Clinical placements

What it was like to deal with a patient in cardiac arrest for the first time

Acting and learning under pressure was emotionally draining – but here’s why it was worth it 

Acting and learning under pressure was emotionally draining– but here’s why it was worth it 

man receiving chest compressions
Picture: iStock

While on a recent clinical placement on an acute frailty unit, I had my first experience of caring for a patient in cardiac arrest. 

I was working with the unit coordinator when we heard the emergency alarm go off. We ran into the bay where a nurse was already with the patient, who was unconscious. There was no pulse and he had clear cyanosis to the face and lips.

Resus status checked

We lifted him from the chair to the bed, and one of the nurses checked to make sure the patient wasn’t breathing. His resuscitation status was checked to see if there was a ‘Do not attempt CPR’ notice in place. There wasn’t.

One of the nurses started chest compressions while I ran to get the cardiac arrest trolley. Another nurse put out the arrest call. A healthcare assistant had taken the patient's relatives to the relatives’ room and offered them a hot drink. They were shaken up by what had just happened, and while saving the patient took priority, we kept the relatives informed as best we could.

The deteriorating adult response team (DART) arrived, and while one of the nurses documented in detail what was happening – which is important in cardiac arrest situations to ensure appropriate care is delivered – I helped place the defibrillator pads on the patient’s chest.

The defibrillator then instructed us to stand back while it analysed the patient’s heart rhythm, a shock was advised and everyone stood clear.

‘… probably the most rewarding moment of my nursing career to date’

The shock was successful and the patient’s pulse returned. He was given adrenaline to increase his circulation and arterial blood pressure, and once the anaesthetist arrived he was deemed eligible for escalation to critical care.

As the patient was unable to give consent for this, the multidisciplinary team (MDT) made the choice in the patient’s best interests.

Observing the critical care admission process

The DART team encouraged me to follow the patient to ITU so I could observe the process of admitting a patient to critical care.

I spent the next few hours in intensive care, learning all about how the machines worked and what they do. The critical care nurse also taught me about blood pressure mapping – measuring the patient’s mean arterial pressure – which is a better indicator of vital organ perfusion than systolic blood pressure.

‘Before this experience, I was worried I would not react in the right way’

I saw an arterial and central line being inserted and learned that the while it is important to keep patients warm in intensive care, if they become too warm their veins will dilate, which can cause blood pressure to drop.

An overwhelming response

When I went to check on the patient the following day, he was less sedated and so able to communicate. When the critical care nurse explained I was part of the team that ‘got him back yesterday’, he gripped my hand and mouthed ‘thank you’.

This was overwhelming – he was so grateful to us for saving his life and it was probably the most rewarding moment of my nursing career to date.

‘Although this was an incredible learning experience, it was also very emotional’

Before this experience, I was worried I would not react in the right way or feel confident to assist in an emergency. Dealing with a cardiac arrest in practice was completely different to our classroom training, and I was relieved I was able to handle it professionally and work safely under pressure as part of the MDT.

An insight into critical care

I was grateful for the opportunity to follow the patient to critical care – this increased my understanding of the role of critical care nurses and interventions following a cardiac arrest.

Although this was an incredible learning experience, it was also very emotional. I spent five hours in ITU with the patient and it was only after I left, that what had happened really hit me.  

When I talked to my mentor about this, she explained it is normal to feel tired and emotional after a cardiac arrest, and that showing care and compassion is an integral part of being a nurse.

My mentor's reassurance

This gave me great comfort because I was worried I had not handled the situation well enough. I felt reassured, and that with further exposure to cardiac arrest situations I will get used to the emotional response.

This experience increased my confidence as a nursing student, and highlighted the importance of good team work. I understand that CPR is unsuccessful in many cases, and I feel fortunate to have been part of a team that had a positive outcome.

Click here for resources on managing stress and building resilience

Katie Dutton is a second-year nursing student at De Montfort University in Leicester and winner of the Andrew Parker Student Nurse Award at the 2018 RCNi Nurse Awards

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