My first code

Nurses General Nursing

Published

Specializes in med/surg, oncology.

I have a question I hope someone can help me with. Last week while at work, a nursing assistant came out of a patient's room and states "Mr. ***** dosen't look too good" That pt's nurse was on the phone, so I went in to look at the patient and we was unarousable, so I started to hook up the dynamap to get a set of vitals for her, when he stopped breathing. By this time the pt's nurse was in the room and initiated a code. Of course we (me and yet another nurse) ran for the code cart while the doc started compressions. When we came back with the code cart, I handed the doc the ambu bag and then I took over compressions. Well the code progressed for about five more minutes when the pt's nurse says, (after looking at her notes) "Wait he's a dnrcc!" Obviously the code stopped and sadly the patient expired. She called a code on a dnrcc patient. My question is, could I get into trouble for being involved in the code when I did not know his code status since he was not my patient?

Up Vote Up Vote ×
Specializes in Surgical.

No, you responded to a code called by a fellow employee. It is impossible for everyone who walks in the door to verify the patients code status before joining in.

Up Vote Up Vote ×

coding a dnr patient can be seen as an assault..although your pretty much in the clear, the others im not so sure about.

Up Vote Up Vote ×

It sounds more like a systems problem to me. Is there no way to mark patients as code or no code? I know some hospitals that had certain notes or colors on their ID bands or above the bed or something. I don't know whether this is allowed anymore or not.

Up Vote Up Vote ×

At my hospital, DNR's wear a green band on their wrist. "Green means go - let them go." We also put green tape on the door and indicate which bed is DNR.

I think this is a great policy.

Up Vote Up Vote ×

At my hospital all who are a DNR have a blue dot sticker placed on their arm bands and on the front and side of their charts. Seems to work well for us.

Up Vote Up Vote ×

"Green means go" - and this is supposed to stop you?

That is confusing considering the world uses the universal color of red to mean stop and green to mean go.....

Up Vote Up Vote ×
Specializes in med/surg, oncology.

I guess it was marked on the patient's chart because the nurse kept saying "it was all over the chart and I called a code." I do not recall this patient wearing an armband. But we do have them they are blue. I think we need a system where there is a sticker of some color representing their code status on the door with their name on it. I just feel horrible. This was the first code I have ever participated in. And to think I did this to him (chest compressions) against his wishes. Everything just happened so fast. Ten minutes prior to this, he was up and walking to the bathroom! I feel so bad!

Up Vote Up Vote ×
Specializes in Education, Acute, Med/Surg, Tele, etc.

My facility doesn't have such markings for patients since I am in assisted living and it gets very confusing! The DNR is located in their charts, which for the most part are quite a hike away from a patients room and well...this could very easily happen, but so far so good (we use codes on the walkie like STAT for potentially life threatening calls like codes so the nurses know to get that chart on their way!). That and I ask "are we in the pink?" which means do we have a DNR order (our POLSTs are pink).

I tried to initiate having residents post their code status paperwork inside the door of the first cabinent of their kitchenette...but managment said that was too morbid and won't allow a DNR to be posted anywhere! Then I suggested a sticker on the bindings of the charts..that didn't fly either because they use colored stickers that tell what level of care they need.

So basically I go with the rule, if you don't know...you code! Luckily for me the CNA's know this well, and we all tag team on finding that chart before we code a patient!

It is tricky, because you can get into trouble for coding a non code patient...and my CNA's will be held accountable if it is their patient (but say a float...proably not) and me because I am RN (and I guess assumed to have ESP or super mind powers that can feel a DNR at 30 paces...LOL!). But so far so good like I said...we normally notice changes or they get us nurses before they go apnec or pulseless...(knock on wood!).

In hospial (back when I did hospital), we also had color stickers on wristbands...that was a large help! It was also marked along with their allergies on a sticker on the binding of their charts, and a colored sticker on the room number sign, and marked on the assignment board too. Couldn't help but notice then!

Up Vote Up Vote ×

What a great idea to identify DNR's. Our unit is fairly small and we have many hospice pts. Code status is usually identified on pt demo sheet and during report. I know if a code was called, I would probably not stop to check out code status myself.

Up Vote Up Vote ×

I have seen literature supporting the use of a wristband with the letters DNR/AND on it, supporting the DNR order. Using the text is safer than a color coded band because color mean different things in different hospitals. Also, this is immediate notification if the patient chart is not with the patient. What do you think about this idea?

Up Vote Up Vote ×
Specializes in Infection Preventionist/ Occ Health.

At my hospital the DNR patients wear blue wristbands. For a while they had problems because the tsunami relief bracelets are also blue (don't think anything actually happened), so they instituted a policy forbidding colored bracelets for patients.

Up Vote Up Vote ×
+ Add a Comment