Anxiety with facing first cor/code blue

[murphynmax]

I am a new grad rn going on 8 months. I work on an ortho unit at a level1 trauma hospital. It's always busy and we constantly seem to be short at least 1 rn and 1 tech each night. I feel thankful that I have not been faced with a cor yet, however I really just want to get the first one out of the way, does that sound sick? I come to work each night in a bundle of nerves, wondering if tonight is the night....any advice? I just want to know that I will be prepared and ready, I don't want to choke....

I think part of my problem is that my father arrested in the ICU at 230 and they were unable to bring him back. We had just left him hours earlier feeling good about his condition with his nurse telling us how stable he was and that he was doing well. This all happened my first year of nursing school.

Any thoughts or advice would be greatly appreciated. This is my first post:uhoh21:

[nurseyr1]

Hi! I'm a new grad as well, this is my second post! I work on a mother baby unit so my risk of a code is smaller, but remains present with PE's and our high risk mom's. I too have worries about code blues (and pinks) and would love feedback from more experienced nurses and look forward to the feedback on this thread!

[DanEMT, ASN, RN]

I have never done a code in a hospital only in the field, but the nerves are the same. You wonder - will I forget to bring something I neede in? Do I remember how to measure the lenght of the Yank for suction? Will I freeze? It's normal, but don't sweat it when it happens your training kicks in and you just DO. There is no over thinking it, it becomes automatic. Shaking a little happens after it's finished. You will be fine. Good luck

[S.T.A.C.E.Y, LPN]

Is there any way you can see if you can respond when a code blue is called in the hospital, just to at least get a feel for what goes on?? Maybe talk to the charge nurse when you are working, and express your concern with this, and present this as a possible solution. Say you'd do that in place of a break (if you even get them). After observing a few elsewhere, you might feel more confident about your own abilities when one happens on your floor.

[NextSummer]

That's exactly what constantly worries me too.... I don't work in a typical hospital setting so the chances of code blues are very low here. And that's why I am very reluctant to leave this place, even though I don't think I will make a good nurse here. whew....

[EmerNurse, BSN, RN]

Everyone gets the jitters when first faced with codes. Many hospitals have a Mock Code type class which may be helpful. Also, have your ACLS, if you don't already - they cover what you'll need pretty well.

At the end of the day, you won't be in a code all by yourself. When you call the Code Blue (if you are the one who finds the situation), your priority is to BAG THE PATIENT if they are not breathing. The next one in the door can do compressions. Remember your ABC's. Other people are going to rush in, place IVs, someone will grab the code sheet to document. Someone will slap the pads of the defibrillator on the patient, someone will pull open the code cart.. etc. You won't be doing it all alone. The fear comes because it's done so FAST, like everything happening at once. They key is this... if you FIND the situation, and you assess a code situation, YOU call the code and address the situation (Bagging the patient, or whatever) and go from there. If it's your patient, you'll be expected to know the status of the patient (allergies, diagnosis, what's been going on recently, have the chart brought in.

If a code is called and you run to help, take a role. Start out with code sheet if you can. In that - your job is to note the TIME everything happens in order, including vitals. Pick ONE clock to chart by, and pay attention. Code called at X time, Bagging in progress, cpr in progress, med given with the time (the one giving the med will say or shout EPI GOING IN or something similar so you'll know). Things like epi are given usually 3-5 minutes apart so someone might ask "is it time for the next epi?" and your time noted will tell you. You can take all these notes on a blank paper (as long as you do it neatly so you can transcribe properly), then you'll transcribe. Grab a code sheet at work and go over it so you know the info you'll be expected to know.

I was very lucky in my very first code as a new nurse. One of the ICU nurses who responded (a very well known, experienced, published nurse) planted me in front of the code cart and stood behind me and walked me through being the cart nurse, and explained why I should get what ready next. She was awesome and patient and really calmed my anxiety.

Sorry this is so long but I hope it helps. The jitters never really go away, but you WILL NOT be alone in a code situation, so bone up on what you need to know, and breathe!

Good luck!

[NotReady4PrimeTime, RN]

Excellent reply, EmerNurse. If I might add... If you can do the documentation for the first few codes you're present for, it will really help you grasp what is happening, what is being done and how it all goes together. As you are writing it out, the picture will become clearer. I usually write everything down on a paper towel or six (all that's usually available at hand in a pinch!), then transcribe it later. Make sure you get the names and titles of everyone involved. Adult codes are typically much easier to keep up with than pediatric ones because there are standard doses for everything... an amp of epi, an amp of bicarb, etc. With kids it's all weight based and if you don't know your PALS drug doses cold, then you'll have to really pay attention, ask for specifics of what was given and so on. That's a good enough reason for me to make my initial notes on scrap paper!