We Should Have Gone To Fancy Pants Hospital

[trailerparkmedic]

Family pulls up to the ambulance dock and requests that we help Very Sick Patient out of car. Ok, not so unusual. Oops, VSP isn't breathing and has no pulse. Our tech crawls into the car and starts immediate CPR. We have to drag the heavy stretcher out because they're better for resuscitation. We put the patient on super heavy stretcher and take 6 people to lift it up the extra high curb (since the car blocked the one tiny ramp) and go inside where we attempted to resuscitate the patient for 20 minutes. It was a really good code, especially considering we usually don't have to start from scratch with no IV access or airway or anything.

We also let the family in, which is a very new thing in our hospital. We had the attending doctor (the boss) explaining everything to the family and answering questions. On the nursing side, my boss's boss's boss was there. This is someone high enough up to wear suits to work, but he still helps in clinical care.

As so often happens with unwitnessed arrests, especially in patients with multiple, significant comorbidities, we knew we weren't going to get a pulse back. The attending gently told the family that, and the significant other and child were upset but understanding. Apparently the patient had been sick for a long time. The child's spouse was very angry and kept saying "We should have gone to Fancy Pants Hospital, they could have saved him."

Look, I know you're upset dude, but we did a bunch of things very well and went above and beyond on some things. You might know us as Hood Hospital but we do emergency care very, very well. I'm sorry you lost someone and intellectually I know you're probably grieving, but please do it out of our earshot. Also, studies say that witnessing this (instead of being in the waiting room) should make you think the opposite in a few days, so hang in there.

[fireheart]

*sigh* and what would have Fancy Pants Hospital done that you guys couldn't have?

Family sounds more like they're in shock if anything.

[Amina516]

Sounds like they're trying to compensate for possibly ignoring/postponing whatever problem this poor person had. Also, 5 stages of grief and all that...

We've rarely had family back for codes (generally just due to how quickly they happen) but when family is around (which we allow) they generally ask for us to stop way sooner then we would have normally stopped. I think all the action scares them, but they also get a chance to see how hard, fast and efficient we code.

Since the boss's boss's boss was there, I expect little fall out, am I right?

[trailerparkmedic]

They should have called 911. Then the patient could have gone to fancy pants hospital and the patient wouldn't have been down for an unknown amount of time. I doubt it would have made a difference in this case, though.

I know they weren't being sucky, but it was like "really? Really??? Come on now."

There will be no fallout. The spouse was very grateful to have a chance to see him and the child seemed satisfied that we were doing everything we could. The bigwigs were very happy with how everything ran (seriously, we could have been in an ACLS video, it was calm and everyone did their jobs by the book and even the med students did great compressions). They especially commended the tech who crawled into the car and started CPR. It was, of course, a tiny car that was difficult to,get the patient out of, as they usually are, and it was Bodybuilder tech who can't drive anything smaller than a full size pickup or SUV.

(True story: the local fire department recently helped hose out the back of a pickup when someone dropped off a gunshot wound to the head who was riding in the bed. Driver didn't want blood on the seats "and don't call no cops 'bout this.")

This was the first code I've worked where family was let in. We've decided for now that family can be in on non trauma codes. The traumas get very gory very quickly and we believe that would be very traumatic for the family. The family was less disruptive than I expected.

[Seshat]

Sounds like you did everything you could, given the circumstances.

Well done. Pat each other on the back for me.