Code Blue

**NickiLaughs, ADN, BSN, RN** · Oct 19, 2011

Do you have to be acls certified on your unit? Usually if u notice a patient going down, you yell for help. The charge nurse of your unit or designated code team will come & run the code. It completely.depends on your hospitals protocol. I would learn that first. Then update your knowledge as needed.

Editorial Team / Moderator · Oct 19, 2011

Have you had ACLS yet? Also, ask your education department about any mock codes that might be scheduled. If your unit doesn't do them, they should.

AusRN · Oct 19, 2011

You won't have to run a code as a first and if you're not advanced life support trained. I'm advanced life support but quite junior, before that I was just scribing, which is a great way to learn how a code is run. As you learn more, you'll recognise when your patient is crashing and hopefully avoid a code altogether, but sometimes that isn't possible. It is scary, your heart beats out of your chest, but if you've got great staff on it's amazing to watch. I work in a high dependancy unit, am advanced life support trained and seen a few code situations in the last month and still am scared.

Good luck

newnurseia · Oct 19, 2011

I'm not ACLS certified yet, but will be in the future. I appreciate all of your advice! It's always nice to hear fellow nurses opinions:)

PMFB-RN, RN · Oct 19, 2011

I doubt getting ACLS certified will make you feel more confident. ACLS has become so watered down as to become almost meaningless.

Just call for help and begin CPR, in that order.

HouTx, BSN, MSN, EdD · Oct 20, 2011

I would advise you to focus your energies on avoiding codes by triggering your Rapid Response team whenever needed. That is a much better goal for your patient population. In order to become really competent/confident in managing codes, you have to work in an environment where they happen regularly enough to give you the experience needed to gain proficiency. This is just should never happen in a MedSurg unit.

Most hospitals have a code team approach, because it is not realistic to have proficient code leaders in all areas (for reasons stated above). Instead, make sure you know what to do first - in order to prepare for the arrival of the code team. This should be spelled out in a policy somewhere. Generally, it involves triggering the alarm, beginning BLS & preparing for the team's arrival (e.g., flat bed, remove headboard, bring cart to bedside, clear traffic, start documentation, etc.) One of the bedside nurse's primary responsiblities is making sure the code team has an fast & accurate H&P on the patient. This process should be covered in a mock code exercise. If there are no mock codes scheduled, talk to your manager to arrange them.

turnforthenurse, MSN, NP · Oct 22, 2011

First off: you are NEVER alone.

Second, does your hospital offer ACLS? I would take it as soon as possible. That will get you familiar with the code blue process. And if a patient is coding, call for help and start CPR immediately.

Ruby Vee, BSN · Oct 22, 2011

i'm a new nurse, working on the med-surg floor for less than two months, and i've never had a patient code, but am nervous that i won't know what to do when it happens. sounds silly, but you don't spend a lot of time in school learning how to "run" a code or what's in the crash cart. any words of advise or website with references??

you're never alone -- there's always someone else there to help you. what you don't remember, someone else will. but as a newbie, i wouldn't expect you to be running the code.

~Mi Vida Loca~RN, ASN, RN · Oct 24, 2011

Call for help and start chest compressions. Running mock codes I think do help and if you can get in and watch any codes that will also get you more comfortable with seeing them.

LogCabinMom · Nov 25, 2011

I think ACLS is a great start - I disagree that it has become 'watered down' - you really don't get anything about codes in nsg school these days and at least ACLS will introduce you to the meds and the algorithms followed. I think EVERY nurse should be required to take ACLS. Most hospitals, even small ones, run mock codes, so hunt them out - and also try to respond to a code anywhere in the hospital to at least record. Good luck!

Editorial Team / Moderator · Nov 25, 2011

I think ACLS is a great start - I disagree that it has become 'watered down'

I don't know about that, it's changed a lot even since I first took it almost 12 years ago, and even then it was referred to as a "kinder, gentler ACLS." LOL. When did you first take ACLS?