In the MSICU we have emergent situations: we have code blues, and it is not unusual to see people die. We know how to handle these situations and we handle them well. However, to do a 2-hour code on a 23-year-old, 27kg patient, with special needs that we have grown attached to is not something we are familiar with.

We had our sweet patient, with her mother at her side, cardiac arrest in front of our eyes. The heart rhythm changed unexpectedly and was caught very quickly. Her heart stopped, the monitor showed asystole and the only sign of life was the occasional wink our patient would give us. She has been our patient a few times within the last year. She is special needs, has chronic trach, and interacts with a quick mouth movement of yes or no. Her mother is her biggest advocate and knows all the nuisances of her needs.

When we lost her, the MSICU all organically moved into their code positions with Dr. Wachira leading the helm. The code lasted for hours, we would get her back and then you could watch the life fade from her body. Her primary RN, Jessica Martinez never left her side, doing pediatric compressions on our adult patient the entire time. The patient is familiar with Kristyn Squibb, RN the most and she stayed where she could see her the entire time. Kristyn rubbed her hair so she could feel her presence and watch the little changes that we had to look for for signs of life.

Staff moved effortlessly around each other, working together in a calm manner, ultimately to the point where we got her back and she survived. I have personally been involved in many codes. I pride myself on my 'we can do it' attitude. However, this code shook me to my core, as it did the whole team. However, we never lost hope, we never gave up. We supported the doctor, the mother at the bedside, the father on the phone, and most importantly we never gave up on the patient and as a result, she survived and went home to finally open the Christmas presents that her family had holding for her.

The day was traumatic for all involved, but we persevered because we had 19 other patients depending on us to keep moving forward. I don't think I have ever been more proud of the MSICU team and their efforts in this particular code and that is saying a lot because I am proud of them, their loyalty, their commitment, and their brilliance every time I work.