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Anatomy of a Code

Nurses Article   (288,751 Views | 53 Replies | 1,522 Words)

Lynda Lampert, RN has 4 years experience and specializes in telemetry, med-surg, post op, ICU.

22 Articles; 49,418 Profile Views; 101 Posts

Only someone who works as a nurse or who has been in a code knows what it is like. The shifting, crazy changes would overwhelm anyone else. In the interests of letting students, prospective nurses, and those who have never been in a code know what it is like, here is a rundown of most of the experiences I had during a typical code a few years ago. ACLS has changed since then and anything missed was because I was involved in other aspects of the care. You are reading page 2 of Anatomy of a Code. If you want to start from the beginning Go to First Page.

xoemmylouox has 13 years experience as a ASN, RN.

1 Follower; 3,150 Posts; 38,756 Profile Views

Very well written. Those darn codes are just frustrating. So often the ending is not a good one. I can say in the 20 or so codes I have seen only 5 survivals. 2 with excellent outcomes, 2 with ok-ish outcomes, and 1 that was in a semi-vegatative state after.

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Flyboy17 has 10 years experience and specializes in EP/Cath Lab, E.R. I.C.U, and IVR.

112 Posts; 6,731 Profile Views

Fortunately from the Cath Lab side of codes we usually have very good outcomes. I hate to say just another day at the office but once you run enough of them it really does feel like just another code. Everything is done by ACLS standards unless the MD asks for something differently. Very well written

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ninja-nurse has 5 years experience and specializes in 3 years MS/Tele, 2 years Neuro ICU/CCU.

52 Posts; 2,998 Profile Views

Well written. In my facility, respiratory does the intubation, and nurses give the meds (no pharmacy for us - at least on nights. Don't know about days) but otherwise this is spot on.

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Certifiable has 5 years experience as a BSN, RN and specializes in Oncology/hematology.

183 Posts; 5,137 Profile Views

Wow, that's a lot of people in one room. You have a pharmacist who draws the meds? cool. Our patient's rooms are so small (all for neutropenic isolation) that it gets extremely crowded as soon when the ventilator is plugged in. When a patient codes (Murphy's law it always happens at the start of a night shift) on my ward (4 RN's, 18 patients), two nurses from the shift are in the room with the code team (usually within 3 minutes they are there. anesthesia doc, icu doc and charge nurse of the hospital) and the other 2 cover the rest of the ward. Of the 2 codes that i've seen, both have been successful and patients extubated not long after a stay in the ICU.

Codes are scary as hell. And that feeling after everything is done... sheesh.

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Lynda Lampert, RN has 4 years experience and specializes in telemetry, med-surg, post op, ICU.

22 Articles; 101 Posts; 49,418 Profile Views

Hi all,

I just wanted to say that I appreciate all of the good comments and praise for my writing. :) Yes, code protocols differ from one facility to another, and this reflected my experience at a very specific work environment. We had private rooms only, we were a trauma center, and we had pretty decent staffing most of the time. It's interesting to see how other facilities and environments handle this very scary situation.

I know that I would not want to go through this in the back of an ambulance, in a LTC facility, in a shared room, or on an understaffed floor. Unfortunately, for my colleagues, they go through this every day. I salute you, truly, and would encourage everyone to share their experiences of codes. It helps to get it out, it helps new nurses to understand, and it gives the public a true look at how hard nursing really is.

Lynda

ETA: This is a scenario of a code that goes smoothly with a happy ending. If I'd actually depicted a code with all its warts and a bad ending . . . I would have had a book!

Edited by Lynda Lampert, RN
added more info

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Dream Catcher has 3 years experience and specializes in Rehab; Women's and Children's.

24 Posts; 1,624 Profile Views

I enjoyed reading this article and the responses. I am a relatively new RN. I am close to finishing my first year. I have not seen a code yet. It is something that I am somewhat anxious about. I have been trained. I am sure that when it happens I will know what to do. However, I am still nervous about it. I suppose it is normal to feel this way.

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tacomaster specializes in ninja nursing.

125 Posts; 5,480 Profile Views

great article :)

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324 Posts; 4,701 Profile Views

Your writing skills are fantastic! You really painted a picture!

I find this job so strange. One minute your getting one patient a coke, the next your doing chest compressions and using an AED on another patient. Then the code is over and you go back to the other patients as of nothing huge has just happened.

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113 Posts; 5,163 Profile Views

I enjoyed reading this article and the responses. I am a relatively new RN. I am close to finishing my first year. I have not seen a code yet. It is something that I am somewhat anxious about. I have been trained. I am sure that when it happens I will know what to do. However, I am still nervous about it. I suppose it is normal to feel this way.

6 months into my job at a hospital I had my first code which was last week. Very scary but with good team mates, it went smoothly. Doing compressions or writing the code are two of the easiest jobs during the code because you get to watch and hear everything in a more relaxed manner.

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1 Post; 338 Profile Views

That was really good writing! I am a nursing student working as a CNA. I have not experienced a code yet. It scares the crap out of me.

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VANurse2010 has 6 years experience.

1,526 Posts; 12,720 Profile Views

Why does this hospitalized patient not already have IV access? Why are we not drawing labs off the IV because of "hospital policy?" Hello, it's a CODE!

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