new nurse-i feel useless when a code is called.

Celia M, ASN, RN · Oct 3, 2005

At our hospital the education department runs a Code Blue and a Code Pink class several times a year. Any nursing department employee has to attend one of these classes when they first hire on. They give you an overview of the code situation and let you get hands on experience with the crash cart etc. It is mandatory yearly after that for those who don't do PALS , ACLS etc. Its an excellent class and really gives a good idea of what happens in a code and what roles you cna play without the stress of ACLS testing or being in the actual code. See if you hospital or any of the local hospitals do something similar. :)

indigo · Oct 3, 2005

I am a new RN and have been through only one code. Even though our patient died, it was amazing to watch everyone jump into action. For the first half of the code, I was more or less a gopher, then I became recorder. It was then that I really could hone in on what was happening. I felt useful and less stressed than I had earlier. I had never seen someone die before, so it was a sentinel event. I am going to take ACLS. I know I can handle whatever is thrown at me....that helps. :specs:

nursemike, ASN, RN · Oct 4, 2005

Get in there and do chest compressions! It's not mindless work or anything, but you can at least peripherally observe what else is going on and get more comfortable in a code situation. If you're doing compressions, no one can ask you to do meds, defibrillate, etc.
Or, if there is no resp. therapist, you could bag the patient.
Just until you become a little more comfortable in an emergency.

My nurse manager gave me this same advice, and I think it's brilliant! Haven't had occassion to implement it, yet (and would be delighted if I never do) but I've assisted marginally in codes as a UAP, and just being in the room gives a little sense of what's going on.

Gompers, BSN, RN · Oct 4, 2005

I work in the NICU, so our codes are a bit different. We don't defibrillate, use very few cardiac drug, stuff like that. Our codes are usually respiratory, so the often involve things like reintubation, needle aspiration of pneumos, and chest tube placement. But they're still terrifying, and not just for new grads!!! Thank goodness we don't have codes very often.

Whenever we do have one going on, we grab the newer nurses to observe. Someone shows them how to record and draw up drugs, so that the next code they witness, they can at least help with that stuff. Usually we'll give the newest person the job of recording. For one thing, it's the least nerve racking because it's not actual patient care. For another, by recording what goes on during the code, it helps the nurse learn what usually happens during this situation, so that she knows what to expect next time. We'll also try and get the newer nurses in there to do chest compressions.

I agree that you definitely should take ACLS or whatever critical care course your hospital offers.

Honestly, codes are terrifying for everybody. You never really get used to it. Yeah, you get experience so you know how to do everything. But emotionally, I don't think anyone ever really gets comfortable.

Antikigirl, ASN, RN · Oct 4, 2005

I sooooooo agree with the ACLS and experience advise...and here is something I tell my fellow nurses that feel the same, and my CNA's!

When a person goes into full cardiac arrest...THEY ARE DEAD! So doing anything you can is a BONUS! Don't worry so much on the count of compressions vs resps...just start pumping/breaths well! Anything is better than nothing! As long as you are trying to the best of your ability at that given time...you are doing awesome!!!

I have had lots of nurses/cna's do their first code with me, and I really am calm and walk them through it calmly! WHY? I actually was terrified of codes, and chose to voluneer for a few ride alongs with paramedic to get some experience! Now I am a pro! I keep my ACLS up to date, and actually use my skills every once in a while sadly (I am the ONLY ACLS nurse in my facility...I am called to all codes as the primary!). Pretty good for a gal scared to death of them...now it is so automatic...but it took ME finding my own way of understanding on what to do..and the advise I just gave..."Triage, they are dead...do what you can and turn this thing around".

I have lost only ONE out of 50 or so, so being calm, gaining experience, being calm has really helped! It is a treatment...keep thinking that...a treatment less involved in my opinion than most sterile dressing changes! :)

You can do it...find your fears, understand them...and work to over come them...a major part of healthcare..understand, learn, adapt, and perform! :)

JulieRN07 · Sep 8, 2007

I know this is a few years overdue, but I just wanted to thank all of you for your helpful advice. Things have gotten better with experiance. The nerves are pretty much gone!

Thanks again!

Christie RN2006 · Sep 8, 2007

The best way for me to learn and become comfortable with things is practice. Do you have a code team at your hospital? If so, ask if you could run with the team for a day whenever there is a code.

Taking ACLS is a good idea because that way you can push meds, etc. and you have a more in depth knowledge on what is going on and why things are done.

One thing to remember though is don't be afraid to say you are not comfortable doing something or admitting that you don't know something. A code is not the time to be practicing things you are not comfortable with/good at. Also, if there are already too many people in the room, step back and let them handle things. There is nothing more frustrating than people getting in your way in the middle of a code. That was a hard thing for me to learn, because I am a very hands on person and I like to be in the middle of action.

margom · Sep 9, 2007

i used to feel the same way when i was new out of school. i worked in the er and i loved it! i just felt that i was inexperienced and in the way most of the time. i found that if i was the gopher and got things for other people or was the scribe and writting it all down, i could still be a part of the team and learn and become comfortable doing codes at the same time. be kind to yourself. it will happen! learn all you can and hang with the people that like to teach, they are always around. pretty soon there will be someone newer than you and you can teach them a thing or two. best to you. peace

margo

DeLana_RN, BSN, RN · Sep 9, 2007

You don't have to be a new nurse to feel uncomfortable in a code - I still have "codophobia" after 9 years! Of course, it didn't help that I had been away from the hospital for a long time and my outpatient setting had exactly one code in 5 years.

Now I'm back in the hospital and, although reassured that help is close by, wish I felt more comfortable with the situation (we haven't had a code in my unit yet). I would take ACLS, but it's not required for my position (inpatient dialysis) and therefore not paid for. BLS isn't a lot of help.

Maybe I'll take ACLS anyway, I sure would love to feel comfortable with the crash cart (other than dusting it off daily :lol2: ).

DeLana