first code blue

  1. I have been a registered nurse for only 2 months. I had my first code on 9-15-01 at 1730. I had never done chest compressions or bagged a real person. It seemed like all my teaching went out of my head. I couldn't think if it was 1 mississippi 2 or 1 and2. It seemed like I couldn't remember anything. The code was called at 1755. I cried and cried. I have been in the nursing field for 10yrs but never have I physically been the one to do the CPR. I left that code saying I didn't think I wanted to be a nurse any more. I guess I just needed to vent. I was wondering if it ever gets easier or with time will I feel more prepared or whatever for situations like this? Need input from more experienced nurses please. Thanks alot for any imput.
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  2. 17 Comments

  3. by   kewlnurse
    They get easier, I personally don't get the adreneline rush anymore. Don't quit just because of 1 code, hang in there, they are few and far between and not everyone dies.
  4. by   donmurray
    That's right, hang on in, I still recall my first, in 1977! I came on duty at 7am. and the night nurse passed me on the way in with "Great! take over from Jenny!" I entered the ward to find the crash taking place in the middle of the "Nightingale" ward, with all the other patients' screens closed, and Jenny kneeling on the bed doing chest compressions! I took over, we didn't get him back, I do remember at least two of his ribs broke, and I later found out that he had gone just after 6:20am. Only one in three codes is completely successful, so the chances are you don't win them all. You just do the best you can.
  5. by   hoolahan
    I don't even want to tell you about my first code. It was a nightmare!!! I felt so incredibly stupid. Nothing can prepare you for this in nursing school.

    It will get easier. If you haven't already, take an ACLS course to learn more about code, and be able to do code simulations. With experience, you will learn that you will not be able to revive everyone. Some people will have heart muscles like mush to start with, and nothing on God's green earth will bring them back. I firmly believe that when it is your time to go, no medical technology or know-how will keep you here any longer. I have also felt the sensation of cracking ribs, and it is icky, but not much you can do about it in the old folks, even with proper hand placement.

    I had a 96 year old lady I saw in home care who choked on food in a chinese restaurant. Luck of all the luck in the world, there was a nurse in the restaurant having lunch with her brother, the pulmonologist! They brought her back even before the ambulance came. She had several fractured ribs. I explained to her with age and ostoeporosis, ribs fracture easily in the elderly, but I said, at least you're here to c/o about them hurting. I said, God's not finished with you yet. She smiled and said, "Yes, I think he likes me." She just made my day with that cute smile. I love the old folks, but I would rather see them die than suffer in the ICU unecessarily, sometimes.
  6. by   e-nurse
    I had my first one just last week @ 11:49 on Tuesday 9-11! Yeah. Talk about your bad days! It was called @ 12:25. It was awful. Buildings were collapsing on the TV, the world was ending, and even right there in front of me my patient was dying. I actually think it was a good day for it b/c I was already numb from the mornings events, and it almost seemed like it could be normal to be having a code. Sure, why not? You know? Turns it it was a bilateral PE. Sudden like you would'nt beleive. She had just gotten back from Cardio Echo. I guess it just happens.
  7. by   hoolahan
    Oops! Duplicate post. Trigger finger again, sorry.
    Last edit by hoolahan on Sep 20, '01
  8. by   P_RN
    Don't be ashamed of crying. I cried at my first, I cried at my last......but what astounded me was the first time we laughed....I thought how crude, how shallow...then a really great trauma surgeon told me that tears and laughter are sometimes the same...they are a release......

    The first and ONLY time I ever did mouth to mouth....this was YEARS ago obviously......was on a young man who had terminal lung cancer, he knew he was dying, but was only in the hospital for a fractured hand when he coded. He had told us just a few minutes before that he was prepared to die, but wanted to see his little girl before he died; she was at her grandmother's about 60 mi away.......

    Gloria and I did CPR on him.....we felt it was at his request......and he got to see his wife and little girl, after he was resuscitated.....he died later that week. I still want to smile about that one.

    So be happy you cried, you will learn the technique by rote, but you will always cry, at least I hope so.

    P
  9. by   cmggriff
    My first was in 1984. I was still in Orientation. Unlike kewl I still get the rush. Some go betteer than others. ACLS helps you be more prepared, but nothing stops the pain of losing a pt. Good luck, Gary.
  10. by   radnurse2001
    Hang in there. I still cry at my unsuccessful codes, and I've been a nurse for 11 years. I agree you should take a ACLS course, it does help. I remember my first code like it was yesterday. He was a renal patient who ruptured his decending aorta. It was a nightmare. I was a student and made a pretty good IV pole. For the first few codes, if you can, record. It will teach you how a code is run, what meds are used etc... Don't be suprised if even after all that you still freeze up once in a while. Also don't be suprised when you start to notice that "code look", and can predict who will code. The first few times are spooky.
    Good Luck .
  11. by   jimminy
    Its good you can cry! Everyone handles it differently, IE: Black humor, crying, laughing, smoking, quiet time. My hardest one was coding a 13 yr old boy GSW victim. He looked just like my 13yr old son. Putting him in a body bag was the hardest thing I've everdone. I went home later, woke up my son a gave him a hug and kiss and thanked him for being where he was supposed to be. This boy that died had snuck out of the house in the middle of the nite. His family got a call to come to the hospital and they didn't even realize he was gone. It was soooooo sad!

    I agree, get your ACLS. It will help. Also be the one to record for a while. It gives you a chance to see the flow of the room versus being focused on just one activity such as IV insertion.
  12. by   canoehead
    My first code the doc says "bag him" and I couldn't for the life of me think what a bag was, figured it had to be in the crash cart somewhere. Then got the deer in headlights look, and the other nurses on the floor worked around me.

    Now if I'm supervising and think someone is going to code I warn the least experienced nurse and ask them if they would like to do chest compressions or just stand and observe. They know to do what they are told, and to get out of the way. No one expects a newbie to be the leader, just follow directions. Oh, and unfortunately at many codes where the adrenaline is flowing someone usually gets snapped at for moving too slow,or for not understanding, and lots of times its the one person who doesn't realize that being rude is part of the ACLS protocol for some people. Just let them spew, it helps them think.
  13. by   CEN35
    being rude is part of acls protocol??? lol! never heard that one before! :d

    anyways.......................
    i don't think anybody falls in and does everything and remembers everything, one year into it........much less two months. i am sure we have all had our moments.....otherwise you would be known as god. i had the same feeling, with sooooo many things.....for the 1st 6-12 months i worked as an rn. now???? i laugh (inside my head at the newbies).....note i said inside my head........i would never do that to a person. as far as the adrenelin rush? imo.....that's something that happens to fairly new people, who pretty much feel like they have acls down pat.....and are going to save the world. five years into it........and when we get a trauma patient, and code, whatever.....there is no more adrenelin rush (except for kids.....i have lost a few...and you try your hardest and it kills me everytime).......otherwise.....i just stroll in......and you just start going to it.....and thinking about what your doing. the adrenelin rush, can be a bad thing at times.

    i will never forget something one of my nursing school instructors said to me, and it makes 100% sense: it does no good, to get excited, panic, or run around like a chicken with your head cut off. no matter what they say about, the 1st minute or two minutes......that always made perfect sense to me. you can run around for 20-30 seconds or more, and barely do a thing......and still not be ahead after that 30 seconds. the patient will do much better, ir you stop.....and take 10-15 seconds...clear your head and say to yourself.......what is the problem.....what do i need to do? then do it!!!!!!!!!

    time will tell.........you shoulnd not feel bad, after only being an rn two months. i know people that have been an rn for two years or more......and they are clueless. they should be the people who are upset.


    smile..........you'll be fine!!!!

    me
    Last edit by CEN35 on Sep 24, '01
  14. by   nur20
    Originally posted by tonia
    I have been a registered nurse for only 2 months. I had my first code on 9-15-01 at 1730. I had never done chest compressions or bagged a real person. It seemed like all my teaching went out of my head. I couldn't think if it was 1 mississippi 2 or 1 and2. It seemed like I couldn't remember anything. The code was called at 1755. I cried and cried. I have been in the nursing field for 10yrs but never have I physically been the one to do the CPR. I left that code saying I didn't think I wanted to be a nurse any more. I guess I just needed to vent. I was wondering if it ever gets easier or with time will I feel more prepared or whatever for situations like this? Need input from more experienced nurses please. Thanks alot for any imput.
    It does get easier,don't be down on yourself,sometimes it does not help,but you did spring into action. I am an American Red Cross C.P.R. instructor and there are new stipulations in place including teaching persons to to use the smaller Defib machines. They will be located in public places. The rules for C.P.R. are more relaxed now, because quite a few people had the same problem that you mentioned, including nurses.Don't even try to remember that 1 mississippi,2 mississippi anymore. Those strict guidelines have relaxed. The Red Cross now says any attempt for breathing and compressions is a good thing and certainly will help. This is why it is important to activate the EMS system first if possible so they can be on their way. If you haven't heard of the new guidelines yet, i'm sure you will in your next class

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first code blue