Walking into the code

Hello and welcome to your evening shift.

You will be relieving an 8 hour person.

And, lucky for you, we have the room where there was just a respiratory code.

But, no worries, the surgery must go on.

Such was the fun that I started my shift with last week.

Better judgement prevailed and the surgery was called.

Next was the disposition of the patient.

Oops, the ICU is full.

Oops, the higher level of care ICU is full.

You know this, and are trying to get the gaggle of anesthesia at the top of the table to pay attention.

As they are fluttering and giving life saving medications and crowd sourcing their next steps, you are working the phones arranging for a respiratory therapist, a vent, a PACU one on one nurse, simultaneously asking an orderly to fetch a physical bed, asking the nurse you are relieving to get you a foley with a urimeter, not just a bag, looking up the cardiologist on call.

AND informing the gaggle that there are no ICU beds, including at the sister hospital. And that the PACU will be adequate, until an ICU bed can be arranged.

Repeat the bed information.

Answer the phone with the ABG results. Write them down, with repeating the information back to the RT.

Hang up.

Call the gaggle’s attention to the board and the ABG results and the fact that PACU is ready for the patient.

Prepare to put in the Foley catheter.

Ask the gaggle to package the patient for transport to PACU.

Remind them again there are no ICU rooms and this is a temporary thing.