Violence is More Important than A Cardiac Arrest?!

Oh dear, I got into trouble last night.....Well, I do not thing I was wrong, unless my assumptions have been wrong.

Ok. I was in a Ward A, when my SHO paged and asked me if I could go to the ward upstairs (ward B) to check on a patient who was violent. He said a security alert has been released but he was too busy to walk over to the medical block to sort it out, and requested me to go on his behalf. He said I should leave whatever I was doing and go up immediately.

So, up I went. It was the same man who has been causing trouble for the past few days. He was in really bad DTs, and I think, he probably has either Wernickes or Korsakoff syndrome. Apparently, he got out of his bed, spat his tablets at the nurses, punched out, kicked, tried to break the fire alarm, etc. There were 5 security guards pinning him down. Yeap, he was THAT violent.

When I was up there, the bed manager/ clincial co-ordinator was up in the ward too. He asked, "That took you quite awhile to come up." I was like, "I don't carry the page and it was my SHO who asked me to come up." "Well, let me tell you, a security alert takes priority. It is, in fact, more important than a cardiac arrest," he said back to me very seriously. I turned red, as what I normally do, and said, "Oh right. I am sorry. But I do not hold the arrest page, it is the other JHO. And I don't think we get security alert calls." "Well, obviously she needs to be here then. Where is she?" he snapped. I shook my head and said, "I dunno." He was clearly unhappy.

Anyway, while I was trying to sort out what other sedatives I can give this man, I received a page from a different ward. "Hi, there's a man here with COPD, he has desaturated to about 85% on 28% oxygen." I told her that she can put up the oxygen and I would see him shortly once I sort this security alert first.

About 15 - 20 minutes later, I walked down the stairs towards that ward with the desaturating man. I met my colleague, the other night JHO and she said, "There's an arrest in this ward." I was like SHIT! My horror came true, it was indeed the man with the low saturations that arrested!

When I arrived, they had done 2 cycles of CPR. The SHO was looking at his notes, and found that patient was actually not for resus. Hence, CPR was discontinued. Patient died not long after that. I felt really really guilty, because, maybe I could have made him die in a more comfortable manner, ie less short of breath. His wife arrived 15 minutes later. I followed the SHO into the patient's room to provide support and also to learn how to break a bad news to the family.

She burst into tears the moment we told him about his death. I felt absolutely devastated. I thought I was going to burst into tears too. You know, before this man desaturated, I was asked to put an IV cannula into him. He was so bright and cheerful, chatting away to me. And now all of a sudden, during the arrest, he was cold, clammy and pale....and now gone. It was dreadful. I felt really guilty.

The SHO told me that she saw him the day before, and she thought he was going to die within the same day. She added that there was nothing I could do that would prevent him from dying. The nurse gave me a big hug and advised me not to worry either. "These things happen," she said.

Ah well, I am ok now. But I still don't get why violence is more important than a cardiac arrest? Or maybe the bed manager/clinical co-ordinator was just telling me a big lie?

Dear god, I am praying for a peaceful night for once this week! Thank you.