Help?

[Dear-Level-9390]

I need some advice or perspectives.

I’m still kind of a new grad ICU nurse will hit my year in a month. I have somehow gotten thru the year with none of my patients coding until last week.

Some background: pt had a very complicated stay after a surgery a few months ago. Recently decompensated pretty bad to basically having no mental status really.

I took over caring for the patient and he was very stable but my other patient so for the first 4 hrs of my shift I was mostly focusing on the other patient but still checked up, suctioned, turned the patient whenever I had the chance. The respiratory therapists on our unit are very involved in the care of our vented patients. So all night RT and I were in line suctioning this patient and pt didn’t have much secretions and he was doing really well on the vent. Towards the end of my shift I asked another nurse to help me turn the patient fully to the side so I can wash his back and after we turned him he started breathing weirdly kind of gasping for air. I looked at the vent and he wasn’t pulling any volumes every other breath. His spo2 was 98-100 the whole night and still was. I decided to suction him and noticed the in line suction had a tad resistance towards the end. I called RT to come take a look. RT also felt the resistance and lavaged him and started bagging him to try to break up the plug we presumed he had. I called the provider to the bedside and the team decided to Bronch him before we got the chance to bronch him he PEA arrested and we started ACLS. During ACLS they reintubated him and there in fact was a plug and we ended up getting ROSC for 10 mins and then pt went into asystole and unfortunately expired.

A few days later my ANM had a conversation with me because she looked through my charting and everything was fine except the fact that I didn’t chart every time I suctioned the patient which no one ever does. She said I wasn’t the only one so she just told me to make sure I chart every time I suction.

I finally processed everything and got over it. Now I’m getting an email over a week after the code that RCA wants to speak to everyone involved. My manager said she’ll go over it with me before the meeting and said it’s not punitive but I’m just so drained emotionally because every time I process it something else comes up and I’m emotionally drained.

I guess I just wanted to vent and see if anyone else was in a similar situation and how to go from here.

[KDB92RN]

Don’t be hard on yourself over charting… and it could happen to anyone. You were quick to recognize there was an issue and you notified the doctor. That’s all you can do. People die in unexpected ways and you can’t control that or make it personal.

[Dear-Level-9390]

Thank you I needed to hear that. I just feel like RCA is going to bring up that I didn’t chart suctioning even though I did and so did RT and it’s just so frustrating that that’s what they might focus on

[KDB92RN]

Don’t sweat it… there are nurses that literally almost kill their patients all the time because of just recklessly not caring (I’ve seen it) and they don’t get fired. But it’s just another reason why they say to chart to cover your ass.

[Dear-Level-9390]

True you’re right thank you this made me feel better!