so... i assisted in a code today... BUT

brownbook · Feb 21, 2017

But you didn't say how you handled it?

sickonXmas · Feb 21, 2017

1 of my patients FAMILY MEMBER told/complained to my director that i wasn't timely on attending to her mothers' needs.
i believe she wanted medication for constipation.
i was assisting in a CODE BLUE.
the family member... was this lady (40-50 years old) and an ICU RN, aLSO. unbelievable... is all i have to say. i'm not sure i could have handled this any different.

got her prn 30 minutes late?

offlabel · Feb 21, 2017

Just a thought that may or may not apply here...

a code in a patient care area is most usually a very crowded affair, as in, a circus. I have never ever seen one without enough people, to the contrary, there are usually too many people, even in the ER and ICU.

When a bank is being robbed, there has to be a few cops that don't respond to look after the rest of the town.

If the patient isn't being directly cared for by the nurse, that person should help out until the code team arrives (assuming there is one) and then discreetly back out unless directed by the charge nurse. Shouldn't be more than about 5 minutes.

RotorRunner · Feb 21, 2017

I concur with offlabel. I have been in a number of code situations in my career. I'm often reminded of the times I was working in the ER and had a trauma room. Whenever I got a trauma code or a CPR in progress to my room, I had MORE help than I needed. In fact, on many occasions I asked extra people to leave the room. Those sorts of situations will turn into a circus if you don't control it. The other patients on the unit are being neglected because everyone wants to participate in a code, and that's not safe.

Just my two cents. But you didn't give very much detail in your post.

sickonXmas · Feb 21, 2017

should i have stopped doing compressions to get the PRN for my patient?

**NICU Guy, BSN, RN** · Feb 21, 2017

If you were actively participating in the code, not just a gawker standing around, then your coworkers, not involved in the code, should have intervened. They could have said "your nurse is involved in a situation in another room. I will ask her about the prn med once things calm down." I have never been in a situation like this, but they could have popped their head into the room and asked if your patient could have the prn and then they could have given it.

The family member is an ICU nurse? She is the one who complained that you were not timely on giving a PRN med while you were in a code? Did she know you were participating in a code? or was she assuming (like the PP) that you were just standing around watching the code and neglecting your patients?

brownbook · Feb 21, 2017

should i have stopped doing compressions to get the PRN for my patient?

I love sarcasm, probably a personality disorder. I frequently answer a post in a sarcastic manner, cancel it, then post a polite response.

Did you and your director have a good chuckle and rolling of eyes over this incident?

if you handled the patient and family member in the same manner you responded to the comments you received here, perhaps you didn't handle it well?

NuGuyNurse2b · Feb 21, 2017

should i have stopped doing compressions to get the PRN for my patient?

are you one of those people who start a thread asking for input, not get what you wanted to hear, then turn salty? cause I can't tell what that sentence is supposed to be - sarcasm? anger?

You said you don't know whether there was anything different you could've done. The previous posts have all said what you could've done differently and you responded with that.

HouTx, BSN, MSN, EdD · Feb 21, 2017

Couple of observations -

From a 'customer' point of view -- if I'm the customer, I never want to hear excuses or reasons why my expectations were not met... because that isn't my problem, its YOURS & the Oganization's. But ensuring consistent levels of "service" (gah - I hate to apply that word to clinical situations) is the responsibility of the department charge nurse/supervisor. S/He has to react quickly and allocate resources to ensure that care for all the other patients doesn't take a nose dive every time something unexpected happens. Usually, it means a team member has to stretch to cover your patients when you're elbow deep in stabilizing that evisceration or bouncing on someone's chest. If this is not part of your department's routine, it should be.

Communication 101 - look beyond the content of patient/family gripes to the underlying issue. Many of those picky requests are a method of getting your attention or (in the case of the family) ensuring that their family member is receiving sufficient attention & that her care is a priority also. If someone had taken the time to simply say "I'm so sorry, but sickonXmas is dealing with an urgent patient situation right now. She will be with you as soon as she can. Is there something I can do for you?".

Since the family member is a CC nurse, it's pretty likely that she is coming with a much more complex set of issues than the usual family. Whenever I am dealing with a hospitalized member of MY family, I guarantee you that I am watching everything.... and taking notes and names. I have been known to physically prevent a physician from touching my family member because he had not washed his hands. I even double-check the I&O for accuracy & make them disinfect the call light regularly. Yeah, I know - bonkers, but I felt that my my role was to serve as a guardian and keep my family member safe.

I know, there are some days when everyone gets on my last nerve too. But I have found that it's better in the long run to just put on a game face rather than do what I really want to do - because that would open up a ton of s.t.u.f.f. that I'll have to deal with later. Like getting called on the carpet. Been there, done that - way too many times.

blondy2061h, MSN, RN · Feb 21, 2017

On a normal day, it would probably take me 15 minutes to respond to a PRN med request, by the time I stopped what I was doing, checked the MAR, got the med, prepared it to be given, and brought it in to the patient. I often took 30 minutes to respond to a PRN request if I was in the middle of something, and just said "I'm sorry this took so long, I was in with another patient." I never had a complaint over a 30 minute wait. If a patient was in agony, I would try and stay on top of their pain and/or advocate for a PCA. This brings me to my point. I'm surprised the daughter complained, even in normal circumstances. It makes me suspect that it took much longer than 30 minutes, or you complained to the patient and daughter about being pulled away from a code for this.

amoLucia · Feb 21, 2017

Not sure what kind of unit OP worked on, but ... working on the floor as the nurse responsible for any particular pt, his/her presence was usually required during code activities. A thousand questions are asked during the code regarding pt diagnoses, medications, recently admin and esp any prns, DNR/DNH, condition before, etc. That nurse usually stays the course.

Not sure who might be responsible for charting, but how could the floor nurse chart if not present?

Am giving OP the benefit of the doubt that she was the floor nurse who was responsible for the coding pt. And might OP work LTC? I was usually 'stuck like glue' in the room when my pts coded.

OP - how did your manager respond to the complaint with you??? Pts and families can be rude and unbelievably unrealistic at times (and it seems like this one fell into the group). Even being a HC provider doesn't always redeem them and earn them any brownie points. And to be honest, some nurses and physicians can be the worst.

Unless your manager became punitive with you, you'll need to 'buck up' and let it go. There's a lot of different personalities out in the wide world with whom we have to deal with. Just realize it is they who are the 'challenged' ones.

From your past posts, it seems like you've been dealing with some unpleasant personalities. You can't keep letting them get to you because at some point, you may step over that fine line in customer service expectations. And then you're SOL.