Dealing with Codes/Serious Emergencies

[Multicollinearity, BSN, RN]

I am a new RN. I need help/tips/advice on managing my psychological response after codes/emergencies. I've done OK with the logistics during the codes, and I stay very calm. In fact, I'm so calm during codes, it surprises me. I operate well at work and then fall apart when I get home.

When I get home I start sobbing, shaking, and cannot sleep. I feel wrecked for a couple days. I get very irritable.

I've tried calling a nurse friend and "debriefing" and that helps a bit. I've tried doing yoga and other exercise to calm down. It doesn't help.

Tips. Suggestions, please. I've gotten a little better after each code, but it is still destroying me for a few days after each one. What do you do? How do you deal?

[Altra, BSN, RN]

This is not uncommon in a new practitioner. Give yourself a little time.

It may help to try to analyze exactly what your anxiety trigger is. Is it the actual death of the patient, if resuscitation is unsuccessful? Is it fear of doing the wrong thing? Is it just being in the presence of, typically, a large group of people who all have their adrelanine pumping furiously?

This will get better ... or you will come to know that a less acute care setting is where your individual strength lies.

[Multicollinearity, BSN, RN]

I've noticed I'm significantly more affected by codes/emergencies that are caused by violence. The medical ones I don't feel destroyed by; I get the adrenalin, and then I deal with it and calm down.

I'm still bothered by a stabbing case from last week. I can still see all the blood. I feel traumatized by it.

[Altra, BSN, RN]

I understand. :hug:

FWIW, I don't know any long-time emergency folks (RNs, MDs, medics, EMTs, firefighters, police officers, ancilliary hospital staff, etc.) who don't have the memory of a particular scene, image, sound, or situation that is still occasionally haunting, even years later.

This will likely get better for you with additional exposure/experience. But you are human, ya know. Allow yourself that.

[LittleOneRN]

I agree with everything Altra said. It takes time. I used to have a similar reaction, and eventually realized that I, for whatever reason, felt totally responsible for the event, how it was performed, and the outcome. That is not reality as there is an entire team there, but that was how I felt. I have, through experience, realized that codes will happen regardless and many do not have good outcomes. I am responsible for doing my best. Find your trigger and deal with it!

[PostOpPrincess, BSN, RN]

You get used to it.

You really....unfortunately do.....

[ebear, BSN, RN]

Multi, you'll be OK, Sweetie! There will always be those that you'll remember, but there will come a time when it won't be so graphic and fresh on your mind. I promise! All is NOT in our hands. God has the final say-so. When you do all you can do---that's all you can do! That is so hard for nurses to accept. Just hang in! :hug:

[kesr]

I used to relive every code in my dreams, I think it was embedding itself in my subconcious. Once I was more experienced and confident the dreams stopped. Give yourself time, you're doing everything right.

Some hospitals have consuling for this sort of thing, if you feel comfortable asking about it.

[Flo., BSN, RN]

I hate codes. I end up spending so much time trying to figure out what went wrong. Did I miss a change in LOC, give too much of a drug, not medicate enought etc.... Then for the rest of the shift I feel so weird and I am obsessive about checking on my other pts. I am trying to get better. I have found that going to the gym and taking my frustration out on the punching bag really helps. Can't offer you much advice other than... I'm going through a similar situation but as a floor nurse.

[canoehead, BSN, RN]

After over 20 years it the screaming of terrified family members that haunts me for weeks and sometimes years. That moment when they realize the enormity of their loss- it's not duplicated on TV, and there's no mistaking what happened when you hear it.

Death, blood, insects, they are good for war stories, but the residual from horrifying grief I can't shake it.

My first code was unexpected, and it was a child. I was about 22, and said something the mom interpreted as me knowing how they felt, and she screamed at me. I remember still the shame and horror at myself for being so inept, it brings tears to my eyes to this day. I think some things you get used to, some things you learn to process, but in this type of business some experiences you will never forget. Your are respecting that family in their grief by keeping up that memory (my best rationalization).

[Multicollinearity, BSN, RN]

Thank you all for the replies. I'm realizing my trigger is violence, and I need to find a way to manage this.

[1287PennEMT]

Great advice from people here there's some good advice. Find the trigger, and also it wouldn't hurt getting some help discovering why it bothers you so much. Sometimes things just hit hard, sometimes too close to home. The more you see the more you are able to compartmentalize and cope.

As awful as they can be, remember that you are part of the solution -- you're doing everything you can to help. Nothing for you to feel guilty about. Also try to get into the habit of leaving work at work. It's a benefit of what a lot of us do -- we can.

Finally, if there is something that really is setting you off, look into the s/s of PTSD. It's not just soldiers -- it's everyone from police, firefighters, EMTs, victims of violence. There is every reason to reach out to a professional to help you learn to cope in a way that works.