First code as a new nurse

[Katniss88]

I've been a nurse less than a year and a few days ago I experienced my first code. Two or three weeks ago we had a pt where a code was called but it wasn't a true code, even then I was terrified and fumbled as to what to do. This time it was my patient.

I was in the med room pulling some meds for another pt when a tech came in and said my pt was complaining of chest pain. So me and another nurse went down to the room and to assess the pt, we did vitals and had a stat ekg done and labs drawn. Long story short, he then coded. I again fumbled and just searched for something to do and felt so helpless, so I just reached for the ambu bag and tried to quickly get the tubing unraveled and it seemed to take forever to get it hooked up to oxygen. When other nurses and more helped arrived, another nurse told me to record. So I started to write stuff down and then another nurse asked If I had recorded before and I told her I hadn't, so she took over. So during the code I just observed and went and got supplies as they were needed. I felt so horrible, standing in the back and this was my pt whom everyone else was trying to save. I always hesitate in new situations and scared to make the first move. When it was all over, my patient didn't make it. The rest of the night I kept running through my mind the whole situation. I kept wondering if the other nurses thought any less of me, in my mind I was thinking if your not doing something to help then get out of the way. Even now, I keep thinking before the code was called I should have moved faster and done things differently.

[nurseprnRN, BSN, RN]

Those plastic ties can be cut open easily with your scissors. You do have a pair of bandage scissors on you at all times, right? :) The longer ones are a lot more useful.

Mueller Bandage Scissors

[akulahawkRN, ADN, RN, EMT-P]

The first code is always the hardest. You did amazing, especially since you haven't had ACLS. Please don't best yourself up over it. If you are interested, ACLS will give you the knowledge to feel more comfortable with any future codes. There are a ton of incredible resources online to help you. I would also inquire at your workplace if you are interested in taking ACLS.

Wishing you incredible success I your nursing career!

I tend to agree. I know going forward that I'm not going to freeze in a code because I've run about a dozen of them. The first code you participate in is usually the hardest because you're put into a situation that you've not experienced before. The hardest part of it is making the decision to call a code and do something about it. One you've made that decision, and you act on it, the rest is easier to deal with mentally.

I would suggest taking an ACLS class, and do the 2 day class. If the class you take has a couple of Paramedics or Paramedic students in it, watch them. They usually have this stuff down pat because it's hammered into them. Same thing if you've got a couple well-experienced ICU, ED, or Transport Nurses there... they've seen it and know how things are done.

And yes, codes do appear to be organized chaos. Once you know the roles, the appearance of chaos is lessened. Unfortunately, sometimes when you call a code, everyone comes running and they can bring everything with them, including the kitchen sink and more than a few Medical Interns and Residents...

[anon456, BSN, RN]

It sounds like you did the right thing-- you recognized that the patient needed attention and you then tried to stay near and help out. The the staff had probably been through a lot of codes and knew what to do. If you had not seen one before, you cannot be expert on how to run it.

I posted awhile ago that I had my first code, and I was relief charge that night after the charge went home sick. I knew to call for help and I shouted out for people to run and get things while I stayed at bedside and bagged the patient (they did not need CPR at that point, just pulmonary arrest). As soon as the team got there I stepped aside and let them take over while I answered questions about the patient's history and current medical issues.

[garciwarsi]

The fact that you are taking the time to reflect on the situation and getting advice from peers about what you can do now or might have done differently I think says a lot about you as a nurse! You want to improve so next time you can make an impact on the outcome. I think what makes it especially difficult is that the patient didn't make it, but the most important part is that you took action on the chest pain which is what you knew how to handle. This is why we work in teams. Not one person is going to know every vital piece of information during these situations. You did what you knew how to do and now you know what to expect. And also, what you can do in the future. I would suggest talking to your manager/educator and possibly getting reoriented to the code cart, how to open it in this situation and where things are. Also, maybe a mock code for the floor to practice skills?