What Is a Code Blue Really Like?

It’s a common question for a new nurse to ask before their own experience has a chance to arrive. As a nurse of any length of experience, losing a patient never gets easier, and it doesn’t matter if you’ve known them for months, weeks, or only a matter of minutes.

There are shifts when it feels personal. You do your best, and it isn’t enough.

The replay will happen for a long time. You’ll never forget because you care too much to let them go, just as I find now, 20 years later.

I wasn’t enough. I broke my promise to you.

You were the patient in a bed, known only by your room number as I took my assignment. This is how I knew you first.

When I met you for the first time, you were sleepy and not feeling well, but that was to be expected for the infection that was ravaging your body. You did your best to be polite and smile at me, so I asked you how you were really feeling. In the next 20 minutes of listening to you explain, cry, laugh nervously, and then finally sit in silence with your hand resting in mine, we built a trust for the night to come.  

I learned about your wife of 33 years and your two grown children. They were all coming to visit you in the morning, so I promised to let you get as much rest as you could. I told you that I would do everything possible to keep you comfortable, and all you had to do was call for me, and I would be there.  

I meant it.

I had visited again in the next hour to see you asleep. Your breathing was easy, but you looked ill, and I vowed to keep an extra close eye on you. I moved on to see my other patients, knowing that you were as comfortable as you could be for now, as I had assured you that you would be.

In the next hour, that’s when I broke my promise.

The second that I heard the alarm from the monitor, even from several doors away, I knew it was yours. I felt it in my soul, and my heart began to pound in my chest from the surge of adrenaline coursing through me. I sprinted to you. I yelled for my peers to bring the emergency cart because you weren’t holding up your end of our deal; your body was giving up, and I was livid that it would dare betray you like that.

As I pushed on your chest with all my strength, trying to get your heart to restart, another nurse was putting the defibrillator pads on your chest, working around me. Another was forcing air into your lungs, squeezing the Ambu bag over your mouth with a rhythm that always becomes a song in my head despite the morbidity of the moment.  

I could feel your ribs cracking with each push beneath my hands until your chest didn’t bounce back up under them as easily. I’m so sorry about that. When they yelled for us all to back away so that they could shock your heart, I didn’t want to, but I did. I wanted to give you everything I had until I couldn’t give anymore.

After working for 45 minutes, you were gone. You weren’t coming back. After everyone had left, I stayed with you, alone, cleaning the room around you, washing you, combing your hair, closing your eyes now that their shine was gone, and preparing you for presentation to your family. I folded your hands over each other and rested them on your chest, giving you the appearance of sleep that I had last seen before it all went wrong. It was like I had imagined it all or that the clock had gone in reverse.

Calling your wife was the worst thing, even though I had done it before, but never like this. She cried; I cried. When she arrived at your room, we cried again. I apologized for my efforts not being enough, and she became the one consoling me. I’m so sorry about that, too.  

They spent three hours with you. They loved you so much. But you should know that they were strong, polite, and thankful, just like you. You must have been so proud of them.

Once they had dried their tears, only to know that more would come when they saw you again, they said goodbye, and the time had come to move you from your room and to the morgue. We carefully removed your glasses and gown and put you into the soulless and stark white plastic bag. I was talking to you the whole time, telling you what we were doing, just like I do with all my living patients.  

I didn’t even realize that I was doing it.

I pulled the zipper to the top of the bag, pausing for just a moment to look at you one more time and brush your hair from your face. You looked comfortable for the first time since we had met only a few terrible hours before. 

If there was nothing else left of myself to offer, at least I could give you that much.