Code Training????? - page 2
Does anyone know if specialty units offer their new employees some sort of "code protocol"? The last hospital I worked at did not - needless to say there was a code and it was a mess.....noone... Read More
Mar 9, '03Occupation: CCU Joined: Aug '02; Posts: 572; Likes: 6Our hospital has a CCU response team. 2 CCU RN's ACLS, an internist, and a resident on rotation, and an RT must wear the beeper. One of the RN's must be a male as they are better suited to prolonged CPR. The floor nurse is only responsible initiating the code, having the crash cart by the bedside, and starting BCLS if we are not there yet, and charting their own flow sheet and med callback. Pharmacy is simultaneously paged and they dispense whatever is not on the crash cart. Most of the time, so many internists show up room around the patient is at a premium. The CCU RN's must participate in intraunit codes in shift assignment. Having had 49 arrests last month hospital wide, with 26 of those in CCU, we get enough practice. It does make us very short staffed though when the response team is out on a code and we have an internal code in the unit. Then the ICU nurses are expected to help us cover temporarily, as they handle their own codes.
Apr 25, '03Occupation: Cardiac/Telemetry RN Joined: Jan '70; Posts: 21; Likes: 3I say ACLS is the only way to feel comfortable at a code - I have always seen extraneous people dismissed from codes, you can't have too big of a crowd! Anyone who doesn't feel comfortable to perform during a code should just step back and let the 'trauma junkies' take over, enough of them always show up at a code.
Apr 25, '03Occupation: Home Health Patient Education Resource Nurse Specialty: 10 year(s) of experience in Hemodialysis, Home Health ; From: US ; Joined: Aug '02; Posts: 21,359; Likes: 7,204Gambro RN..
are you referring strictly to "specailty units" as in your dialysis unit?
There should be a protocol in place. We all have to be CPR/AED certified annually. But basically, we call 911 and initiate CPR until the ambulance gets there, and they take it from there.
That's our protocol. Nothing more, nothing less. Give the patient's blood back, start CPR. We don't give meds (although we have an "emergency kit" which is checked monthly for expired drugs, etc.), don't intubate, or anything like that. Doesn't happen often, thank goodness, but it's scary for the other patients when it does. We always make sure we screen the code patient and have one or two staff "carry on as usual" with the other patients to calm/reassure them.
Apr 29, '03Occupation: RN Specialty: Critical Care Baby!!!!! ; Joined: Apr '03; Posts: 125; Likes: 11I work in an openheart unit. We run our own codes, with the cardiac surgeon. All other codes in the hospital are run by a "code team" that consists of residents, house supervisor, resp. therapists, and nurses from the other 2 ICU's. My advice to any RN is to get ACLS certified. Where I work you have to be ACLS certified to work in an ICU. If you aren't an ICU RN then you should go and get certified. Check with your manager, the hospital may pay for you to get the certification. I just think that it should be mandatory for every RN.
Apr 29, '03Occupation: RN Joined: Dec '00; Posts: 826; Likes: 16Originally posted by wsu.rn
at the previous hospital i worked at, there was a code team: which consisted of icu er nurses docs etc.
now that i am at a new hospital the code team rotates through staff nursing. i work tele-med surg. i am new to this hospital and have not been on a cocde team bfore. i feel like i am being pushed. if the code pager goes off and my name is on the board i am expected to go. role being either recorder or med nurse.
i do not feel comfortable first of all i am never been oriented to the code cart or the code team. when i see my name on the board i tell resource i am not comfortable, i would rather go with another nurse a few times. the response i get is you can meet the pt care manager at the code. i have never worked in a hospital that does the code team this way. many mistakes i have heard have been made. i feel like if there was a regular code team of staff that does this repeatedly, codes would run more smoothly. input: how do your hosipitals do this?
Regarding your facility's practice -- yikes. I'd grab the clip board and start writing (recorder.) But we even get validated yearly regarding the recorder position! You should be oriented to the position, the crash cart, the meds/location, etc. Do you have a nurse educator? You need to meet with your manager regarding this -- if you don't get anywhere, then I'd write her a formal letter something like this:
As I stated in our conversation today, I am asking for orientation to the crash cart/code team. Although ______ (facility's name) does not offer a formal orientation/validation for the code team, I am requesting a class or review with a Nurse Educator. Thank you very much.
cc: personnel file
Edited after I had a cup of coffee.Last edit by susanmary on Apr 30, '03
Apr 29, '03Occupation: rn Joined: Apr '03; Posts: 56; Likes: 6i just got acls last month. i've been on a crazy medical/oncology/nephrology floor up until last december. i'm now in a small er and i would also like to have mock codes occasionally to keep sharp. i also need to learn rythms better..i know the deadly ones, but want to be more " fluent". does anyone have a good way of learning them?
Apr 30, '03Occupation: Home HEalth Nurse, Agency on the side Joined: Aug '02; Posts: 166; Likes: 3Originally posted by amk1964
i just got acls last month. i've been on a crazy medical/oncology/nephrology floor up until last december. i'm now in a small er and i would also like to have mock codes occasionally to keep sharp. i also need to learn rythms better..i know the deadly ones, but want to be more " fluent". does anyone have a good way of learning them?
Most hospitals offer a class, the same one they give the monitor techs. (mine was great.) They also offe EKG classes and acls.
Acls was the best. Though I am not sure if all acls classes teach monitor/EKG strip reading. Somtimes you have to take that before acls. The more info the better. Thats what I always say.
Believe me... if you work in an ER this would be very beneficial.
Apr 30, '03Occupation: nurse Joined: Sep '02; Posts: 364; Likes: 3We have mock codes monthly.The crash cart is checked every shift and a different person does it each day so that the layout of the cart becomes familiar.When we have a new nurse or new grad on our floor, they usually check the cart so that thay can become familiar with where everything is. All nurses, even the LPN's are trained in ACLS. The LPN's can't push the drugs, but they know the sequence and what needs to be done.This is not hospital policy, but it is the practice on my unit and I think it is a good one. I have participated in codes on floors that I have been floated to. It's scary when the charge niurse didnt know how to set up suction.