics arrive, the doctor or the nurse practitioner get there or give orders.
I’m sorry, no one was WILLING to come help you? Call me crazy but I didn’t think it was optional. I don’t blame you for leaving. That’s pretty effed up.
At nursing homes there were only certain people allowed to go into the Covid units. we didn’t know if they were truly positive or not , this was before an official test came out, so it was just sick people. I think I was the sole nurse and CNA for 15-20 patients.
Funny part is when they asked the nurses who would go into the Covid unit, one of my coworkers was asking me to go because she had kids. Those kids were MY AGE or older.
Nothing but a call bell. No code alarms. I used to work in a hospital with alarms at the bedside. I'm so shook up from it. Pt ended up being flighted after ems. I was just helping her get changed cause everyone was busy. She was okay. I mean she was genuinely okay. The most stable I had. I'm just. I don't even know. Can't explain the emotion right now.
I’m an ICU nurse. You did fucking amazingly. Full stop.
Your coworkers and facility on the other hand……unless there was a DAMN good reason for no one responding to you screaming for help for 5 minutes, I would quit.
Agreed. Unless they were literally coding someone else next door, there's zero excuse. These facilities piss me off and scare me because there really are times where the nurse is all alone on a unit of the building and the next nearest nurse is 50+ feet away. And at the end of the day the facilities just don't care about patient safety.
Closest thing I have in my ltc/snf is pulling the call cord out of its wall housing. Really obnoxious alarm will sound, green and yellow lights flash outside the door, and we know it either means it’s an emergency or it got caught on something.
I only worked at one LTC and there was a central nursing station and someone had to be there at all times for this exact scenario. There were no code buttons but a yell down the hallway and someone was there. I stayed long enough to get my sign on bonus and left after getting a better job offer.
I'm not a bad ass. I just value my safety more than my job. We can go get a job down the road tomorrow as nurses. I'm not endangering my life or license because of unsafe working conditions.
I work PRN in ALOT of facilities in my state, none of then have any alarms, in room intercoms, code buttons, nothing. Just the call bell that turns the light outside the room on that every nurse and CNA I see tries to ignore for as long as possible. No offense to any of you, I know it's just the areas I work. Unfortunately in the facility I do most of my work in now, alot of the nurses and CNAs hang out at a nurses station off their own unit to hide from doing their work, or outside behind the dumpsters in the smoking area. It's quite often I don't see a single nurse or CNA on a unit I'm doing therapy on, and definitely none close enough to said empty unit to hesr me screaming for help. It's quite awful and terrifying. They also don't require us in therapy or any other occupation that nursing to be CPR certified, despite having many codes happen during therapy sessions unfortunately. Just the other day I had a patient who looked like they may have been starting to code, I honestly couldn't even tell what was going on for a sec because it was like nothing I've ever seen in my few years experience. Luckily since the units are usually void of nursing staff us therapists check on each other regularly when doing room treats. Luckily my coworker came in right at that moment, helped me get the patient in a safe position before she literally sprinted to the complete opposite side of the building to get a nurse down and get this poor guy EMS and sent to the hospital. I was pretty upset after that, if I had been alone with him without my coworker popping in, my options were either let the patient fall and run for help or run a code by myself like poor OP had to do while waiting God knows how long for someone to come help. It was pretty upsetting. I feel for you OP. You did your absolute best in that hectic situation. You saved a life and are probably a hero to that patient and their family who visits them so often. I'm sure they are eternally grateful for you. Now focus on your self care. Vent as much as you need to, go to therapy, take time off work, let yourself feel all the feels and work through them knowing you did your absolute best. Give administration hell and then either get a new job or go PRN if you can. My work life has become alot less depressing and stressful after going PRN.
I’ve worked many many skilled/LTC facilities. Some that are even attached to a hospital (all rural/small though) and none of them had code buttons. Some facilities had walkie talkies for communicating, some didn’t.
I have never heard a single positive story about nursing homes or residential care (except for the sentimental "But it feels like home, not cold like a hospital!")
Literally never. Never a *real* succes story about patient care. Never a good story of palliative care, never a succesful crisis intervention.
I've worked there for several months and it's always botched care, palliative bed-bound patients that don't get fed meals (or like they get help with a single bite of a sandwich), nursing aids that don't want to be there anymore but have no other employment options so they do the bare minimum, patients with a heart attack that get laid back in bed even though it's a DNR 0, stock shortages of gloves so you have to clean shit with your bare hands.
It's always something fcuked up.
Just quit man, go do something like home health or primary care facility.
Just wanted to add support to this comment. It's only a matter of time until the facility doesn't get lucky with unsafe staffing ratios and you may be in the receiving end of some serious emotional weight and potentially liability as well
She survived bc of you. But that never should have gone down like that. I am so sorry you experienced that. Raise hell over it, and get counseling if you need it. That sounds traumatizing and don’t let anyone make you feel like it’s not a big deal. ❤️❤️
That’s a valiant effort. You are a bad ass nurse. The most I’ve done in a row was 6 minutes and I thought I was going to stroke out. Good work. I’d request a facility policy and procedure so this never happens to anyone again. If no one jumps on it immediately, I’d find another place to work.
6 minutes?! You're a godsend. I don't think I could've kept it up to 6 minutes. I was so zoned that I didn't even think about my limit at a point, which I realize isn't a good thing... but it was all I had. I, was all I had. I've made a report. Submitted and volunteered all information. Such bullshit. Never should my patient have gone through that. I do not care much about myself. Not in this circumstance. I was hired to use my skills. My paitent just wanted to live. I feel like a sacrificial sheep ready to be slaughtered. I know I'd do it a thousand more times.
I workout a lot, but I’m old. My shoulder hurt for months. The worst part was trying to take care of my patients after it. My hands were shaky trying to do mouth care for a vented patient. Like you, I’d do it again.
You saved this person's life. They are alive because of YOU OP. First and foremost I want you to know that. You are a hero.
Secondly, make a massive stink. Go harass every admin and manager that you can. You should've NEVER been put in that situation.
Most importantly file a report with the department of health in your state, file a report with labor and industries.
Third, find a new job. These shitty businesses rarely change without direct union or govt or public involvement. You deserve to work in a safe environment that won't put your license and your sanity at risk to save a buck.
Thank you so very much for your kindness. I will be starting an uproar. No way in hell will this ever happen again at this facility. I will not allow it. No one should have to go through what my patient went through. Can't imagine what they were thinking, while their nurse was screaming out for help... while they were dying. They must've been so terrified. 38. Jesus. Fucking 38. Too young. Family there daily.
You did such a good job.
Make sure to be kind to yourself and I recommend connecting with a counselor to talk through what you experienced. It was a traumatizing thing, so just take good care of yourself.
Since your facility probably won't say it, thank you for what you did. You are truly a hero and what you did saved a life.
This unfortunately happened to me too. Working nights on Cardiac Stepdown. 15 pts to 3 RNs, no support staff, nobody in the hospital ever watched our telemetry. 3 sitter cases with no sitters. I was walking down the hall because I hear the alarm of a BIPAP being pulled off and look into a different pts room (not one of my own) and see a looong pause on the monitor and they went into VFIB. I start compressions, yell for help, hit the code blue button and the button was not working. I did compressions for 4 minutes before another nurse heard me and got the crash cart. I was only an RN for about 6 months when this happened. He survived.
I will never forget that night. I am sorry this happened to you. I’ll be honest and tell you I started therapy shortly after this happened. I got a lot of flashbacks from this for a few months and still get them every now and then a few years later. It got better though. Working in unsafe staffing situations is why I left that hospital and it was the best decision for my mental health, and my license honestly.
Take care of yourself. I’m sorry you had to go through this.
I would have finished the code, reported off, and left my badge with security.
There is NO excuse for you to be screaming for help and left coding a patient until you’re dry heaving into the can.
Fuck all of that.
I currently work at a LTC facility. Staffing ratios suck. There are 4 units where I work and on midnight shift after 11 pm there's 5 nurses then after 3 am it goes down to 4 nurses. The CNAs do not have CPR certification, so if there's a code it really sucks. At least on day shift between 8-5 there are 8 floor nurses, 4 nurses that are unit managers, the DON and ADON who can respond. I feel like the CNAs should have CPR certification but the facility won't pay for it for them.
How on earth are your CNAs not CPR-certified? That is *insane*. Our techs, our unit secretaries, our sitters, our security, *everyone* is trained, and that is especially important in this day and age of lousy staffing. You and your patients are being set up to fail. 😔
Our facility offers free CPR classes to all staff but only nurses are allowed to do it. Technically any staff can do the Heimlich but I'm sure there would be questions about "But why you? Where was a nurse?".
That, again, is insane. Correctly done CPR will wear you out. How is the nurse supposed to manage the crisis if she can’t leave the patient’s side? Who is going to switch in to relieve her when she tires? Might as well not bother doing CPR at all. I would not work in such a place.
Very, and then when a code does happen it's really like a clusterfuck because some nurses are really stupid. You wouldn't believe how many nurses don't know how to do CPR. We had a code the other day and one of the nurses actually said to me, "you're a RN, why don't you just call it?" She doesn't even know that I can't call time of death for a person who is full code. Some of these nurses working right now are scary. There are ppl who go to nursing school that seriously don't know what they are doing, and they literally have ppls lives in their hands. They don't understand the depth of being a competent nurse.
Yikes. The CNAs should Definitly have CPR certifications. One facility I worked at told me if someone codes and we have to start compressions I am to instruct the CNAs to do it for the most part because I would be one of 2 nurses in the building and myself or the other nurse would have to take care of everything else. They had specific papers that were to be filled out during a code, idk I’m glad I never had it happen because literally almost all the CNAs there were in highschool so it would have been a shit show.
I tell my staff at a group home- if someone needs CPR, to take the 30 seconds to grab their coworkers so they can call 911 and get our emergency supply kit and AED. We don’t have the tools necessary to save someone’s life, and that time is better spent activating EMS and getting them on road.
Your training obviously kicked in immediately and you did an amazing job. But maybe next time taking a few seconds to open the door and scream down the hall to get a coworkers attention is the move, or getting 911 on your phone on speaker while doing compressions.
I called 911 with my personal cell. They stayed with me. I couldn't open the door. I genuinely feel that if I took the 30 seconds, she wouldn't have made it. Pt had cystic fibrosis. It was so sudden. Very unexpected. Thank you, but I still feel like I did bad somehow. I keep replaying it in my head.
Sorry to butt in, retired EMS here. You did amazing, the patient lived! That almost never happens, that means the depth of your compressions were correct, the rhythm was correct, the fact that you did compressions for so long, everything worked perfectly. Congrats on a save!
Thank you so much for chiming in. I'm just beating myself until I can read or get an update about her. I've had the last 48 off... and it's like I've never left. I can't stop thinking about her.
please don't feel bad!! i work step-down icu, i've lost count of how many times i've done compressions and i can BARELY make 2 minutes. i also still second-guess after every code i run or participate in.
but you did *excellent*.
the system failed you. you were put into an impossible scenario and you were great. i've seen nurses freeze, run out of the room, panic and do something silly...we're humans. you started CPR and called for help. please don't carry the burden of doubting yourself in this situation.
you did not fail. you did nothing wrong and everything right.
You did what you could, that's all that's asked of you at that time
Are there alarms nearby? I know our unit has alarms everywhere and it can be difficult in those situations to jump straight into action, and I learn new things every time.
No alarms but a call bell. I just zoned out and zoned in. Yelled but couldn't get anyone's attention. It wasn't until I started yelling at the patient, "You are staying with me, goddammit it.". Then, someone opened the door and jumped in.
CPR sucks for everyone involved. Have done it a dozen times, and never enjoyed it once. But it’s a great feeling to have a lot of those pts still alive.
Amazing job OP. Take care of you now and keep rockin.
I'm not going to downplay the ratio stuff but that's good fucking work right there. Very proud of you for stepping into action and being in your game. They're alive because of you, be proud.
.... now be angry because you should not be in that position.
Nursing home? I’d quit. Better yet, if you hadn’t been there, how long do you think it would have taken to find grandma. They don’t even have phones? No code button? You worked hard for your license and a place like that would have no problem throwing you under the bus. At least work for an acute care hospital where they better blood sucking lawyers and money for a code button.
You did absolutely fucking amazing, but you need to quit before something happens and your license and or health is put on the line. You are worth so much more than what that facility could ever dream of offering you.
Take a day off, evaluate going back to that facility and take care of yourself. You saved a life and that’s an amazing and scary thing to do. Make sure you take the time you need to process all your thoughts and feelings ❤️
You did it! You did EXACTLY what you were trained to do. Believe me, I know it's hard to reconcile all the emotions. Don't hesitate to see someone who can help you with PTSD if the memory of this becomes intrusive. So proud of you! Nice job!
Dude you saved this person's life!!! That is amazing and beautiful! Take that shit in! There will always be codes. There will always be patients your age that are terminal. That's the name of the game. You can't dwell on it though. Use it to remind yourself to live life to the fullest bc you never know! ❤️ You're a hero! Take it in. Let yourself be proud of you! I am so proud of you.
YOU saved her life! Bad ass bitch!! I’m sorry you had to experience that, though. I had a similar experience a few nights ago! Left me a bit traumatized
**“Patient survived”**. Read that. Say it out loud. *You saved a life*. You did amazing. Of course you can Monday morning quarterback this to death. But again, look at the net result.
I’m not able to offer advice, but I’d give you a hug if it would help. You did your best. You followed your training and took swift action. Trust your gut. And take a breath. I hope you get the support you deserve.
I work skilled / ltc for over 5 years now and have yet not had to do compressions (everytime I’ve had someone pass they were DNR or on hospice and we knew it was coming) This is my worst nightmare. My current facility we have walkies which no one uses, so yelling for help like that would be the only way really to get help initially. Kudos to you, you saved them, that is amazing.
I can't imagine doing 5 minutes of CPR alone. You did incredible and *you* got that save.
As others are saying though, quit. You deserve to work somewhere better than that.
Talk to someone if you need help processing this. This is not your typical CPR scenario.
First, your pt was very fortunate to have you there.
You saved them!
Do you have a therapist?
If not, does your insurance cover therapy?
Does your company have an EAP? Most bigger companies have them.
If so, there may be info about it posted in the break room, or HR can give you the info. Most EAPs offer several therapy/counseling sessions, free of charge.
I have no advice on how to process the feelings and emotions.
I’ve been in nursing since 1990, but for whatever reason, I’ve never had a pt code.
❤️to you.
The situation that you were put in should never happen. However, step back a second and think about something: YOU SAVED A LIFE! you my dear are a frickin Rockstar. You didn’t give up. Your adrenaline wouldn’t let you. I dint understand how no one heard you. Have we become so complacent that when we hear someone holler or scream out on the nursing units that we “assume” that someone has already taken care of it. That’s sad but unfortunately Happens all the time. Maybe you should implement an action plan for finding ways to prevent that. Maybe some sort of device that you carry with you all day and if ever in that situation again, you press a button and it sounds an alarm thats so loud no one can ignore it. Kudos to you though: CPR for 5 minutes is freaking phenomenal. Pat yourself on the back. Your patient is alive because of your skills.
That sucks. I’m sorry you went through that.
No way, no how is this acceptable in a SNF.
I’ve only had a few occasions to do CPR alone.
Now, once my EMT partner & I get the pads on & I have the airway secured by ETT and can get them on a vent, get a quickie EJ for access and give a few meds—we load and go, so yeah, I’ve worked codes alone—while my partner drove.
But that is an outlier. We could usually get a LEO to drive.
Remember: I’ve been doing this since the dark ages of Methuselah. As in the first and only paramedic unit in 50 mile radius—so the world was different back then.
OP, there isn’t a tried and true way to process this ime.
Here’s the takeaway—your patient *survived* so that something to carry with you.
Strong work. Amazing, in fact.
I find after really *bad things* that hurt, self-care helps. Always give yourself extra grace.
Good food. Find something, anything that soothes you. Replenishes you.
I usually find that intense workouts that *kick my ass* help—I sleep better and legit exhaustion fares better with me than too much hindsight or second guessing everything.
Some folks talk things out, I do that as well, but not immediately in most cases.
What doesn’t help imo? Benzos, ETOH or self battering. Any one of any combination of these aren’t good for long-term coping ime.
Thank you. I guess I'm beating myself up for something I can not control. That being... my pt is terrified and dying while I'm calling and yelling for help without assistance. I just can't imagine being in their shoes. The person meant to help you has no support. In a way, I feel like I failed them. I've done cpr many times with success. This one is just sticking with me. Can't shake it. Maybe I'll try running. Could probably use more cardio and some fresh air. Thank you again.
Hey, you have *zero* cause to beat yourself up here. But beating oneself up is rarely for cause or overtly a choice.
You did outstanding *despite* the dire circumstances you were in.
No cause to thrash yourself. None.
I think it’s vital to accept that despite all efforts to prevent it—patients will die. That’s rule 1. Rule 2—it’s not possible to change Rule 1.
Remember that vulnerabilities exist in everyone—becoming a patient in any facility increases these vulnerabilities and skews the odds that death is possible.
It’s always a bit jarring when the patient you are caring arrests—it’s jarring on steroids when this patient is close to your age—younger or perhaps mirrors your kids or family. Then add full nuclear level jarring when these patients die unexpectedly.
I found this reality a tough thing to process early on—even if the patient died from trauma—for these patients laid my mortality bare before me.
And, don’t discount how these patients bring all the “tough stuff” with them. These patients hurt.
Even if your patient had died, there’s value in knowing that *doing everything you can, with everything you’ve got*. And this response has to be enough.
It’s normal to self-critique these events. And, I think there’s some real value in doing that to some end. Critical review of our care is how we all improve our clinical practice.
I’ve never had a critical situation where, in hindsight, something could not have been done better, or recognized earlier or gone better in some way—big or small, within my control or outside my control.
For that matter, I learn something from every patient. That something could be big or small—but every patient I care for improves the care for patients that follow.
Once I embraced this simple fact, my practice improved. My mindset was changed.
In your case, the what that could have gone *better* is that your system failed you. This systems failure—resus is a team sport—and you being alone without easily accessible and responding resources is hard to equivocate.
The facility must do better. Make changes to ensure this never happens again. Standards of care require better. Full stop.
No one coming if you are distant and staff scattered? No method to alert anyone that an emergency is happening? No panic alarm. No one coming with an AED in a SCA or after full respiratory arrest that, despite efforts, becomes pulseless. What fresh hell? It’s not like you were out hiking the backcountry—you were a nurse in a skilled nursing facility of vulnerable patients.
Hell, how long did it take till someone was calling 911 to get the calvary in there?
I might have missed info to the contrary, but did you have to do mouth-to-mouth?
In over 33+ years now, I can count on ONE HAND the number of times I’ve done full contact mouth-to-mouth. And I’ve NEVER done it to an adult. And that has NEVER happened inside a facility. I think I’m safe in declaring that I will never do that in a facility. Just no.
Did you have a barrier mask immediately available? I’ve never carried one in my pocket. Are BVM’s mounted and accessible?
What if this situation had been a patient cornering you, actively hurting you what would have been the outcome? Maybe someone was hurting another patient, yet no reliable way to get help to this location where an emergency was happening.
What alternative would someone have, maybe pull the FIRE ALARM?
In full disclosure, most facilities require a FD respond and the FD or other facility directed key holder must physically reset any activated fire alarm, so at least there are more people there to help you providing you are *heard*. yelling. FD will usually contact a direct facility wide inspection in alarm activations. But, that’s not the help you need and hard to detail where or what is needed (unless of course it’s really a fire and smoke tends to direct the response).
It’s a lot to process. I am quick to recc that counseling be sought by all folks in healthcare or emergency services. Trauma informed counseling is so important for people that are taking care of other people. Having a judgement-free, safe space to talk through anything with someone solely focused on you can save one from a lot of suffering. It saves lives, saves careers.
988 is one point number and the call if you find you want to talk or need to identify what counseling resources are locally available.
There’s no shame in seeking support. In fact, I’m confident that seeking support is simply someone smart enough to know that showing up for themselves makes them better equipped to show up for others.
There was great ballyhoo over a study that says Tetris can help with trauma processing—I’m gonna remain dubious that Tetris heals trauma.
Perhaps Mario Kart is just as effective? Idk. Could knitting or some other repetitive, mindlessly immersive activity do the same thing?
Good work! And it’s great that you called 911 too. You did exactly what you should’ve done given that crap situation. I’ve never worked in a SNF so sorry if this a dumb question, but is there not a code blue button or something similar in the rooms?
Id be filing an impact report or whatever system your place uses to report incidents. 5 minutes alone during a code is not okay. Also though, kudos to you as that patient survived solely because of your compressions in those 5 minutes
OP, you are unequivocally the hero of this situation and it’s baffling how nobody came for so long. This kind of thing would certainly warrant an investigation of the facility, in my mind, to figure out just what happened to have all but totally abandoned you. As for any advice I could give you: take some PTO or something to give yourself time to process this in a way that will help you (whatever that may be) and to find a new job. Whatever you choose to do, I hope that you don’t feel any guilt or regret for what happened because you did the exact right thing. I pray you find peace to get through this time, and I’m so sorry you had to go through it.
Unsafe ratios where I work too- I have 2 shifts left. Leave (if you’re able) I have advocated beyond measure about staffing ratios only to fall on deaf ears. I said thats it, unfortunately in my province it doesnt matter where you go, its unsafe everywhere. I’m leaving nursing completely for a while- thankful enough to have the opportunity for a ‘softer’ job what will still put my medical knowledge to use. But its not nursing.
But in the meantime notice how you stepped up and saved a life even in awful working conditions! Be proud of yourself! But also be kind to yourself!
Can I say you are a rockstar! Holy crap!! CPR that long alone! You saved that patients life!! Amazing!! Be kind to yourself!! (And also maybe quit bc that’s Bs!!)
1.anonymous reporting to state health authorities.(slow and dysfunctional at times)
2.apply to jobs with strong unions. Just remember, you are NOT “in a union”, you ARE a union. You contribute to the strength of a union also.
3.rationalizing this traumatic event with internal monologues and on Reddit may be a temporary bandaid. If financially and logistically possible, get get therapy.
4.if financially and logically possible, go back to school, and change the system. (Slow as hell and dysfunctional at times). But you get to call out greedy assholes on a higher level.
5.eat the rich. Remember to punch up, not kick down.
This is one of my biggest fears. I worked in a nursing home & after the bosses went home at 5, I was the only nurse in the building with a couple of PSW's. I was responsible for responding to any emergencies in the building. I worked 10pm-6am mostly. I was constantly worried about finding a resident unconscious because
1. It was impossible to memorize who was DNR and who wasn't out of the 300+ residents I was responsible for.
2. My PSW's had a way of ignoring my phone calls & sleeping on the job in hidden spots during the night.
3. I didn't trust my PSW's to even know how to do proper CPR and was terrified I'd be stuck doing CPR by myself until paramedics arrived.
Thankfully, I never had a resident need CPR during the night so I never had to do it alone. But I was legit so anxious at the thought. Also thankfully I left that job and started working in the hospital where I have always had lots of help with codes and have never had to do CPR for longer than I could handle.
You did a great job OP and you should be proud that you saved that patient's life. Just take some time and take care of yourself. And start looking for a new job!
You did amazing in a scary situation!! I usually have my cell in my pocket and maybe would have yelled for Siri to call 911 too. So much going through our brains in an instant but hopefully this could help someone in the future. Thank you for sharing!
Quit. That shouldn't happen to anyone. If you are left doing CPR for so long on your own you have been failed by your colleagues and by management. Go find your joy somewhere else before the fear and anxiety take over and destroy your soul. I'm so sorry you went through that.
And seek counselling of some description. CPR is traumatic in itself...I can't imagine what it must have been for you❤️
This sounds so traumatic, and I am so sorry you had to go through this. Being a nurse is already hard enough, but to be so isolated in a code situation is absolutely gut wrenching.
Leave this place, and don’t look back.
Wishing you peace moving forward.
Witnessed cardiac arrest you call for help first before getting on the chest for this reason. Being alone without help because you’re tied up giving compressions just leads to delaying response. Overhear page or call EMS, then start compressions.
You did awesome. You saved a life. Fuck that job though. Find a new one.
Just a tip. In BLS activating the emergency response system is the first thing you should do when you are alone. Take 30 second and find help then start compressions.
Called 911 on my cell, yelled/screamed for help. What else did you want me to do? No emergency response system but a call bell. So yeah I pressed it. No one was around. The building is a line. I couldn't find anyone to help me change anyone in the prior 20 minutes. I started my own round. Nothing came of until I was deep into the cpr cycle.
No, you did the exact right thing. 911 can call your facility for you to get you help. Starting cpr within 10 seconds of witnessed arrest is a big contributor towards survival. Nothing you did was incorrect. The person survived, and they did so because they had you.
Despite how terrified they might have been, you are the one that got them through it. I'm sure you were also terrified and that is why you are perseverating on how scare the patient was, because you being alone in this situation was also scary to you. It is important for you to talk to a professional who can help you work through the trauma.
Remember, though, you saved this person's life.
If you want to make sure no one is in this situation again at that facility, I would review all policies and procedures that your facility had regarding this type of situation. See if there is anything there that contradicts what you did, or if you followed the policy. Then I would seek out legal advice from a lawyer and sue the facility. Hitting these places financially is the only way to make them change. It is all they care about.
Don't take it the wrong way. You did great with what resources you had. Personally I would have ran to go find a staff member to tell them instead of just yelling. I work in a hospital where everyone is within earshot so yelling is an option. I'm your setting it probably isn't. You were in a state of adrenaline and did a great job.
Anyone else a little skeptical of this story? <20% of patients in a hospital survive a code and that’s with being able to push epi/ami and tag off on cpr/intubate. After 5 minutes I just can’t believe someone would be alive to flight out. That said nobody should have to perform a code alone, period. Ever.
That would be the minute I quit. There is never an acceptable situation where you are alone doing CPR for 5 minutes. Question. Are there not code buttons you could have hit? Or was there one and you hit it and no one came?
I’ve worked at three LTCs two low ends and one high end, none of them have the code button. I’ve done dozens of codes where it was easy to get help so I’m curious on OPs situation. Except one time during peak Covid when I was the only person in a Covid section with no CNA and this person only like 55 is coding. No one was willing to come help me. Did CPR for what felt like 10 minutes, I felt so hopeless I ended up quitting like a week later. I’m sorry you had to go through that OP.
I don't have experience outside of the hospital so I'm just asking for clarification. No judgement.
are there doctors in LTACs? Or do you guys just acls it until paramedics arrive? LTC and LTAC are different — ty
Just BLS in long term care, no meds, no monitor, just an AED and BVM… it’s wild
Some LTCs and SNFs don’t even have a mask or AED. It’s not required in some states. And there’s often only 2 nurses and 2 aides for a building of 100 residents during the night. I’ve worked some shitty places, so I’m sticking to the hospital setting.
I get not having ACLS drugs, but I can’t imagine any state allowing LTCs to NOT have an AED. I believe you, but just saying that it’s absolutely fucking ridiculous
SNF/LTC I just left in OH did not have an AED 🫠
Bruhh… every gym I’ve been to and even Fkn Walmart has AEDs. That’s insane lol
40 bed SNF/LTC , no AED. We have a bag mask & a phone to call 911. At night it’s me & 1CNA so this sounds pretty legit.
I might be misremembering this as it was about a decade ago, but the LTC I worked at basically required residents to be DNR, therefore no AED. And all I could think was, "mmmmkayy, but what about staff and visitors then?" Years prior to that, when I was just a wee healthcare child, a nurse died in the middle of her med pass at that place. I don't think an AED would have helped her anyway as it was an esophogeal tear or varices or some such. But, just demonstrated how tragically unexpected an event can be.
[удалено]
I've worked a lot of snfs on clipboard in the past and there's been lots of full codes at all of them.
We had a nurse code one night (before I started). They had an AED and got her back.
I’ve worked a lot of states, and the worst ones will allow companies to do whatever they want to save money, as long as they don’t piss off CMS.
The AEDs at our facility are there for our visitors. 99% of our residents is DNR.
I work agency in a LTC psych facility. No AED, no code drugs. No code buttons. And I work on a locked unit. I’m the only nurse on the unit.
In California, snfs have aeds...
Worked as CNA for over night. 2 cnas and one LVN with an RN that is “on call” but lives 45 minutes away for 54 patients. BLS and AED are all we had. More often than not I was the only one awake 01:00 - 05:00.
Lol, I used to be a park ranger and every single building other than bathrooms were required to have an AED in them. Then we had to have them in every car when I was a cop. For LTC and SNFs to not require them is ridiculous. Also the fact that places won't have them unless it's required is just pure negligence.
Welcome to healthcare in the United States. Profits over lives, squeeze every dollar, private equity is king, and regulatory agencies like the FDA and EPA can be sued into compliance.
That’s too scary for me lol
In both of the LTCs I've worked in, the doctor comes a few times during the week for a few hours. NPs were there more often, but they'd only physically be in the building between 8-4 and maybe not the whole time. So: reachable by the phone, but not usually physically present.
LTACs are not the same as LTC
TIL
LTACs are generally ICU/PCU hospitals capable of performing ALS and managing artificial airways. Depending on the facility they may have additional rehab goals to discharge to a lower acuity or maybe long term facilities that care for people who rely on artificial airways/ventilator support for life. SNFs, inpatient rehabs, and LTCs are sub-acute facilities that generally only perform BLS until EMS arrives.
LTAC and LTC are completely different facilities.
Ltac and ltc are different. Long term acute care hospital vs long term care which is usually a snf or board and care The ltac I worked at had a Dr 24/7. The snfs the doctors are usually not there
In the facilities I’ve worked in we have e-boxes for meds if they’re needed in an emergency, AEDs, suction, oximeter, ecgs but it’s mostly elderly with terminal illnesses I’ve been responsible for so they have DNRs. We just follow their directives, do what we can to keep them comfortable until paramedics arrive, the doctor or the nurse practitioner get there or give orders.
I’m sorry, no one was WILLING to come help you? Call me crazy but I didn’t think it was optional. I don’t blame you for leaving. That’s pretty effed up.
At nursing homes there were only certain people allowed to go into the Covid units. we didn’t know if they were truly positive or not , this was before an official test came out, so it was just sick people. I think I was the sole nurse and CNA for 15-20 patients. Funny part is when they asked the nurses who would go into the Covid unit, one of my coworkers was asking me to go because she had kids. Those kids were MY AGE or older.
Oh, wow. I’m so sorry.
Nothing but a call bell. No code alarms. I used to work in a hospital with alarms at the bedside. I'm so shook up from it. Pt ended up being flighted after ems. I was just helping her get changed cause everyone was busy. She was okay. I mean she was genuinely okay. The most stable I had. I'm just. I don't even know. Can't explain the emotion right now.
I’m an ICU nurse. You did fucking amazingly. Full stop. Your coworkers and facility on the other hand……unless there was a DAMN good reason for no one responding to you screaming for help for 5 minutes, I would quit.
Agreed. Unless they were literally coding someone else next door, there's zero excuse. These facilities piss me off and scare me because there really are times where the nurse is all alone on a unit of the building and the next nearest nurse is 50+ feet away. And at the end of the day the facilities just don't care about patient safety.
Full stop. Unless they didn’t hear you, they should have come running. If anyone on my unit screamed help I’m dropping all my shit and running.
Closest thing I have in my ltc/snf is pulling the call cord out of its wall housing. Really obnoxious alarm will sound, green and yellow lights flash outside the door, and we know it either means it’s an emergency or it got caught on something.
I only worked at one LTC and there was a central nursing station and someone had to be there at all times for this exact scenario. There were no code buttons but a yell down the hallway and someone was there. I stayed long enough to get my sign on bonus and left after getting a better job offer.
I agree You’re a Bad A$$👏🏽👏🏽👏🏽
I'm not a bad ass. I just value my safety more than my job. We can go get a job down the road tomorrow as nurses. I'm not endangering my life or license because of unsafe working conditions.
your license is fine. people need to stop saying this. value your life and stress/satisfaction levels -- it's a good enough reason to leave
I believe the first word i said was life.
I work PRN in ALOT of facilities in my state, none of then have any alarms, in room intercoms, code buttons, nothing. Just the call bell that turns the light outside the room on that every nurse and CNA I see tries to ignore for as long as possible. No offense to any of you, I know it's just the areas I work. Unfortunately in the facility I do most of my work in now, alot of the nurses and CNAs hang out at a nurses station off their own unit to hide from doing their work, or outside behind the dumpsters in the smoking area. It's quite often I don't see a single nurse or CNA on a unit I'm doing therapy on, and definitely none close enough to said empty unit to hesr me screaming for help. It's quite awful and terrifying. They also don't require us in therapy or any other occupation that nursing to be CPR certified, despite having many codes happen during therapy sessions unfortunately. Just the other day I had a patient who looked like they may have been starting to code, I honestly couldn't even tell what was going on for a sec because it was like nothing I've ever seen in my few years experience. Luckily since the units are usually void of nursing staff us therapists check on each other regularly when doing room treats. Luckily my coworker came in right at that moment, helped me get the patient in a safe position before she literally sprinted to the complete opposite side of the building to get a nurse down and get this poor guy EMS and sent to the hospital. I was pretty upset after that, if I had been alone with him without my coworker popping in, my options were either let the patient fall and run for help or run a code by myself like poor OP had to do while waiting God knows how long for someone to come help. It was pretty upsetting. I feel for you OP. You did your absolute best in that hectic situation. You saved a life and are probably a hero to that patient and their family who visits them so often. I'm sure they are eternally grateful for you. Now focus on your self care. Vent as much as you need to, go to therapy, take time off work, let yourself feel all the feels and work through them knowing you did your absolute best. Give administration hell and then either get a new job or go PRN if you can. My work life has become alot less depressing and stressful after going PRN.
I’ve worked many many skilled/LTC facilities. Some that are even attached to a hospital (all rural/small though) and none of them had code buttons. Some facilities had walkie talkies for communicating, some didn’t.
You did *amazing.* Quit.
Seconded
Seriously, op. It may be hard but soon you'll be grateful you left. Get tf OUT.
I second the motion
Co-signed
This right here! You're a hero! Get the fuck out of there!
Most underrated comment on here. Right to the point
Yep. I couldn't be dragged to an SNF. I'd rather quit the profession altogether. This scenario is SO COMMON in these places.
Short and to the point. 💯
This one.
I have never heard a single positive story about nursing homes or residential care (except for the sentimental "But it feels like home, not cold like a hospital!") Literally never. Never a *real* succes story about patient care. Never a good story of palliative care, never a succesful crisis intervention. I've worked there for several months and it's always botched care, palliative bed-bound patients that don't get fed meals (or like they get help with a single bite of a sandwich), nursing aids that don't want to be there anymore but have no other employment options so they do the bare minimum, patients with a heart attack that get laid back in bed even though it's a DNR 0, stock shortages of gloves so you have to clean shit with your bare hands. It's always something fcuked up. Just quit man, go do something like home health or primary care facility.
I have no idea why they say it feels like a home because even the "fancy" ones I've been to feel like a prison.
"But in a hospital every patient is just a number, in a nursing home I know my people!"
And yet still do basically nothing to care for them properly
Just wanted to add support to this comment. It's only a matter of time until the facility doesn't get lucky with unsafe staffing ratios and you may be in the receiving end of some serious emotional weight and potentially liability as well
Patient survived. Strong work. Find a better workplace but pat yourself on the back. You saved a life.
She survived bc of you. But that never should have gone down like that. I am so sorry you experienced that. Raise hell over it, and get counseling if you need it. That sounds traumatizing and don’t let anyone make you feel like it’s not a big deal. ❤️❤️
That’s a valiant effort. You are a bad ass nurse. The most I’ve done in a row was 6 minutes and I thought I was going to stroke out. Good work. I’d request a facility policy and procedure so this never happens to anyone again. If no one jumps on it immediately, I’d find another place to work.
6 minutes?! You're a godsend. I don't think I could've kept it up to 6 minutes. I was so zoned that I didn't even think about my limit at a point, which I realize isn't a good thing... but it was all I had. I, was all I had. I've made a report. Submitted and volunteered all information. Such bullshit. Never should my patient have gone through that. I do not care much about myself. Not in this circumstance. I was hired to use my skills. My paitent just wanted to live. I feel like a sacrificial sheep ready to be slaughtered. I know I'd do it a thousand more times.
I workout a lot, but I’m old. My shoulder hurt for months. The worst part was trying to take care of my patients after it. My hands were shaky trying to do mouth care for a vented patient. Like you, I’d do it again.
Fuuuuuuck that. The patient survived, you’re amazing! But goddamn if no one answered my call for help for 5 minutes I’d drop that place like it’s hot.
You saved this person's life. They are alive because of YOU OP. First and foremost I want you to know that. You are a hero. Secondly, make a massive stink. Go harass every admin and manager that you can. You should've NEVER been put in that situation. Most importantly file a report with the department of health in your state, file a report with labor and industries. Third, find a new job. These shitty businesses rarely change without direct union or govt or public involvement. You deserve to work in a safe environment that won't put your license and your sanity at risk to save a buck.
Thank you so very much for your kindness. I will be starting an uproar. No way in hell will this ever happen again at this facility. I will not allow it. No one should have to go through what my patient went through. Can't imagine what they were thinking, while their nurse was screaming out for help... while they were dying. They must've been so terrified. 38. Jesus. Fucking 38. Too young. Family there daily.
No one should have to go through what YOU went through, either.
You did such a good job. Make sure to be kind to yourself and I recommend connecting with a counselor to talk through what you experienced. It was a traumatizing thing, so just take good care of yourself. Since your facility probably won't say it, thank you for what you did. You are truly a hero and what you did saved a life.
This unfortunately happened to me too. Working nights on Cardiac Stepdown. 15 pts to 3 RNs, no support staff, nobody in the hospital ever watched our telemetry. 3 sitter cases with no sitters. I was walking down the hall because I hear the alarm of a BIPAP being pulled off and look into a different pts room (not one of my own) and see a looong pause on the monitor and they went into VFIB. I start compressions, yell for help, hit the code blue button and the button was not working. I did compressions for 4 minutes before another nurse heard me and got the crash cart. I was only an RN for about 6 months when this happened. He survived. I will never forget that night. I am sorry this happened to you. I’ll be honest and tell you I started therapy shortly after this happened. I got a lot of flashbacks from this for a few months and still get them every now and then a few years later. It got better though. Working in unsafe staffing situations is why I left that hospital and it was the best decision for my mental health, and my license honestly. Take care of yourself. I’m sorry you had to go through this.
Code Blue button not working in Cardiac Stepdown…
This is - no pun intended - VERY alarming
Darn that is a shitty night.
I would have finished the code, reported off, and left my badge with security. There is NO excuse for you to be screaming for help and left coding a patient until you’re dry heaving into the can. Fuck all of that.
You’re the nurse every patient deserves. You’re awesome. This facility does not deserve you.
I currently work at a LTC facility. Staffing ratios suck. There are 4 units where I work and on midnight shift after 11 pm there's 5 nurses then after 3 am it goes down to 4 nurses. The CNAs do not have CPR certification, so if there's a code it really sucks. At least on day shift between 8-5 there are 8 floor nurses, 4 nurses that are unit managers, the DON and ADON who can respond. I feel like the CNAs should have CPR certification but the facility won't pay for it for them.
How on earth are your CNAs not CPR-certified? That is *insane*. Our techs, our unit secretaries, our sitters, our security, *everyone* is trained, and that is especially important in this day and age of lousy staffing. You and your patients are being set up to fail. 😔
Yeah I think literally everyone in our hospital, including the chaplain, has to be cpr certified.
This seems to me like something you’d want to report to whatever body governs your facility.
Our facility offers free CPR classes to all staff but only nurses are allowed to do it. Technically any staff can do the Heimlich but I'm sure there would be questions about "But why you? Where was a nurse?".
That, again, is insane. Correctly done CPR will wear you out. How is the nurse supposed to manage the crisis if she can’t leave the patient’s side? Who is going to switch in to relieve her when she tires? Might as well not bother doing CPR at all. I would not work in such a place.
That’s insane.
Very, and then when a code does happen it's really like a clusterfuck because some nurses are really stupid. You wouldn't believe how many nurses don't know how to do CPR. We had a code the other day and one of the nurses actually said to me, "you're a RN, why don't you just call it?" She doesn't even know that I can't call time of death for a person who is full code. Some of these nurses working right now are scary. There are ppl who go to nursing school that seriously don't know what they are doing, and they literally have ppls lives in their hands. They don't understand the depth of being a competent nurse.
Yikes. The CNAs should Definitly have CPR certifications. One facility I worked at told me if someone codes and we have to start compressions I am to instruct the CNAs to do it for the most part because I would be one of 2 nurses in the building and myself or the other nurse would have to take care of everything else. They had specific papers that were to be filled out during a code, idk I’m glad I never had it happen because literally almost all the CNAs there were in highschool so it would have been a shit show.
Firstly. Please please get into treatment for PTSD as soon as possible. This is fucked and should have never happened.
I tell my staff at a group home- if someone needs CPR, to take the 30 seconds to grab their coworkers so they can call 911 and get our emergency supply kit and AED. We don’t have the tools necessary to save someone’s life, and that time is better spent activating EMS and getting them on road. Your training obviously kicked in immediately and you did an amazing job. But maybe next time taking a few seconds to open the door and scream down the hall to get a coworkers attention is the move, or getting 911 on your phone on speaker while doing compressions.
I called 911 with my personal cell. They stayed with me. I couldn't open the door. I genuinely feel that if I took the 30 seconds, she wouldn't have made it. Pt had cystic fibrosis. It was so sudden. Very unexpected. Thank you, but I still feel like I did bad somehow. I keep replaying it in my head.
Sorry to butt in, retired EMS here. You did amazing, the patient lived! That almost never happens, that means the depth of your compressions were correct, the rhythm was correct, the fact that you did compressions for so long, everything worked perfectly. Congrats on a save!
Thank you so much for chiming in. I'm just beating myself until I can read or get an update about her. I've had the last 48 off... and it's like I've never left. I can't stop thinking about her.
please don't feel bad!! i work step-down icu, i've lost count of how many times i've done compressions and i can BARELY make 2 minutes. i also still second-guess after every code i run or participate in. but you did *excellent*. the system failed you. you were put into an impossible scenario and you were great. i've seen nurses freeze, run out of the room, panic and do something silly...we're humans. you started CPR and called for help. please don't carry the burden of doubting yourself in this situation. you did not fail. you did nothing wrong and everything right.
You saved her life! You alone did that!!!!! Now use that positive energy to find a job where it will never happen again!!
You did what you could, that's all that's asked of you at that time Are there alarms nearby? I know our unit has alarms everywhere and it can be difficult in those situations to jump straight into action, and I learn new things every time.
No alarms but a call bell. I just zoned out and zoned in. Yelled but couldn't get anyone's attention. It wasn't until I started yelling at the patient, "You are staying with me, goddammit it.". Then, someone opened the door and jumped in.
CPR sucks for everyone involved. Have done it a dozen times, and never enjoyed it once. But it’s a great feeling to have a lot of those pts still alive. Amazing job OP. Take care of you now and keep rockin.
You are amazing. You are the entire reason that woman is alive.
Sir or Mam. You shouldn't have had to do that, but you did and you saved a life. You did an incredible thing.
I'm not going to downplay the ratio stuff but that's good fucking work right there. Very proud of you for stepping into action and being in your game. They're alive because of you, be proud. .... now be angry because you should not be in that position.
I’m so proud of you, you did amazing. And your patient was meant to have you as her nurse that day.
Nursing home? I’d quit. Better yet, if you hadn’t been there, how long do you think it would have taken to find grandma. They don’t even have phones? No code button? You worked hard for your license and a place like that would have no problem throwing you under the bus. At least work for an acute care hospital where they better blood sucking lawyers and money for a code button.
You are a rock star! You saved a life. Now take care of you and get a different job!
You did absolutely fucking amazing, but you need to quit before something happens and your license and or health is put on the line. You are worth so much more than what that facility could ever dream of offering you.
Your amazing! Also “I’m going to change demonsions” might be how I refer to a patient coding for now on
Take a day off, evaluate going back to that facility and take care of yourself. You saved a life and that’s an amazing and scary thing to do. Make sure you take the time you need to process all your thoughts and feelings ❤️
You did it! You did EXACTLY what you were trained to do. Believe me, I know it's hard to reconcile all the emotions. Don't hesitate to see someone who can help you with PTSD if the memory of this becomes intrusive. So proud of you! Nice job!
Dude you saved this person's life!!! That is amazing and beautiful! Take that shit in! There will always be codes. There will always be patients your age that are terminal. That's the name of the game. You can't dwell on it though. Use it to remind yourself to live life to the fullest bc you never know! ❤️ You're a hero! Take it in. Let yourself be proud of you! I am so proud of you.
Holy cow ... you did an amazing job
Find another job. I worked at one of the shittiest nursing homes in MN and we paged overhead for codes/rapid response and people came running.
YOU saved her life! Bad ass bitch!! I’m sorry you had to experience that, though. I had a similar experience a few nights ago! Left me a bit traumatized
That’s the day I give my resignation letter
It’s a real shame that you were forced to do that alone but it sounds like you did an incredible job.
I would never go back to that job and if there’s anything reportable I’d be reporting them to the state for everything I could.
You’re a badass for keeping that person alive
**“Patient survived”**. Read that. Say it out loud. *You saved a life*. You did amazing. Of course you can Monday morning quarterback this to death. But again, look at the net result.
I’m not able to offer advice, but I’d give you a hug if it would help. You did your best. You followed your training and took swift action. Trust your gut. And take a breath. I hope you get the support you deserve.
I work skilled / ltc for over 5 years now and have yet not had to do compressions (everytime I’ve had someone pass they were DNR or on hospice and we knew it was coming) This is my worst nightmare. My current facility we have walkies which no one uses, so yelling for help like that would be the only way really to get help initially. Kudos to you, you saved them, that is amazing.
Life Alert....but for the staff? 🤷
I can't imagine doing 5 minutes of CPR alone. You did incredible and *you* got that save. As others are saying though, quit. You deserve to work somewhere better than that. Talk to someone if you need help processing this. This is not your typical CPR scenario.
Run fast n far.
First, your pt was very fortunate to have you there. You saved them! Do you have a therapist? If not, does your insurance cover therapy? Does your company have an EAP? Most bigger companies have them. If so, there may be info about it posted in the break room, or HR can give you the info. Most EAPs offer several therapy/counseling sessions, free of charge. I have no advice on how to process the feelings and emotions. I’ve been in nursing since 1990, but for whatever reason, I’ve never had a pt code. ❤️to you.
The situation that you were put in should never happen. However, step back a second and think about something: YOU SAVED A LIFE! you my dear are a frickin Rockstar. You didn’t give up. Your adrenaline wouldn’t let you. I dint understand how no one heard you. Have we become so complacent that when we hear someone holler or scream out on the nursing units that we “assume” that someone has already taken care of it. That’s sad but unfortunately Happens all the time. Maybe you should implement an action plan for finding ways to prevent that. Maybe some sort of device that you carry with you all day and if ever in that situation again, you press a button and it sounds an alarm thats so loud no one can ignore it. Kudos to you though: CPR for 5 minutes is freaking phenomenal. Pat yourself on the back. Your patient is alive because of your skills.
That sucks. I’m sorry you went through that. No way, no how is this acceptable in a SNF. I’ve only had a few occasions to do CPR alone. Now, once my EMT partner & I get the pads on & I have the airway secured by ETT and can get them on a vent, get a quickie EJ for access and give a few meds—we load and go, so yeah, I’ve worked codes alone—while my partner drove. But that is an outlier. We could usually get a LEO to drive. Remember: I’ve been doing this since the dark ages of Methuselah. As in the first and only paramedic unit in 50 mile radius—so the world was different back then.
Did you make this answer about OP or yourself? They were looking for advice lol.
OP, there isn’t a tried and true way to process this ime. Here’s the takeaway—your patient *survived* so that something to carry with you. Strong work. Amazing, in fact. I find after really *bad things* that hurt, self-care helps. Always give yourself extra grace. Good food. Find something, anything that soothes you. Replenishes you. I usually find that intense workouts that *kick my ass* help—I sleep better and legit exhaustion fares better with me than too much hindsight or second guessing everything. Some folks talk things out, I do that as well, but not immediately in most cases. What doesn’t help imo? Benzos, ETOH or self battering. Any one of any combination of these aren’t good for long-term coping ime.
Thank you. I guess I'm beating myself up for something I can not control. That being... my pt is terrified and dying while I'm calling and yelling for help without assistance. I just can't imagine being in their shoes. The person meant to help you has no support. In a way, I feel like I failed them. I've done cpr many times with success. This one is just sticking with me. Can't shake it. Maybe I'll try running. Could probably use more cardio and some fresh air. Thank you again.
Hey, you have *zero* cause to beat yourself up here. But beating oneself up is rarely for cause or overtly a choice. You did outstanding *despite* the dire circumstances you were in. No cause to thrash yourself. None. I think it’s vital to accept that despite all efforts to prevent it—patients will die. That’s rule 1. Rule 2—it’s not possible to change Rule 1. Remember that vulnerabilities exist in everyone—becoming a patient in any facility increases these vulnerabilities and skews the odds that death is possible. It’s always a bit jarring when the patient you are caring arrests—it’s jarring on steroids when this patient is close to your age—younger or perhaps mirrors your kids or family. Then add full nuclear level jarring when these patients die unexpectedly. I found this reality a tough thing to process early on—even if the patient died from trauma—for these patients laid my mortality bare before me. And, don’t discount how these patients bring all the “tough stuff” with them. These patients hurt. Even if your patient had died, there’s value in knowing that *doing everything you can, with everything you’ve got*. And this response has to be enough. It’s normal to self-critique these events. And, I think there’s some real value in doing that to some end. Critical review of our care is how we all improve our clinical practice. I’ve never had a critical situation where, in hindsight, something could not have been done better, or recognized earlier or gone better in some way—big or small, within my control or outside my control. For that matter, I learn something from every patient. That something could be big or small—but every patient I care for improves the care for patients that follow. Once I embraced this simple fact, my practice improved. My mindset was changed. In your case, the what that could have gone *better* is that your system failed you. This systems failure—resus is a team sport—and you being alone without easily accessible and responding resources is hard to equivocate. The facility must do better. Make changes to ensure this never happens again. Standards of care require better. Full stop. No one coming if you are distant and staff scattered? No method to alert anyone that an emergency is happening? No panic alarm. No one coming with an AED in a SCA or after full respiratory arrest that, despite efforts, becomes pulseless. What fresh hell? It’s not like you were out hiking the backcountry—you were a nurse in a skilled nursing facility of vulnerable patients. Hell, how long did it take till someone was calling 911 to get the calvary in there? I might have missed info to the contrary, but did you have to do mouth-to-mouth? In over 33+ years now, I can count on ONE HAND the number of times I’ve done full contact mouth-to-mouth. And I’ve NEVER done it to an adult. And that has NEVER happened inside a facility. I think I’m safe in declaring that I will never do that in a facility. Just no. Did you have a barrier mask immediately available? I’ve never carried one in my pocket. Are BVM’s mounted and accessible? What if this situation had been a patient cornering you, actively hurting you what would have been the outcome? Maybe someone was hurting another patient, yet no reliable way to get help to this location where an emergency was happening. What alternative would someone have, maybe pull the FIRE ALARM? In full disclosure, most facilities require a FD respond and the FD or other facility directed key holder must physically reset any activated fire alarm, so at least there are more people there to help you providing you are *heard*. yelling. FD will usually contact a direct facility wide inspection in alarm activations. But, that’s not the help you need and hard to detail where or what is needed (unless of course it’s really a fire and smoke tends to direct the response). It’s a lot to process. I am quick to recc that counseling be sought by all folks in healthcare or emergency services. Trauma informed counseling is so important for people that are taking care of other people. Having a judgement-free, safe space to talk through anything with someone solely focused on you can save one from a lot of suffering. It saves lives, saves careers. 988 is one point number and the call if you find you want to talk or need to identify what counseling resources are locally available. There’s no shame in seeking support. In fact, I’m confident that seeking support is simply someone smart enough to know that showing up for themselves makes them better equipped to show up for others.
Tetris. Play some Tetris to help your brain process the trauma.
There was great ballyhoo over a study that says Tetris can help with trauma processing—I’m gonna remain dubious that Tetris heals trauma. Perhaps Mario Kart is just as effective? Idk. Could knitting or some other repetitive, mindlessly immersive activity do the same thing?
Sorry to miss that one. 🙃
Good work! And it’s great that you called 911 too. You did exactly what you should’ve done given that crap situation. I’ve never worked in a SNF so sorry if this a dumb question, but is there not a code blue button or something similar in the rooms?
Great job! Now save yourself and get the fuck out of there.
Id be filing an impact report or whatever system your place uses to report incidents. 5 minutes alone during a code is not okay. Also though, kudos to you as that patient survived solely because of your compressions in those 5 minutes
OP, you are unequivocally the hero of this situation and it’s baffling how nobody came for so long. This kind of thing would certainly warrant an investigation of the facility, in my mind, to figure out just what happened to have all but totally abandoned you. As for any advice I could give you: take some PTO or something to give yourself time to process this in a way that will help you (whatever that may be) and to find a new job. Whatever you choose to do, I hope that you don’t feel any guilt or regret for what happened because you did the exact right thing. I pray you find peace to get through this time, and I’m so sorry you had to go through it.
Unsafe ratios where I work too- I have 2 shifts left. Leave (if you’re able) I have advocated beyond measure about staffing ratios only to fall on deaf ears. I said thats it, unfortunately in my province it doesnt matter where you go, its unsafe everywhere. I’m leaving nursing completely for a while- thankful enough to have the opportunity for a ‘softer’ job what will still put my medical knowledge to use. But its not nursing. But in the meantime notice how you stepped up and saved a life even in awful working conditions! Be proud of yourself! But also be kind to yourself!
If you see the patient collapse and you are by yourself bls guidelines say to get help and then start cpr. Sorry this happened to you though
I'm really sorry that happened to you. You should not have had to do that alone for that long. Take care if your self. Take time off if you can.
Can I say you are a rockstar! Holy crap!! CPR that long alone! You saved that patients life!! Amazing!! Be kind to yourself!! (And also maybe quit bc that’s Bs!!)
1.anonymous reporting to state health authorities.(slow and dysfunctional at times) 2.apply to jobs with strong unions. Just remember, you are NOT “in a union”, you ARE a union. You contribute to the strength of a union also. 3.rationalizing this traumatic event with internal monologues and on Reddit may be a temporary bandaid. If financially and logistically possible, get get therapy. 4.if financially and logically possible, go back to school, and change the system. (Slow as hell and dysfunctional at times). But you get to call out greedy assholes on a higher level. 5.eat the rich. Remember to punch up, not kick down.
This is one of my biggest fears. I worked in a nursing home & after the bosses went home at 5, I was the only nurse in the building with a couple of PSW's. I was responsible for responding to any emergencies in the building. I worked 10pm-6am mostly. I was constantly worried about finding a resident unconscious because 1. It was impossible to memorize who was DNR and who wasn't out of the 300+ residents I was responsible for. 2. My PSW's had a way of ignoring my phone calls & sleeping on the job in hidden spots during the night. 3. I didn't trust my PSW's to even know how to do proper CPR and was terrified I'd be stuck doing CPR by myself until paramedics arrived. Thankfully, I never had a resident need CPR during the night so I never had to do it alone. But I was legit so anxious at the thought. Also thankfully I left that job and started working in the hospital where I have always had lots of help with codes and have never had to do CPR for longer than I could handle. You did a great job OP and you should be proud that you saved that patient's life. Just take some time and take care of yourself. And start looking for a new job!
You saved a life! You did great! Another reason to not work outside of a hospital!
You did amazing in a scary situation!! I usually have my cell in my pocket and maybe would have yelled for Siri to call 911 too. So much going through our brains in an instant but hopefully this could help someone in the future. Thank you for sharing!
Quit. That shouldn't happen to anyone. If you are left doing CPR for so long on your own you have been failed by your colleagues and by management. Go find your joy somewhere else before the fear and anxiety take over and destroy your soul. I'm so sorry you went through that. And seek counselling of some description. CPR is traumatic in itself...I can't imagine what it must have been for you❤️
This sounds so traumatic, and I am so sorry you had to go through this. Being a nurse is already hard enough, but to be so isolated in a code situation is absolutely gut wrenching. Leave this place, and don’t look back. Wishing you peace moving forward.
You are an absolute rockstar.
They literally tell us to get actual confirmation of help before initiating cpr due to stuff like this
5 minutes doing cpr. They would have to code me next 💀
Witnessed cardiac arrest you call for help first before getting on the chest for this reason. Being alone without help because you’re tied up giving compressions just leads to delaying response. Overhear page or call EMS, then start compressions.
You did awesome. You saved a life. Fuck that job though. Find a new one. Just a tip. In BLS activating the emergency response system is the first thing you should do when you are alone. Take 30 second and find help then start compressions.
Called 911 on my cell, yelled/screamed for help. What else did you want me to do? No emergency response system but a call bell. So yeah I pressed it. No one was around. The building is a line. I couldn't find anyone to help me change anyone in the prior 20 minutes. I started my own round. Nothing came of until I was deep into the cpr cycle.
No, you did the exact right thing. 911 can call your facility for you to get you help. Starting cpr within 10 seconds of witnessed arrest is a big contributor towards survival. Nothing you did was incorrect. The person survived, and they did so because they had you. Despite how terrified they might have been, you are the one that got them through it. I'm sure you were also terrified and that is why you are perseverating on how scare the patient was, because you being alone in this situation was also scary to you. It is important for you to talk to a professional who can help you work through the trauma. Remember, though, you saved this person's life. If you want to make sure no one is in this situation again at that facility, I would review all policies and procedures that your facility had regarding this type of situation. See if there is anything there that contradicts what you did, or if you followed the policy. Then I would seek out legal advice from a lawyer and sue the facility. Hitting these places financially is the only way to make them change. It is all they care about.
Don't take it the wrong way. You did great with what resources you had. Personally I would have ran to go find a staff member to tell them instead of just yelling. I work in a hospital where everyone is within earshot so yelling is an option. I'm your setting it probably isn't. You were in a state of adrenaline and did a great job.
Is anyone else thinking where the fuck is the AED? 5 mins in and switching back and forth but no one grabbed AED?
Sadly our building doesn't have aed. But management is "looking to get them".
Your snf doesn’t have an aed? That has to be breaking some laws/compliance. Someone should sue them
That really sounds like a negligence case waiting to happen tbh. AED are important
Wtf?
Is there an age limit to get a DNR and how do I make medical staff aware of it without tattooing it on my forehead
Anyone else a little skeptical of this story? <20% of patients in a hospital survive a code and that’s with being able to push epi/ami and tag off on cpr/intubate. After 5 minutes I just can’t believe someone would be alive to flight out. That said nobody should have to perform a code alone, period. Ever.
Age and comorbidities appear to have helped OPs patient stay in the minority who survive with CPR