New RN, terrified of codes and emergencies

  1. Hi everyone,

    I'm a new RN and have only been on my own as a nurse for a little over a month. I have anxiety, which I have had for a long time, that is starting to creep into other areas of my life.

    I am constantly fearful of codes, emergencies, etc. I know the fear in general is normal, but I also feel that the level of anxiety I have about it definitely isn't normal. There aren't many codes on the unit I work, but the possibility of one happening is enough to cause me to be anxious. My greatest fear is to walk into a pt's room and find them unresponsive. Thinking of that makes me sick. I know what to do (in my head), but I feel like I'll just freeze or panic and be useless. I'm scared and it's starting to interfere with my desire to even continue being a nurse. I'm also on night shift so I don't know if that has anything to do with me feeling anxious and depressed.

    Has anyone else experienced this?
    Any advice?

    Thanks guys!
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  2. 30 Comments

  3. by   snowflower2016
    Hang in there. I think this is a completely normal feeling. Have you been involved in any Rapid Responses or Codes? I would suggest going to ALL of them....observe at first. Watch and observe the different roles that people take and how things progress. Eventually get in there and get involved. Record keeping is a good start. Chart vitals, who is in attendance, what is happening, what medications are given, what is the patient's status, etc (however your unit policy dictates). Taking vitals is another role you could take. When you're ready or when the time comes, instinct will kick in and you won't even think twice about jumping in and doing compressions. I have anxiety about drawing blood in an "emergency" when others are watching, so I let others do this and I do other things that I'm more comfortable with. If you're not in an ICU or the ER, codes are not that common so hang in there and don't give up.
  4. by   dd05434
    Quote from snowflower2016
    Hang in there. I think this is a completely normal feeling. Have you been involved in any Rapid Responses or Codes? I would suggest going to ALL of them....observe at first. Watch and observe the different roles that people take and how things progress. Eventually get in there and get involved. Record keeping is a good start. Chart vitals, who is in attendance, what is happening, what medications are given, what is the patient's status, etc (however your unit policy dictates). Taking vitals is another role you could take. When you're ready or when the time comes, instinct will kick in and you won't even think twice about jumping in and doing compressions. I have anxiety about drawing blood in an "emergency" when others are watching, so I let others do this and I do other things that I'm more comfortable with. If you're not in an ICU or the ER, codes are not that common so hang in there and don't give up.
    Thanks so much! I've only been in 3 codes. The first two I mainly observed. The most recent one was my second week of orientation as an RN, and it was my patient. I did compressions and they survived and were discharged home with no deficits. Still anxious though.
  5. by   JKL33
    I'm sorry you're feeling this way - it's pretty common and you will feel more confident with time.

    My answer is a bit different - times of extreme anxiety call for BASICS. You say you know what to do. Therefore, for right now, in your mind you need to think of your responsibilities in terms of the immediate basics. When you think of it this way, you will be able to act without delay should your worst fear happen.

    The paralysis comes from thinking too far ahead. You do not need to be an expert at correctly putting on defib pads or quickly finding/preparing meds from the crash cart. Right now while you are not yet the code expert, your job is to quickly and immediately do about 3 things.

    What 3 things will you do (regardless of any uncertainties about anything else, including "what happened here??") when you enter a room and notice your patient is possibly unresponsive and/or has no normal breathing?
  6. by   dd05434
    Quote from JKL33
    I'm sorry you're feeling this way - it's pretty common and you will feel more confident with time.

    My answer is a bit different - times of extreme anxiety call for BASICS. You say you know what to do. Therefore, for right now, in your mind you need to think of your responsibilities in terms of the immediate basics. When you think of it this way, you will be able to act without delay should your worst fear happen.

    The paralysis comes from thinking too far ahead. You do not need to be an expert at correctly putting on defib pads or quickly finding/preparing meds from the crash cart. Right now while you are not yet the code expert, your job is to quickly and immediately do about 3 things.

    What 3 things will you do (regardless of any uncertainties about anything else, including "what happened here??") when you enter a room and notice your patient is possibly unresponsive and/or has no normal breathing?
    Assess ABC's/responsiveness, call for help, start CPR.
  7. by   JKL33
    So the next part is using healthy self-talk. You do know what to do, and that is exactly what you WILL do when you face these anxiety-provoking situations. If your mind starts racing with all the what-ifs, reign it back in and focus on the fact that you know these basics and there's nothing to fear because those are what you are going to do when you need to. The thing about thinking this way is that it not only helps with the feelings of anxiety but it will develop your confidence. Because you know. You DO know what you are going to do.

    Let all the other what-ifs go for right now.
  8. by   smf0903
    I will also add a piece of advice I got after my first (MY patient) code: take a breath! I had been to and participated in codes but they were never my assigned patient. The first time one of my patients coded I was literally shaking from the adrenaline. I did what I had to do but I'm quite sure I would have been processing and thinking much clearer had I taken a nice deep breath walking into that.

    I talked about this with another nurse that I trusted and who has 30+ years of experience. She said "hey, it's a stressful situation and I will tell you what another nurse told me years ago, and that is to take a second to take a deep breath." Granted you can't stand there and get yourself centered for five minutes but you'd be surprised at how that one deep breath will help you focus.

    The other advice I have is get familiar with stuff. Ask to have the crash cart drawers opened so you can see where stuff is at. We're scared of what we don't know, things we are unfamiliar with. Crash carts can always be retagged. Regularly look at your ACLS algorithms.

    Good luck to you!!
  9. by   dd05434
    Quote from JKL33
    So the next part is using healthy self-talk. You do know what to do, and that is exactly what you WILL do when you face these anxiety-provoking situations. If your mind starts racing with all the what-ifs, reign it back in and focus on the fact that you know these basics and there's nothing to fear because those are what you are going to do when you need to. The thing about thinking this way is that it not only helps with the feelings of anxiety but it will develop your confidence. Because you know. You DO know what you are going to do.

    Let all the other what-ifs go for right now.

    Thanks! That's great advice. I know I get ahead of myself in my thoughts due to my anxiety. I just have to find a way to reign it all in. I am seeing a counselor in 2 weeks - hopefully that will help me too.
  10. by   Julius Seizure
    And remember, codes are scary for pretty much everybody. I've seen nurses with 30+ years of experience who can hardly draw up code meds because their hands shake too bad under the pressure. Its not anything wrong with you or your nursing ability - codes are stressful!
  11. by   jodispamodi
    I think its a right of passage every new nurse goes through. Even though in my EMS background I was used to running codes, as a nurse my role was totally new to me and I was terrified. When we had a code on the floor, I made sure to get involved even if only paging teams and recording times and meds. Then when I walked in on one of my patients who was pulseless and not breathing I pulled the code light and started compressions, and waited for the "professionals"(lol) to arrive and tell me what to do. yup, it was scary yup it was stressful, but there are a whole group of people who show up to help.
    Do you have a nurse educator where you are? I'd suggest speaking to them and seeing if you can get a group (maybe other new grads?) together and run some mock codes, it won't take all the anxiety away but it will help. Good Luck.
  12. by   lcgivz12
    I was the exact same way. Repeated exposure got me desensitized. It'll get easier with every code.
  13. by   Richard Wolfe
    Quote from dd05434
    Thanks so much! I've only been in 3 codes. The first two I mainly observed. The most recent one was my second week of orientation as an RN, and it was my patient. I did compressions and they survived and were discharged home with no deficits. Still anxious though.
    No one survives a code and goes home with "no deficits".
  14. by   RotorRunner
    Walking in to a room and seeing your patient unresponsive is scary for ANY nurse. It is natural to have some anxiety...it is a stressful thing. It sounds as if you have been in this situation before and rose to the occasion. You didn't freeze, you didn't panic. You reverted to your training. I have faced this exact same anxiety, and I bet most good nurses have as well.

    You will be just fine. Have confidence in yourself. We have all been there.

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