Code Blue

Recently on my cardiopulmonary placement I encountered an experience which taught me a lot of varying lessons. This occurred on my last day which I think is quite amusing. Anyways, there was a patient who was a young man aged 15. He had been in hospital for approximately 8 months, he had been admitted for major transplant surgery, however had a multitude of different things going on pre and post op. This young fella was very popular throughout the hospital and my ward, as I guess most younger people are especially if their medical condition is serious, and long term. Everyone including myself had a soft spot for this patient and we all tried really hard to do our best for him.
Along with my supervising physio we had been progressing the intensity of activity this patients physio management, in the hope improve strength and exercise tolerance. On the day in question, I had come to the end of my placement and was working independently and just touching base with my supervisor if I had any queries. I decided to take the patient down to the physio gym, because I was aware he really enjoyed the gym, and therefore I thought he would benefit from the trip to the gym for physical and psychological reasons. My supervisor had done the same thing the previous day.
Anyways on this day I did all the stuff we should do before touching a patient, ie read notes, check obs, subjective and ongoing objective assessment. And there wasn’t anything suggesting to me or I think it’s safe to assume a qualified physio that the planned treatment would be contraindicated.
I took him to the gym and we did some fairly light work. The whole time the thoughts going through my mind was stuff like, “don’t forget this kid is sick. Don’t let him over do it”, I know from personal experience male teenagers have a tendency to do. So I was really trying to hold him back which I did quite successfully because he really was a great patient to work with. Coming towards the end of the session we were doing some light walking and all of a sudden with no prior warning he screamed out loudly “argh my chest”, grabbed his chest in agony and stumbled against the wall. Lucky there was a chair right next to us and I managed to slide it behind him so he could sit/fall into it. At this stage my brain started stressing very hard. Again luckily just as this was happening in a relatively quite part of the hospital another allied health profession student walked past. I asked her to call a cold blue, but she said she didn’t know what to do so I made the decision for her to stay with him for a moment whilst I ran and called a code blue.
Being near the physio gym, it wasn’t long before experienced physios caught wind of what was happening, and they were on the scene within seconds (I think :P). So I took a back seat and just tried to keep him comfortable whilst they checked his obs, and administered O2. After the emergency team came and took over my brain really started to race. Apart from the obvious worry for my patient, I was thinking about things like, what did I miss, what did I do wrong, what could have done to stop this from happening, am I going to fail on my last day after everything else had gone well thus far, is everyone going to hate me because I made this fella worse, plus many more negative thoughts. Basically I was blaming myself in my mind and stressing about the consequences for the patient and myself and what the rest of the staff would think of me.
Thankfully my supervisor was REALLY great, when he found out about the occurrence he came to find me ASAP. He really reassured me a lot, asked me what I did and promised me he would have done the same thing. He told me that these things happen and are normally out of our control. And b/c physio stress sick people’s bodies more than other professionals, it is more likely to happen with us. He reminded me that as long as we take the precautions we should, the benefits out weigh the risks for a carefully thought through treatment.
This helped me a lot and I appreciate it immensely, I held this person in high regard prior to this, and now I hold him in even higher regard and am very happy to have learnt from him.
What I learnt from this will help me a lot in the future. Firstly I saw how the experience physios dealt with the situation so calmly and surely and will definitely follow what they did in the future. Also all though it will never be easy to see a patient suffer whilst in your care, I know that sometimes these things happens and I won’t beat myself up as much. And probably most importantly I am and will continue to be even more alert and observant of my patients. I’m not saying I made mistakes however I am now VERY aware of what can happen and will do my absolute best to make sure I don’t make mistakes with patients especially of this nature.
I am actually very thankful that this happened to me, in the environment it did. I feel very lucky as I have throughout this year. For interests sake, when I left that day the docs still couldn’t figure out what happened, however they had pretty much ruled out heart issues.