An essay written in English 1101 on “THE FIRST TIME A PATIENT DIED UNDER MY CARE”

Many years ago, I graduated from school of nursing. I was young, smart and adorable. I applied for a staff nurse position in a government hospital. The interview went smoothly, my interviewers were dazed at my aptitude and eloquence. I was offered the job to work in an acute care setting. My orientation was supposed to last for four weeks. After two weeks, I was already approved to function independently. I earned an award as the best orientee.

Then came this memorable day. I was alone in my section on an evening shift. The manager and senior colleagues have gone home. I admitted a twenty five year old man into the resuscitation room. He was brought in by family members, from a village two hours distance apart from the hospital. There was no 911 or any kind of ambulance. The road connecting the village to the urban city where the hospital is located is so deplorable that a journey supposed to be one hour can actually take two hours. When I was taking the history, I knew they would have spent over two hours on the way before getting to the hospital.

Then I began my care. Took the vital signs, put him on cardiac monitor, collected blood and urine samples to laboratory, put intravenous line and started saline infusion. His vital signs were apparently normal, nothing to raise alarm. The cardiac monitor rhythm did not show any kind of distress. The physician came, examined and made prescriptions. The order was carried out immediately. Resuscitation given and patient responding. Patient looked fine. The physician and I waited for the laboratory result to know the next line of action. The physician left, to be called back when results are out.

What happened next is unexplainable, patient suddenly started twitching, stretching, and convulsing. I immediately inserted an airway into the mouth, gave anticonvulsant and convulsing stopped. Cardiopulmonary resuscitation commenced. The secretary in the unit activated the code team. Code team is made up of experienced doctors, nurses, respiratory therapist and pharmacy. Immediately, the room was filled with the resuscitation team. Patient’s heart rate was fifty beats per minute against the normal value of sixty beats per minute for an adult.

The doctor decided to intubate patient. As I gave the pulmonary intubation medication, patient made a generalized, tonic-clonic muscular stretch and the pulse was gone. Alas! I screamed patient is pulseless! The doctor replied, “No the medication is supposed to keep up the pulse, let’s continue with intubation” Cardiopulmonary resuscitation continued and patient on hundred percent oxygen. Thereafter, the doctor palpated the pulse and confirmed no pulse. He ended CPR after thirty minutes of unsuccessful resuscitation and pronounced the patient dead.

I was battered, confused and sobbing like a baby. Was there anything I should have done, that I did not do? Did the family members bring him too late to hospital? Why would he convulse and die despite the medications I gave to him? Who could explain to me the physiology behind such sudden death? I sobbed and grieved. Up till today, I have not found an explanation to these questions. In the course of my career, every time a patient dies, there is often a cause for the death. The first patient that died in my care remains indelible in my memory because even now, I cannot fathom why he died.