Caution reading this post!...We need prayers

This blog is a hard one to write and please note this is NOT normal for these patients. Last night was easily the worst night of my entire nursing career. Granted the circumstances are entirely different then what I normally work under. It was long, it was hard, it was sad, it was dirty, it was filled with complications, and it was exhausting. Our 62yo patient Duncan had an awesome night. He's a sweet, sweet man. Unfortunately, our second patient Roger (pronounced Rajay) did not make it through the night. He came back from the OR to our unit at 2am with a breathing tube(expected). His surgery was rather long but ended up relatively well and the surgeons felt he would have an ok night with your "normal" complications. Early on we had some pump malfunctions and had to give a lot of volume due to lack of ability to give blood pressure medicine through his pump. We quickly trouble shooted the pumps and got the Epi going. We celebrated a good blood pressure around 345; Mary even took a picture of us and Roger with his stellar BP. Around 4am he woke up and we asked if he was in pain. He noded his head no then fell back asleep. 

At 415 Kristen and I noticed his sats (oxygen levels) would not show up on the monitor and soon after his blood pressure stopped reading. The oxygen was gone...we couldn't find any in the entire hospital and he had severe pulmonary edema. We never got oxygen back. He was cold, his pulses were hardly palpable. Mary decided to give some epi to increase his BP. At this point his heart rate was always stable. After the epi bolus his heart began to trend down(that doesn't usually happen. His heart wanted O2). We had been bagging him continuously and he had massive pulmonary edema. His heart rate continued to drop and had no BP or sats. We started CPR. I, honestly, cannot tell you how much epi, calcium, bicarb, dopamine, magnesium, etc we gave. We even ran out of some of it. At this point we were calling every number we could find and we couldn't get a hold of anyone. No surgeons, no more doctors, no more nurses. We ended up shocking him twice with no resolve. 

While Mary was doing CPR and Kristen was pushing epi I ran out of the hospital to one of the surgeons houses to get him. He followed me to the pt and after an hour of CPR we opened his chest up. We began to give "internal cpr" and shot epi directly into his heart a couple times. An hour and a half passed and we had literally done everything possible; his heart was just too tired to come back. We called it around 530am. We were in shock and sad b/c Roger himself was a nurse in the Congo. He was part of our nursing family. Mary said pre-op he was very very happy and always smiling. She said he was so sweet and patient while waiting in the clinic. Because he is from the Congo they are unsure what to do with his body. They may bury it here on the hospital grounds. At this point I'm not sure how to feel. I'm humbled, I'm sad, I'm in shock, and I'm frustrated. So many things went wrong that would never ever happen back home. 

I'm so incredibly thankful for Kristen B. and Mary for being there and encouraging and instructing me. The team here is amazing and I couldn't ask for a better crew but sometimes it doesn't matter who the care givers are if you lack the resources. Today all surgeries are on hold. The team is shaken and as long as we are unsure of our oxygen situation we cannot risk another patients life. I'm sorry to bring you bad news but the team needs prayers and rest. Both our surgeons were up working for almost 24hrs yesterday and needing sleep. So just remember this, even though our health care systems is whacked out at least we have it! Be grateful for one another today! I love you all and miss you!