Calling the Code Again and Again and Again

An old man lies in the ICU right now. He's vented but awake, AO3. His ex-wife stays at his bedside relentlessly.

I would bet every dollar I have on the fact that within the next 6 hours he will code. Why would I do that?

Because he has coded 10 times in 2 days.

His ex-wife, as his only family, has requested he be a full-code each and every time. She watches each compression. The code bells go off so often these days other patients believe it is merely a phone ringing. The code bells go off so much we don't even wait for the room anouncement, we know who it is and where he is.

He is asystolic. Again.

My fellow nurses cry out in anger and sadness that anyone would be put through this torture.

The medical students and residents groan because little "work" can be done between codes.

He is a full code each time....each time he gets compressions and meds and bagging, and you name it.

Each time he recovers. A little worn and a beaten from the events preceeding this alert state. But he's awake and listens intently to the fact that he has been revived, again.

Nurses stopped responding to his codes long ago. It doesn't take many staff to compress and push meds. Deep down inside, they find it unethical and cruel to code him over and over again.

Each time my hands sink inches into his chest and I watch my compressions on his ECG, I am baffled by the science. There is no room for emotion. How can a human body sustain so much trauma induced from a code? How many times can a heart give up before it won't be revived anymore? And if it is so strong to be revived 10 effing times, why can't we believe he may walk out of this ICU one day?

Putting the stress and the emotion beside, I am amazed to watch his case night after night. Prior to coding these 10 times, he has coded several others...about 15 times in all. The nurses want this madness to stop. We keep the ex-wife in the room for each code so she can see his pale chest being manipulated back to life.

But my curiousity lingers. Most patients or families don't make it past one code, let alone 10+. How many times can we call a code for one person? Not a game of numbers, a game of endurance.