Nurses all have those points in time. The code that shouldn’t have happened. It’s not fair. They were too young, too healthy, a treasure, an angel of the community.   Or it was too sudden, you weren’t mentally prepared for how bad it really was, and they had family that depended on them. The code blue that stays with you, that makes you question everything.

I was seventeen years old and working in a very rural, tiny community sponsored ER. The locals called it the “band aid station”, an accurate description.  It was the nineties and our lone ventilator was the size of a deep freeze. We shipped most major traumas out by helicopter. The ER had four beds counting the “trauma room”. The staff included one RN, one LPN (sometimes 2) and me. I was the triage secretary/respiratory therapy assistant. I had taken a correspondence course to get my respiratory therapy assistant certification. Yes, this was actually legal back then.

The ER was attached to a small twelve bed hospital unit. It had an “ICU” which consisted of two beds next to the nurses station. Majority of the time they were used for hospice patients. Most of the nurses had worked there for years and knew the hospitals quirks. Like that the last room on the left was used as storage because one of our nurses sons had passed away in that room. It was permanently closed out of respect. Or that the county we lived in was “unincorporated” and had no laws on the books about burial. Many locals came to collect their dead in pickup trucks on the back dock, to be buried in family plots. This was where I cut my teeth in health care and where I grew up.

Our staff was a perfect combination of sass, kindness, knowledge and dedication. One nurse in particular I admired so much. She was so kind, never lost her temper, or had a hair out of place. I knew I could never be that nurse, but I still watched her like she had the secret to life. She still took the time to fluff pillows and give back rubs, even to the most surly of patients. She had the perfect nurse face for head lice, backwoods sock feet, maggots in wounds and rope chaw mouth.

Her daughter was beautiful and worked as a physical therapy assistant. French Indian high cheekbones and skin like her mother, she was as gentle and soft spoken as the woman who raised her.

It was a typical Sunday morning in the ER. People waiting to be steri stripped and hoping for pain meds for brawling the night before, a couple of drunken backroads accidents. Poor Odie (not his real name), an emphysema patient waiting on his almost daily breathing treatment and enjoying our air conditioning and cable television. The only thing different about that morning was that normally we used a temporary Physician’s Service from the nearest city. They didn’t have anyone available, so one of our own surgeons worked extra to accommodate the staffing.

Then the call came over the scanner from the local EMS. We thought it was a bad connection, we could barely understand them. Then we realized they were crying. They burst through our doors and it was her, our own precious angel, in full arrest. Her daughter was right behind, followed by the physical therapist to help support her.

She had complained of a headache before church and sat in her recliner to rest, then had a massive aneurysm. We coded her for nearly three hours  amidst our tears, pleas and prayers. I bagged until my arms were jello, then mustered up the strength to do chest compressions. Finally, one of the nurses laid her hand gently on the doctor’s arm and shook her head. He called time of death and then went to the call room to cry.

I put on my “nurse” face and went back to triage. I worked the rest of the evening along with the other staff. We had a job to do, the other patients in the waiting room were just as important as her and we all knew she would have understood that.

We all have that moment, where we swallow our own trauma and move on to doing our job. But, there are some of those bitter pills we never forget.

My grandmother Mona with a bear. I guess taking a picture of a toddler with a dead bear was all the rage when you were nearly starving to death.