Today, I was kind of looking forward to an uneventful shift. I guess I was hoping too much… Just right after our endorsement, a patient started to complain shortness of breath. Oxygen support through face mask was then given to the patient. I felt she was really having a discomfort and was starting to be in respiratory distress because she kept on changing positions.
The resident physician in charge came and assessed the patient, like what we were suspecting, the patient was having an allergic reaction to a particular drug. Since the patient was already in thyroid storm when she came in, anaphylaxis (allergic reaction), was something you wouldn’t want to happen..
Clinically, by just looking at the patient , I knew that she was a candidate for intubation( a tube being inserted to the lungs through the oral cavity straight to the trachea) so that a patent airway can be secured, since I believed that time was of the essence, and I didn’t want to end up doing CPR.
We(I and 2 other nurses), were all set and ready for the action, but to our silent surprise, the physician decided to wait for his senior’s go signal to do intubation.. Upon looking at the patient, I knew that we were running out of time….My disturbed mind kept on shouting…please intubate the patient now .. and it kept on repeating over and over….I kept myself from speaking my mind coz I told myself, they were doctors and they knew what they were doing… I kept on convincing myself that he (the doctor) must have a very valid reason not to intubate. And so we waited.
After an agonizing 40mins, the doctor decided to do it, but like how we expected it, during the process, the patient went into cardiopulmonary arrest. CPR was done, and emergency drugs were given…After 4 doses of epinephrine, the patient was revived but was already in a state of coma.
After everything that’s happened, I wondered, would it have had a different outcome had I braved myself to speak my mind? Would they have considered my suggestion or would they have taken it as an insult to their capacity to decide on an emergency situation.
Well, I guess, I have no one but myself to blame…I feel like a coward and looser for not telling the doctor what I thought was the right thing to do… It was indeed a lesson learned the hard way and with full of regret. We could have saved that person’s life you know.