A Question RE: Nurses and Codes

[nurseclairebear]

To my CCU nurses out there - I have a question for you. I am an experienced nurse transitioning into my role as an education coordinator for my hospital, however I am BLS trained and have only responded to a FEW codes as a floor nurse.

Part of my role is running mock code-blues, RRTs, and stroke alerts (etc) with a few other educators and MDs. We have run into a myriad of problems and learned a ton from the experience. I am turning to you to see if you have any ideas for what we should be teaching the nurses who are the primary nurses or first responders (or both) to report to the MD or resident who is in charge of the code so they know what is going on clinically. Ie: reason for admit, when they were last known to be normal, what prompted the code, DOB, last VS? What would you recommend?

Thanks!

Claire

[jennycRN]

Not a CCU nurse, but when I was on the floor we were trained in ISBAR communication. Additionally we print a medical emergency response communication sheet for a code or rapid response, which lists allergies, medications, most recent lab values. All the rest is always a bit 'hit or miss' which I know is the part you are trying to fix. But the above two things have been helpful to us.

[Do-over, ASN, RN]

Leave the primary nurse free to communicate with the code team. A sheet to print out (assuming it can be done quickly and rushed to the scene) sounds like a great idea.

In the heat of the moment, a nurse with 5 or 6 other patients may easily be stumped by the questions fired at them as the team rushes in the room.

[Kitesurfing bum]

I respond to RRT's and codes frequently. When the team responds, I do not expect the floor nurse with 5 pts to know an extensive history, lab trends, etc. I DO expect them to have the chart pulled up and be able to rattle off labs, medical hx and recent meds. I expect them to use their critical thinking skills and describe their recent interactions with the patient, especially why they called the code/RRT (this often times is unclear). I also do not want this nurse to take off just because the response team has arrived!

I realize floor nurses are not exposed to these situations as frequently... Which is good! They can be scary, but the nurse needs to keep their head on straight.

Last thing, if you are training responders please emphasize how important it is for them to NOT belittle/blow off the floor nurse. They are just as valuable as anyone else, we need them to feel comfortable to call RRT or codes!