Can a nursing student use the word "code"?

suanna · Jul 10, 2008

Becoming confident in your judgment abilities is a ongoing process but I think you are being a bit over cautious if you are hesitant to call a code in an obvious crisis situation. We have housekeepers, security staff, and even visitors that call codes at my hospital. It turns out to be a minor issue from time to time but no one complains. It's better to call a code and find a someone that got lightheaded from the hospital lunch room food than to hesitate and miss the chance to save a life. All you risk is looking a little silly if the problem turned out to be minor. The patients risks being dead if it is something serious! If anyone gives you grief about it you are in your rights to share with them your surprise that they would advise risking a patients life over wasting a few minutes if it turns out a code wasn't necessary. The less experience you have the more willing you should be to call the code- it gets the most help to your bedside the fastest!. Twenty years from now you may perform a brief assessment to evaluate the problem but more often than not, even the most experienced of us is going to call the code first and ask questions later.

Keepstanding, ASN, RN · Jul 10, 2008

you did the right thing ! you did your best by the patient. i find no problem with a student using "code blue". either way, you are to be congratulated for your observation skills and acting upon the situation. :heartbeat

newtress, LPN · Jul 10, 2008

My instructor at the end of the day today wanted to go over our previous days charting and nurses notes. I'm the individual who fussed and fretted over whether I could call out the "code blue" or just yell out for help STAT, patient in distress! Yes I documented this all in my nurses notes. That was my oportune time to ask her if as a nursing student I am allowed to use the term code blue. She said "no you are not to do so as a nursing student, let a staff nurse go in to your room, assess and he/she should initiate the code. And furthermore, you acted inappropriately by not assessing for pulse and respirations prior to calling out for help or assistance. That alone Miss Newtress, is reason enough for you not to pass this clinical." O....M....G :eek: As a previous poster stated, far better to not lollygag around checking and recheck wasting precious time if you SEE and SENSE an immediate medical emergency. I feel without a doubt I acted appropriately and was validated by the other nurses on the scene also. I now know why I was afraid to yell out "code" because I was afraid that if I did, I would get nailed by my instructor for acting like a RESPONSIBLE HEALTH CARE PROFESSIONAL! As a nursing student at this college, I am now not supposed to use my safety first, critical thinking, instinct cap. The tears, here they come.

Blee O'Myacin, BSN, RN · Jul 10, 2008

My instructor at the end of the day today wanted to go over our previous days charting and nurses notes. I'm the individual who fussed and fretted over whether I could call out the "code blue" or just yell out for help STAT, patient in distress! Yes I documented this all in my nurses notes. That was my oportune time to ask her if as a nursing student I am allowed to use the term code blue. She said "no you are not to do so as a nursing student, let a staff nurse go in to your room, assess and he/she should initiate the code. And furthermore, you acted inappropriately by not assessing for pulse and respirations prior to calling out for help or assistance. That alone Miss Newtress, is reason enough for you not to pass this clinical." O....M....G As a previous poster stated, far better to not lollygag around checking and recheck wasting precious time if you SEE and SENSE an immediate medical emergency. I feel without a doubt I acted appropriately and was validated by the other nurses on the scene also. I now know why I was afraid to yell out "code" because I was afraid that if I did, I would get nailed by my instructor for acting like a RESPONSIBLE HEALTH CARE PROFESSIONAL! As a nursing student at this college, I am now not supposed to use my safety first, critical thinking, instinct cap. The tears, here they come.

If you are seriously in danger of being failed for this, I'd try my best to track down the primary RN for this patient or the charge nurse or NM that day to speak on your behalf.

FWIW, I generally holler "I NEED A CRASH CART IN HERE NOW!!!" and the first time it ever happened, I was walking with a patient and she just fell over dead in the hallway. One of the housekeeping staff members was right there and helped me catch her and ease her to the floor. I don't even think that my call for help was anything resembling coherent speech.

nightmare, RN · Jul 10, 2008

This post brings back memories of an incident when I was a student.I was walking past a bed when I just double looked at the patient because he looked so ghastly. I drew the screens and asked his if he was OK,he lifted the bed clothes and there,lying on the sheets was just one mass of blood and tissue.I ran for the Sister and what did she say, "what's his BP,temp,etc" This was an emergency!! Next thing doctors ,nurses etc were piling in there and he was rushed to theatre.Had I stopped to do 'vitals' would that time spent doing them have cost him his life??

While there is a need for this info.sometimes it can be secondary to immediate help.

almostthere08 · Jul 10, 2008

Your nursing instructor is clueless. She has obviously been away from the bedside too long. Have not doubt that you did the right thing. As the saying goes, "There's nursing school, then there's real life." Just do what you have to do to get through it, shooting birds in your pockets (as a wise nurse once told me while I was in school.)

TexasPediRN · Jul 10, 2008

My instructor at the end of the day today wanted to go over our previous days charting and nurses notes. I'm the individual who fussed and fretted over whether I could call out the "code blue" or just yell out for help STAT, patient in distress! Yes I documented this all in my nurses notes. That was my oportune time to ask her if as a nursing student I am allowed to use the term code blue. She said "no you are not to do so as a nursing student, let a staff nurse go in to your room, assess and he/she should initiate the code. And furthermore, you acted inappropriately by not assessing for pulse and respirations prior to calling out for help or assistance. That alone Miss Newtress, is reason enough for you not to pass this clinical." O....M....G As a previous poster stated, far better to not lollygag around checking and recheck wasting precious time if you SEE and SENSE an immediate medical emergency. I feel without a doubt I acted appropriately and was validated by the other nurses on the scene also. I now know why I was afraid to yell out "code" because I was afraid that if I did, I would get nailed by my instructor for acting like a RESPONSIBLE HEALTH CARE PROFESSIONAL! As a nursing student at this college, I am now not supposed to use my safety first, critical thinking, instinct cap. The tears, here they come.

Ugh.

Do not let her get to you, shes an idiot.

Your patient was in severe distress and you did the right thing. I understand why you didnt call out "Code" - its an evil word and hard to decide when you should call one when you are just learning.

You did the right thing, so take comfort in that.

I would however, document the entire incident while its fresh in your mind, just in case she tries to fail you later down the road. You can always go above her and find out how they feel about what you did, but again, you did the right thing.

And Bull - as for having the nurse assess the pt before calling a code- if a patients coding and a nursing student, or tech, came to find me to tell me the patient was coding and they knew for sure and didnt hit the code button, that person just wasted precious time..ohh.. I'd be so darn mad. I would want you to yell help from the room - even if you were wrong..

Your instructor is so wrong..

Roy Fokker, BSN, RN · Jul 10, 2008

I'd rather call a Code and get chewed out if it were a mistake...

... than be all "dot your I's and cross your T's", not call the code and have a patient crash or worse.

Don't sweat it. You did the right thing.

Losing a patient is never easy - be you a student nurse or a veteran of decades.

Good luck...

becembrie · Jul 11, 2008

Are you kidding me? I agree with a previous poster to ask one of the folks who responded to your call to give you something in writing saying you did the correct thing. I can't believe she failed you. Can you speak with another teacher at school about this? I would think she would praise you.

Sorry, this really floors me.:angryfire You did a great job.

suanna · Jul 11, 2008

... That alone Miss Newtress, is reason enough for you not to pass this clinical." O....M....G As a previous poster stated, far better to not lollygag around checking and recheck wasting precious time if you SEE and SENSE an immediate medical emergency. I feel without a doubt I acted appropriately and was validated by the other nurses on the scene also. I now know why I was afraid to yell out "code" because I was afraid that if I did, I would get nailed by my instructor for acting like a RESPONSIBLE HEALTH CARE PROFESSIONAL! ...

OMG!!!! have you spoken to your student advisor or the dean of the school. I can't help but be very concerned when somewhat skilled health care provider (student) cannot use thier better judgement when calling a code. Check a pulse and resp- only if there is a question of whether the patient is in acute distress- From what you described there was no question in this case and a code needed called ASAP. Didn't you say the patient died? You obviously have good instincts. The instructor is advising you to be negligent in your duty to your patient to avoid looking a little silly if you are wrong!!! Your student advisor needs to know this and I would insist she discuss it with the dean. I can't believe that is the official school policy. :banghead:

Otessa, BSN, RN · Jul 11, 2008

Hello to all, I had an unfortunate experience this morning at my clinical site with my patient I was assigned to. This was my third day in caring for her so I had a good prior history of her and her condition. As I was returning to her room to check on her she had moved herself onto a small couch and was out of bed. I asked her if she wanted to remain sitting there or could I assist her back into the bed. She responded and continued to conversate with me. I didn't feel comfortable with her sitting there as she had her IV line bunched around her ankle and was sitting on her line. As I helped untangle her line which was running only NS, right in the middle of her talking to me she suddenly pursed her lips, cheeks filled up like she was holding her breath, made a gutteral sound and eyes rolled completely back and head flodged back. The code button was not in an easy within reach area for me to get to and the room was directly in front of the nurses station. I sensed immediate emergency in my gut. I made the choice to not talk or ask any questions to her and immediately yelled out " help STAT help STAT, patient in distress!" Within seconds numerous staff and paged doctors and RT were in the room and she was in full code. After 35 minutes of all measures she was pronounced. This was my first code experience in clinical with an assigned patient. I'd like to know if I did the right thing first, and secondly am I not within any scope or parameter to use the term "code blue!" in a situation like this. I feel sad to have lost a patient so suddenly and wonder if I alerted properly.

You did all the right things-take comfort in the excellent care you gave her:

-she was not alone-you talked with her and checked back with her

-you got help right away-calling a code or saying you need help stat is appropriate

-you had taken care of her for 3 days and knew her well-your gut reaction will guide you well throughout your career-

otessa

Otessa, BSN, RN · Jul 11, 2008

You have got to be flippin' kiddin' me!!!! She will fail you for doing what ANY nurse in their right mind would have done!!!???!!!???!!!!

All I can now say is-I'd be fighting this one to the bitter end and get letters from EVERYONE who assisted with the code to back up your correct action.....