AAACK! My first Code!!!!

OMG..you poor girl! You know I am petrified of this ..and my instructor told me last semester she will gaurantee someone will code on me at some point in time whether during clinicals or after I am working as a nurse & that we would all be surprised by what we really know & don't realize.........I am very fearful of exactly what you just went through...but I think as time goes by maybe you will be less nervous & ok.............maybe get on the charting part of the code team to start off so that way you can observe what everyone does while you chart the meds, procedures, times etc of what the code team is doing & then you will be a bit more ok........I remember one time I was waitressing and a man was choking on food.... my friend who worked with me was literally yelling " does anyone know the heimlich or cpr?" & no one even looked up to even acknowledge her...so I just happened to walk by at the time..unknowingly to what was going on or her yelling out.....and saw the guy holding his throat...I just walked up behing him without even giving it a second thought & was very calm..and just gave him the heimlich..it took about 4 shots but it worked...and let me tell ya.....after I had jelly knees & was shaking & crying................I got the adrenaline rush then fell apart.........I even think I left work for the night after that one......anyway the man was perfectly fine........ I think we all go through what you are feeling ......I am really terrified of this ..I am afraid I will be too slow, not know what to do etc etc.....but I realize experience comes with actually doing over time.......I am sure you will be fine.........good luck!

Thanks. Good to know I am not alone in my fears. Another thing that really got me thinking is that the other nurse who serves as charge only has 6 months more experience than I do and she is very hesitant - what would have happened if she were on last night?????

I've been a nurse for 8 yrs don't worry you never get used to it!!!! Also, no matter how many yrs you are in this business you are never completely prepared or feel like it went well even when the patient survives. It is never fun for anyone but sounds like you had a great support team and that is what counts.

oops!! I forgot to mention that she did make it. I stopped in ICU on my way out and she was resting comfortably.

Everyone remembers their first code and it usually has the same effect. The best thing you can do is look over the crash cart to familiarize yourself with it. If you get a chance to get in on a few ER codes this will also make you feel more comfortable. I see this quite often. Many of our new nurses and even some that have been around awhile go to codes in ER and are sent away because they have enough help- but watching, or recording will make you feel more comfortable. We've all been there. You did a good job. My first code (many years ago) was a little old lady and when I did chest compressions I could feel bones cracking. I didn't do chest compressions for about 2 years after that.

oops!! I forgot to mention that she did make it. I stopped in ICU on my way out and she was resting comfortably.

If by code you mean cardiac arrest (we call them different things in the UK) I spent 3 years as a resuscitation training officer and as such attended all cardiac arrests and peri arrests within my hospital. you don't ever really get used to them but it does become easier with experience and knowledge of the protcols for arrest management.

When I teach resuscitation skills I always tell my students that once the cardiac arrest has happened it doesn't matter what you do you cannot make things any worse, the patient is not going to survive without intervention so anything that you do will improve the chance of survival. I worry more about living breathing patients they are the ones that will cause you more trouble.

If your patient survived then you did a really good job - well done

do you have ACLS or PALS? Just taking a class and pretending to be in a code situation made me more confident. (still not anywhere even close to comfortable in a code situation)

Also...say to yourself a zillion times a day...AIRWAY BREATHING CIRCULATION...Does your pt have an airway? always start with airway...

Lori,

The first code is never easy, the second may be just as difficult. People need to do the best they can given the situation. When I first started in nursing, I remember praying that a code wouldn't happen. Then, it happens. The first time, I stood there, not knowing what to think, or what to do exactly except to stay out of the way. The next few times after that, I was like the designated furniture mover...getting everything out of the way. I then worked in a 20 bed hospital and sometimes it was a RN and myself at night. Codes would come in on the squad often. I eventually learned what my role was in a code and what needed to be done. Everyone is nervous and stressed. It is never a pleasant situation. I have been hollered at by doctors, other nurses and RTs. Each situation becomes a learning experience. Now when I am involved I know what my role is. Everyone involved usually helps each other out by giving reminders to each other, though keep in mind some my shout those reminders at you. I have learned not to take any of that personally, that in itself took some time. Codes don't usually happen very often, thank goodness. Please don't give up. You are so needed. You will learn your role. It takes time.

Everyone remembers their first code and it usually has the same effect. The best thing you can do is look over the crash cart to familiarize yourself with it. If you get a chance to get in on a few ER codes this will also make you feel more comfortable. I see this quite often. Many of our new nurses and even some that have been around awhile go to codes in ER and are sent away because they have enough help- but watching, or recording will make you feel more comfortable. We've all been there. You did a good job. My first code (many years ago) was a little old lady and when I did chest compressions I could feel bones cracking. I didn't do chest compressions for about 2 years after that.

There is some wonderful advice here...familiarize yourself with what is on the code cart. I liked to get involved in the daily checks of the cart. I then knew where everything was, what was there, what wasn't. Also being the recorder a few times, that helped me too.

Everyone here is giving you wonderful advice!! You really don't get used to them, I've been a nurse for 7 years and I still hate codes! Luckily, we don't have many. I work on a step down cardiac surgical unit and we try to get our patients to the ICU before they code, but of course we get them anyway! What I did in the beginning was just act as a gopher (VERY important!), took furniture out of the way, stayed with the patient in the next bed if we couldn't get them out of the room, stayed with coding patient's family if they were there, and watched whatever I could. Then, I started with doing "little" things, recording (great way to learn!!!), hooking the patient up to the lifepak/zol/whatever you want to call it, hooking up a saline gtt to give meds through, CPR, etc. "Baby steps", I just did a little more each time I was comfortable. And like someone else said, remember your ABC's!! It's more difficult than you realize!! I see a coding patient and I just want to SHOCK! lol You've got to remember the basic ABC's. Good luck! :)

P.S. The story about the Heimlich maneuver reminded me of a story....I work with a nurse who has been a nurse for about 20+ years. One day she went down to the cafeteria to get her lunch and saw someone choking by the bathroom, which is a bit set off from the rest of the cafeteria. She went up to the woman, she wasn't coughing, holding her hands to her throat, the works. This nurse got behind her, have her the Heimlich a couple of times and the food came up. NO ONE saw this happen, the woman didn't say so much as "Thank you" (I'm SURE she was just to shocked to think of it!), said she was fine and walked off. So, this nurse went back upstairs to the unit, a little anxious after her experience, and all the other nurses just looked at her and said "What took you so long???" LOL!! The poor thing! She had just SAVED A LIFE, no one saw it, she got no thank you, and was criticized when she got back to her unit!! She let them have it!! LOL! All turned out okay. :)

OMG! I just remembered my heimlich thing..after reading the thing about not even getting a thanks...lol.....The man I saved from choking was with his wife...and granted they were a bit on the old side but I will never forget their bill was $34.13 and all they left me was a $2.00 tip..the running joke for the longest time at my job between my co workers & my regular customers was that they all said for $2.00 I should of let him choke to death... I could care less about money but I did get a little laugh out of that one.....they would say for God's sake you saved him from dying & all they could do was leave you a measley $2.00??????? I have a warped sense of humor so it did strike me kinda funny.....but I would save someone for $0.00 so it doesn't matter...lol....just had a flash back after seeing the part of not being thanked....lol:trout:

do you have ACLS or PALS? Just taking a class and pretending to be in a code situation made me more confident. (still not anywhere even close to comfortable in a code situation)

Also...say to yourself a zillion times a day...AIRWAY BREATHING CIRCULATION...Does your pt have an airway? always start with airway...

Truly excellent advice. When I was first a floor nurse 20 yrs ago, I was about 6mo out of school and I decided to take ACLS. No one on my unit had ACLS and at that time, ACLS was incredibly hard to pass. I took it, passed and about 1wk later, someone coded on our floor. I felt so much more comfortable with the emergency and it was all b/c of running through the scenarios from the ACLS classes. So that is a great suggestion and there is a reason why ABC's are used to make resusitation easy. Good luck.