Quote from chiromed0
Okay, I didn't think this would bother me as much as it does but I had my first patient die today. All my patients are kind of on the edge but generally make it out. I work in a cardiac unit that basically doubles as an ICU step down/Intermediate care unit. I've been lucky so far in 6 months of nursing (yes, I'm a newby) nobody has coded on me. However, this came out of the blue today on a patient I never would have guessed was in distress.
My issue? I have the certs: BLS, PALS, ACLS and a few degrees: ADN, passed all my BSN courses and working on my RN to MSN-NP, I also have a BS in Anatomy and a D.C. degree. All that to say I don't know squat in a code situation. I felt so incompetent not knowing where to begin and what was going on. Yes, I remember the parts/pieces but my ACLS class was videos by a paramedic talking using plastic dummies. How about you guys? Is this typical in a first code situation to stand back and watch? I feel bad b/c that's MY patient and I wanted to help not just do post-mortem care, I have knowledge not skills, and the other nurses know I've got background (albeit useless in this situation).
I will say this inadequate feeling is not specific to this situation. Heck, I've felt this way since day one but I've progressed a lot in 6 months I think (maybe not?). I'm just really tired of feeling helpless and only able to contribute 70-80% to my patients because I just don't have the experience or specific job knowledge. Sucks. I'm used to knowing what to do and that just ain't gonna happen anytime soon and I'm overwhelmed with learning bedside nursing AND advanced practice nursing. Yes, it all has similarities to what I already know as a D.C. but the information is used differently and the skills are vastly different. Thanks for reading my story...looking forward to hearing your experiences.
At six months, it's normal to feel as though you're only contributing 70-80% to your patients. You don't have the experience. And it's normal to not know what to do in a code situation, certifications be damned. You were probably better off standing back and watching than getting in the way. The only way to GET competent in code situations, though, is to participate.
When YOUR patient codes, you will of course activate the code team -- or whatever they do on your unit. We run our own codes, other units do not. Once the code team shows up and you can get off the chest, you should be standing next to the patient's IV access pushing the code drugs. Since you've been taking care of the patient, you presumably know what's running through the IV access, how sensitive the patient is to its being interrupted and can ask (if you don't know) if that drug you're about to push is compatible. It's a relatively safe place to be -- you can see everything and watch everything and yet you're participating.
When someone else's patient codes, try to help out by being the recorder. It's another way to watch everything that is going on, and at the same time you can start putting together how things work and start anticipating what they're going to do next in this situation. Being on the chest is another relatively safe place to be -- you can see and hear everything and you already know how to do CPR, right?!
We've all been newbies. We've all been through our first code and most of us felt utterly useless during that code. (Sometimes multiple codes.) We've all felt inadequate to the assignments we have or the task at hand. That's all part of being new. You'll get through it. Unfortunately, the only way to GET through it is to GO through it. You're at the halfway mark of that first awful year . . . congratulations. It'll start getting easier now.