did i do the right thing? - page 2
I had 2 patients i am only on my second week. I was with a patient in the room who was dying of lung ca and i was giving him iv push morphine. When i heard a bang and heard people go running to the... Read More
Jun 23, '09you did the right thing. you can not endager the pt you are with to help another pt, especially if there are other nurses helping the other pt. I have een in this position before and have always finished up what I was doing then went to see if I was needed.
Jun 23, '09You did exactly what you should have. Watch all the codes you can, offer to help, but unless you've got prior training/experience, you can't do much right now beyond CPR.
My advice for code newbies:
- Don't be the first at a code when you're new. Stick to your preceptor. When you're off orientation, stick with the charge nurse.
- Get the furniture (tray table, chairs, etc.) out of the room to make space for the code cart/team
- Turn on the AC -- that room's going to get hot.
- Be the runner -- if someone says, "I need a xxx" and YOU KNOW WHERE IT IS, go get it.
- Watch everything, offer to do what you know you can do.
- finally -- realize that people are coded because they are dead. Most of the time, they stay dead.
A doc once told me the function of a code is to throw enough nurses on the patient to give the MD time to figure out and treat the underlying cause of the code. He was full of garbage, since most of the time in the middle of the night, we've already either got the person back or know he's just going to be pronounced when the doc finally shows up, but he was right about buying time to figure out what's wrong and treat it.
Worst one I was ever on was a young husband, wife, kiddies in the hallway. They figured out at autopsy that his ventricle literally "unzipped" along a line of necrosis from an unknown prior MI. Guy had been A/O, talking with us during admission to our floor, we got about 25 feet down the hallway when they called the code. Guy never got perfusion (no kidding). I'll never forget his little boy screaming "Daddy wake up!" when the wife took them into the room to see their dad.
Jun 23, '09oh my god!!!!! THAt is horrific! How did you personally emotionally handle that? Its so hard being a nurse and see something like that! This was a young women who i also was in with maybe 2 hrs before and she was a/o! she had a seizure but no prior history and was here for complications from a lp. l but ended up seizing and fell on the floor face down! when the nurses walked in she was blue..hence the code! I have seen my second code now in 5 days! i see what the dr are asking of the nurses. and it scares me because i have no idea how you guys are able to remember all that stuff!
Jun 23, '09First rule of nursing: the patient's job is to try to die on you, with as little advanced notice / reason as possible....*grin*
Unfortunately, you do codes enough, and you just learn. Plus, you look at the rhythms, and that narrows down what you do/can do in terms of meds/shocking the pt. Take the telemetry class at your hospital, and the ACLS class if you can get into it. It will help what you see make sense, and also deal with the helpless feeling you get when you're new.
And as for the bad stuff....you find someone to talk to, friend, spouse, sibling, pastor. The trick is, you have to pour that stuff back out, because if you don't, it fills you up and you drown in it.
Jun 24, '09I think you did the right thing by not leaving your patient. The most important thing was to stay with your patient and finish administrating the medication. After you finished administrating the med. and assured that the patient was safe then you can leave for the code. If you hadn't started administrating the morphine then I would have gone to the code to see if I was needed and if I wasn't needed then I would have gone back to my regular patients.
!ChrisLast edit by cjcsoon2bnp on Jun 24, '09
Jun 24, '09As a new nurse, you did the right thing. Best thing for your first few codes is to witness as much as possible before moving up to exterior roles such as recorder or runner. My first few codes all I did was things like help the family in the hallway, run get extra gloves etc. I do have one question though. How much morphine were you giving? I don't think I've ever pushed morphine over 5 minutes. If its 2mg, I give it about over a minute. I dilute it in a flush too but honestly I've never given it that slow. Perhaps I'm not doing it correctly but generally I only give things that slowly that are specifically stated to push slowly (protonix or lasix > 40mg) or cardiac medicine.