How important is it for a Charge Nurse to be able to run a code? - page 3

Another thread here today got me thinking. On a scale of 0 to 10, with 0 being totally unimportant and 10 being absolutely essential, how important is it for a charge nurse to be able to run a code?... Read More

  1. Visit  psu_213 profile page
    0
    It depends on the hospital, how quickly the code team will be there, etc, etc... Where I worked before, I would rate it about a 2. Recognize a deadly rhythm, call the code, check a pulse, have someone start CPR, get the crash cart, get the pads on... Maybe give the first drug/shock if indicated. Either way, the floor RNs/charge should not need to actually "run" the code.

    At my first job as an RN, they wanted each floor nurse to be telemetry (though no necessarily ACLS) trained and be able to start CPR and analyze the rhythm/shock using the AED.
  2. Visit  love-d-OR profile page
    1
    As the person that stated a charge nurse should be able to run or at least know what to do in a code in the other thread the OP is referring to, I'm glad to see many of my peers on this forum agree that it is an essential skill. A charge nurse should be a resource for the nurses working on the unit. The charge nurse does not have to know everything, but enough to know what she/he does not know and to support the staff.

    In my unit we run ours codes. We do not call a code blue, and we do not have a RRT in the hospital. Events usually go like this: nurse recognises the event, calls for someone to get the crash cart --> we starte coding as the secretary or someone else pages the resident rotating that month and calls the charge nurse. The resident may or may not come immediately but usually they do and we continue.

    I work in a busy ICU and all our charge nurses have over 10 years of experience and are very smart and capable. A lot of times the junior residents look to us to know what to do, so it is very crutial that we have knowledgable people working the unit. Most especially those in charge. I understand this might not be how things work in other units, so I know why some people might feel comfortable being in charge with only 2.5 months of experience as an RN (since probably its the norm at their hospital).
    Altra likes this.
  3. Visit  PMFB-RN profile page
    0
    Quote from love-d-OR
    As the person that stated a charge nurse should be able to run or at least know what to do in a code in the other thread the OP is referring to, I'm glad to see many of my peers on this forum agree that it is an essential skill. A charge nurse should be a resource for the nurses working on the unit. The charge nurse does not have to know everything, but enough to know what she/he does not know and to support the staff.

    In my unit we run ours codes. We do not call a code blue, and we do not have a RRT in the hospital. Events usually go like this: nurse recognises the event, calls for someone to get the crash cart --> we starte coding as the secretary or someone else pages the resident rotating that month and calls the charge nurse. The resident may or may not come immediately but usually they do and we continue.

    I work in a busy ICU and all our charge nurses have over 10 years of experience and are very smart and capable. A lot of times the junior residents look to us to know what to do, so it is very crutial that we have knowledgable people working the unit. Most especially those in charge. I understand this might not be how things work in other units, so I know why some people might feel comfortable being in charge with only 2.5 months of experience as an RN (since probably its the norm at their hospital).
    *** I take it for granted that an experienced ICU RN can handel any role in any code situation. We don't call codes in our ICUs either, nor to they call RRT. My comments were in relation to a tele floor where the OP works.
  4. Visit  LouisVRN profile page
    0
    I think it is important 10/10 that the charge nurse is able to handle the initial steps if there is a code, call the code overhead, get the crash cart, get the bed positioned, try to make sure there are multiple iv accesses, fluids.
  5. Visit  anotherone profile page
    1
    Does it depend on where you work? I work in med surg in a huge teaching hospital. Most of the nurses on the floor are NOT ACLS certified. Charge role is often assigned randomly. If a code where to be called in about 2 minutes the room would be filled with about 20 MDs all ACLS certified and the code team.
    wooh likes this.
  6. Visit  hherrn profile page
    0
    Quote from ~*Stargazer*~
    Another thread here today got me thinking. On a scale of 0 to 10, with 0 being totally unimportant and 10 being absolutely essential, how important is it for a charge nurse to be able to run a code? Are there other leadership qualities that are more important?

    The reason I ask is that I was recently at my ACLS refresher. One of the charge nurses from a 40 bed inpatient telemetry unit was in my group. This nurse should not have passed the ACLS refresher, IMO. He or she struggled every step of the way, and had it been a real code, I would have feared for this patient.

    Now, I'm not saying that *I* could run a code seamlessly. There is a huge difference between a classroom environment and the real deal. But, I am not a charge nurse.

    What say you?
    I think it's more interesting that the nurse's gender is indistinguishable. That's uncusual. Unfortunately it's quite common for people to get ACLS without the ability to be marginally helpful, let alone manage a code.

    In a recent PALS course, the instructor started with "Don't worry. You are all going to pass."

    Apparently these courses used to be hard and intimidating, so many would not take them. In my experience many come unprepeared, and the course is dumbed down for them. More certifications, lower quality.

    A better question is whether anybody who holds an ACLS cert should a least have a reasonable shot at running a code.

    And yes- A charge nurse n a 40 bed unit with ACLS certification should be able to manage a code.
  7. Visit  anotherone profile page
    0
    Quote from anotherone
    Does it depend on where you work? I work in med surg in a huge teaching hospital. Most of the nurses on the floor are NOT ACLS certified. Charge role is often assigned randomly. If a code where to be called in about 2 minutes the room would be filled with about 20 MDs all ACLS certified and the code team.
    2 minutes is a long time. But in our unit we would def be able to position the bed, get the crash cart, start cpr, etc before than. I really wish we always had an experienced charge nurse or experienced nurse around but we don't. Some times it is to the point where someone with 2 years med surg experience is a verteran.
  8. Visit  RNChristy profile page
    0
    Quote from PMFB-RN
    *** I take it for granted that an experienced ICU RN can handel any role in any code situation. We don't call codes in our ICUs either, nor to they call RRT. My comments were in relation to a tele floor where the OP works.
    Even on the ICU/CCUs that I worked on, we always called the codes so the ER doc and RRT would respond. If it was an impending problem that had not gotten to the point of a code yet, we always just called the ER doc for intubation if needed or informed the attending or specialist. I have actually worked with ICU nurses that had no clue where or what things were in the crash cart though, which was very sad. Sometimes, they had been there longer than I. That is another reason that I always made sure that I was familiar with the procedures.

    Christy, RN
  9. Visit  netglow profile page
    0
    Heck I just re-upped my BLS, some nurses fumbled severly even with the CPR practice, and then were still working on the written test, or were being educated on things they got wrong by the instructors after I left ?! These were nurses with many years experience. This is basic response folks.

    ...and some of us can't get a break for a hospital job.
  10. Visit  GARN912 profile page
    1
    It could be that he/she struggled because it was a class and not the real thing. I've gone through a class with a nurse who has been an lpn for over 30 years and the way she acted and responded to questions and during mock code would make you think it was time to retire. But in actual codes she is totally different. In fact, she will tell the doctor what they need to do. There is something about having to perform in front of people in those acls classes that some people cannot handle. I would think (and hope) that the charge nurse has made it this far for a reason.
    wooh likes this.
  11. Visit  mama_d profile page
    1
    I work nights on a tele floor at a 350 bed hospital. A few weeks ago we had the craziest night I've ever seen. Two code blues, a code stroke, a RRT, and a trauma roll up to the ED all within an hour. Spread out over different floors, of course...if all those happened in one night on my floor I'd still be gibbering in the corner!

    So, yeah, a charge should be able to theoretically run a code if necessary...on tele floors and up at least, since our med-surg nurses aren't ACLS certified. Even at that, by the time the code team shows up, basics should all be done...CPR, suction, NS up and running, pads on, etc...no matter what floor or area you're talking about.

    IMHO, no one should be thrust into the charge role without significant experience under their belt. My facility requires a year as a RN, which I don't think is anywhere near enough time to be comfortable dealing with emergent situations, b/c there's just not been a chance to get enough experience. Minimum should be participating in several code blues and code strokes if you're talking the acute care side of things. There's nothing worse than the blind leading the blind until the calvary arrives.
    netglow likes this.
  12. Visit  wooh profile page
    1
    Quote from NevRN912
    It could be that he/she struggled because it was a class and not the real thing. I've gone through a class with a nurse who has been an lpn for over 30 years and the way she acted and responded to questions and during mock code would make you think it was time to retire. But in actual codes she is totally different. In fact, she will tell the doctor what they need to do. There is something about having to perform in front of people in those acls classes that some people cannot handle. I would think (and hope) that the charge nurse has made it this far for a reason.
    This is me. Imagining all the parts of the scenario takes up brain space that in real life I'd be using to fix the patient. I'm a VERY visual person. And not at all auditory. The scenarios KILL me. I need to see the person, see the symptoms. Hearing them doesn't register for me at all, so renewal kills me. I rock on the floor. I rock the written exam. I suck at scenarios. I saw an RT struggle with a PALS recert that is one of the people I'd want in the room if a patient was actually crumping. And I've seen people that rock the scenarios that suck in the real life situation. So from experience, I don't judge based on how people do in scenarios.

    That said, I think it all depends on facility. Previous facility, charge from each floor would respond to the code. We'd never be the ones running the code though, that would be the ER doc. I think being comfortable in the situation is all we really needed there.
    Current facility, there's an entire code team, and only the primary nurse stays in the room. Here, I think being able to get things ready for the code team is what's needed, definitely don't need to run the code because most of the time won't be in the room.

    It seems a lot of people are taking glee in how much better they are at coding patients than other nurses. Personally, I take pride in my ability to keep my patients from reaching the point where they are coding.
    SweetOldWorld likes this.
  13. Visit  K+MgSO4 profile page
    0
    Just a curiosty aside.......... any trained monkey can do chest compressions. All staff in my hospital are refreshed on CPR every year. So I'd have a porter or CA doing compressions. I can do it...but they cannot insert IV's, hang fluids, insert an LMA. Having a nurse compressing is a waste. Get a CA or student to do it.


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