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Discussion

advice needed....

okay here goes...As you can see my name is Christina. I am an RN new grad working on a med/surg floor at a small local hospital. Here is the scenario:

Last week a code 10 was called in the ER, the charge nurse, myself, and the unit secretary...yes the unit secretary responded to this code. okay so let me just give some background..the very first code I ever participated in when I first started working this floor was very chaotic no one seemed to know what their role was so after this incident I looked up in the policy and procedure manual and it clearly states that in a code situation the charge nurse the east end nurse/or RN, one RN from ICU with the crash cart, and the supervisor are to respond. The east end nurse/RN to do compressions, the charge nurse to record and the supervisor to start IV lines or whatever else is necessary.

So, back to this incidence as we arrive to the ER me being the east end RN was ready for my role of compressions. The unit secretary at this point says okay well I will record...:uhoh21: In the mist of all the drama nothing was said even though she had to stop and ask how to spell names of medications that were being administered. I just did my job and said nothing thinking that at some point because the sup was trying to help the doc intubate he would eventually take over the recording part. Well, nope everything continued on this way. After two hours we finally were able to stablize the patient. So, I mosy my way back to the floor. I asked the nurse who who remained on the floor if any of my patients required anything in my absence. She stated that no she wasnt aware but that had to stay a majority of the time in one of her patients room who was vomiting. So, as I make rounds on my patients two of them stated that they had called several times on the call light and no one responded. Thank goodness one was needing some cough medicine, and the other another gown, but all I kept thinking was wow..what if one of them had been in any distress. Then a patients family member called and stated they had attempted several times to contact the nurses station but no one answered the phone. The night went on as I toyed with bringing this up because me and this unit secretary have gotten to know each other and would consider us friends. I eventually just decided I would deal with it later as I had somethings to come up. The next day the med/surg coordinator told me that a couple of the patients I had the previous evening complained and wanted to know what the problem was. I just stated the facts that I participated in the code and the unit secretary was absent from the floor also in the code. I was feeling a little bad because I "ratted" on her but at the same time I was kinda upset about the situation too. She then asked me what she did in the code and I said well ...she recorded. At that point she became furious and said she would take care of it. Well, today being the first day that I have worked with this unit secretary since this incident I decided I would have a little talk with her about it. I told her that a couple of my patients complained because no one was there to answer the call light and that the coordinator had asked me about the situation as well and that I too was concerned. She stated that she was a first responder with CPR certification and that is why she also responded to the code and that no one had brought anything up to her about it yet. At that point I stated but when you work here your role is unit secretary what if one of my patients had been in distress? She became real defensive and started saying she was going to bring it up herself with the DON and the supervisor on Monday and that with her qualifications she should be allowed to respond to code situations. For the rest of the night she wouldnt speak to me and made comments like well if other people knew what they were doing, and she had been involved in several code type situations in comparison to some of the others..blah blah blah... I was a little taken back by her reaction. I was trying to talk to her about it because I knew that eventually something was going to be said to her about it. what do you guys think about this situation ..comments, advice appreciated......:uhoh3:

Featured Replies

I think she is going to be very surprised when she does talk to the DON is what I think!!

It's her job to know hosp policy too. Your patients on the ward could have been in real trouble and no one would have helped them. What happened to the ICU Nurse that was supposed to repond as well?

1st responder CPR is NOT THE SAME as ACLS. She was doing nursing documentation. She needs to be taken down a notch. If she wants more responsibility, she should continue her education. Just leave it alone and let the managemetn handle it. Hopefully they do their job.

My hospital does have an assigned clerk to go to codes, so they can be a gopher for supplies, order labs and xrays and call people that need to be called. And all trauma/critical care cases in the ER also have a clerk assigned just to them for the same reason. Of course, that's their stated job, and well documented what exactly they are supposed to be doing. We might, on occasion, take down meds or something that's being done, but not in the chart itself, just on scratch paper to help remind the nurses who are doing the official charting.

That is crazy that she was actually planning on helping code a patient. As a UC at my hospital, the only situation you should ever actually be doing CPR is if you happen to come upon someone who is coding and you do that while you wait for help to come and take over.

I worked for 8 years as a unit secretary in Peds ICU and NEVER, NEVER would I have dreamed of being the recorder. Against hospital policy big big time...this is an RN function in our facility. I would have been fired so quickly - any hope of working in that facility as a secretary or RN would have been out the door. The secretary's most vital function in code situations is getting what needs to be ordered/gotten/persons called, crowd control, call bells, etc.....not away from the desk.

I have been the recorder once, my first day of preceptorship (final semester in nursing school) in Peds ICU, under the guidance of my Nurse Manager. I also drew up meds (again, under my NM's supervision). My Nurse Manager also made sure that the other 2 students (from another school in the area), as well as myself, took turns doing compressions and bagging.

Let us know how this turns out - I'm betting the secretary is in for a big surprise. Kudos to you for looking up and understanding YOUR role .

Cindy, RN

We have had several codes on our floors and the unit secretary stays put at her desk at all times to help with the floor needs, contact staffing if we need someone to cover for a nurse or what not, and continue the tasks they have...which is usually quite the pile!

No way would any of the ones I know ever go help a code. When one is called there are assigned RN's and MD's on each floor including ED that rush up to do the code. So far it seems to go very very smoothly and well!

Maybe this incidence will be benificial in that administration may do an inservice to rememind folks of their roles in a code situation...I work agency and I see many nurses and docs that can't remember 100% the policy so a reminder is always good (even a memo now and then).

I am sorry she took it that way, I would have explained I was worried about her job as well as my patients well being and was just trying to clarify. But now, well...maybe best to leave it be in your mind and efforts and let management handle this one!

No matter what certifications she holds, she canNOT perform anything she is certified for if it's not in her job description. She could be a paramedic able to intubate, but if she's working as the unit clerk when someone codes, she'd best not touch that pt.

  • Author

Thx you guys for the comments and advice. I really do hope management does do something about this. I think she is in for a rude awakening when she "confronts" the DON and whoever else about this. According to her, she was told she could "help" if needed in code situation. However, there were more than enough of us at this partuicular instance and she was performing a duty completely out of her realm. Im just glad that no one was in any distress because this could have turned out quite uglier. :uhoh21: This apparently after speaking with some of coworkers occurs with another unit secretary who is in nursing school and best friends with his supervisor. Maybe she got the well he does so I will mentality. Anyway, whatever the reason it rubbed me wrong way. I think I may have lost my friendship but I still have my license.

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