Saturday, May 21, 2011

How to Save a Life

Sometimes it feels like the world is against you.  Sometimes all the complaints and negativity is enough to make you throw in the towel.  Sometimes you wonder, “Why do I give my sanity, happiness, and life to others who just complain and use me?”  These are some thoughts going through the minds of a nurse daily.  I know I think them often.  However, tonight something happened that has affected me greatly.

I work in the critical care unit of a community hospital.  I am the charge nurse about 80% of the time.  As charge nurse, not only am I responsible for all the patients and nurses on my unit, I am also the first responder to any emergency in the hospital, what we call a “Rapid Response Team.”  A rapid response was called on a patient who had just been admitted to the medical-surgical floor from the emergency room.  She was not waking up and had low blood pressure.  Unable to arouse her, the doctor and I agreed that she needed something to help her wakeup.  She had received a narcotic, dilaudid, in the emergency room.  Narcan (Naloxone) is the antidote to opioids such as dilaudid and morphine.  Narcan (Naloxone) is specifically used to counteract life-threatening depression of the central nervous system and respiratory system.  The pharmacy sent a medication and the nursing supervisor drew up the medication in a syringe.  She rushed it to me and said, “Here is 10 mg of Narcan.”  I frowned and looked at the empty vial in her hand.  I said, “This is not Narcan.”  (By the way, the dose for Narcan is 0.4 mg.)  What the pharmacy had sent, and what she had drawn up, was Nubain (nalbuphine), a synthetic opioid.  Had this been administered to her, she would have possibly drifted into an even deeper sedation and possibly even into respiratory arrest.  This is called a near miss.  This medication error made it through two providers and I was the last set of eyes before it was administered to the patient.  In the end, I did give the proper dose of Narcan to the patient, and she woke up, mad as hell at me that her back was now hurting.

Not to sound too overly dramatic, but I quite possibly saved a life today.  And she will never even realize that.  But that is the life I chose, and I love it.