First code - help/advice

[LouisVRN, RN]

So had my first code this morning. It was unexpected. I am a new charge nurse and wondering if someone could give me advice, ideas for improvement for the next - assuming this will unfortunately happen again at some point - time. I was there finishing some documentation on a prior incident when it was called. I went to grab the code cart as other people had already started CPR. I was also able to provide a brief synopsis of pt hx once the code team got there, although not as much as I would have liked as i had already given report and threw my paperwork away, one thing I learned was probably to keep the paperwork until I'm on my way out the door. The code team at our hospital basically does everything so I basically delegating getting supplies to the other nurses from our floor that had come to help. Overall though I felt kind of useless. I was able to anticipate some of the things I thought they would need ahead of time, like suction, and get those readily available before they asked, but missed some obvious ones like normal saline and saline flushes. We are not ACLS trained. The other thing I think would have been beneficial would to tried to have gotten the story of what had happened from the nurses before the code team got there and had delegated one nurse to providing information to the code team. As it was whenever they asked a question two to three people would respond with information. Otherwise, what should I do/know for next time?

[NO50FRANNY]

Hi there,

It sounds like you did really well. At my facility our code team is just two people- an ICU doctor and ED RN (me). You anticipated things, were able to give a history and so on which is great. The last arrest I attended had nurses such as yourself who were very helpful. It is our responsibility to delegate and run the code, don't worry about feeling üseless", I'm sure that you weren't- getting supplies is very important! The last thing I need is to have to run around trying to find things. I know that at the last arrest I went to everything that I asked for was in my hand straight away, the nurses were paying attention to me, giving me new sets of gloves, wiping my face! Codes are a messy affair so don't feel like you need to anticipate everything, that's our job. I guess from my side of the fence the most helpful things to remember are keeping people away who don't need to be there, making sure other patients are not distressed who are nearby, and most of all just keeping calm. It may be worth checking out some information about ACLS. It will give you some understanding of what processes to expect and how you may be able to help, even if you are not certified you will know the process/algorithms, drugs and interventions to expect. Learn about your ABC's and basic bad cardiac rhythms, you will be more confident to step in and help. I usually ask someone to draw up a tray of flushes as soon as I arrive, they will get used. Just remember arrests are like everything else you do when nursing, repetition is how one gets good at it, and the patient is already dead so we can only improve from there. It's always a team effort and it sounds like you did great.

[DookieMeisterRN]

It can and is a different experience each time. Sounds like you did great! Remember, it's a team event, you're not being tested. When I call a code on my pt I pull up the EMR on the computer in the room so info can be accessed and that's usually where I stand as the DCN, the CN is usually outside the room after the team arrives to help delegate other nurses to attend to my other pts, place orders, fetch supplies, make phone calls, direct the team. Rarely do I see the CN stay in the pt room for the entire code, the rest of the unit can fall apart fast. There would only be the DCN in the room also, not other floor nurses. Who is taking care of their pts? There is usually enough help from the code team where I work and floor nurses aren't needed as it gets too crowded and chaotic. The more you are involved in the smoother it will seem and try to get management to send you to an ACLS class, it will help it all make more sense.