Doing real CPR as a student.

~Mi Vida Loca~RN, ASN, RN · Mar 26, 2011

This reminds me of the first time I had to do a code. I had never seen CPR before so I figured I would help get supplies and watch. Next thing I knew I was next in line for compressions if it wasn't for my adrenaline pumping I think I would have passed out I was so nervous. The patient ended up passing away but afterward everyone kept telling me how great my compressions were. I remember being so sore the next day! I always wondered in my head what my role would be in a code and if I could handle it. After doing CPR I felt like if I could do that then I could do other thing's and be a nurse.

Thank you for sharing your experience! You bring up a good point with the soreness. When I had to do it on the Full Size sim doll, the next day I had bruises and soreness on the tops of my hands. I couldn't figure out what, than I realized it was from doing the compressions, going at a rate of I think it was 100 a minute. The force of one palm on the top of my other hand doing the fast and deep compressions left my hand sore for days.

ashleyisawesome, BSN, RN · Mar 26, 2011

Right now, I'd prefer to watch- unless I'm in a situation where I was the only person there who could save someone. At least one of my instructors has said to use the method you're trained in, and I wouldn't want to have to stop giving compressions to give breaths.
After I renew my CPR in the next few months, and get certified with the new compression-only technique, I'll probably be eager to try it for real.

i dont think that technique applies to healthcare providers.. if you are in a medical setting, i think you are expected to give breaths, but then you usually have 2 people, one for breaths and one for compressions so you wouldn't have to worry about stopping..

AOx1 · Mar 26, 2011

I want my students to give compressions during a code. Before stepping on the floor, we review what to do in an emergency. I would rather they work through this now with readily available emotional support than as a newly licensed nurse, where you have little chance to receive support after a code. I believe it lets them work as a team.

turnforthenurse, MSN, NP · Mar 27, 2011

Lol my first code happened in the MICU as a student. Not any of our patients...some guy they brought up from the ER. We were all going about our business and we heard "code blue - MICU" on the overhead so we all rushed to the MICU side to see what was happening. Everyone took turns doing chest compressions. I was scared at first and one of the other students encouraged me so I just jumped right in and honestly, I loved the adrenaline rush :) I could feel the patient's ribs and sternum cracking as I did them, and although unfortunate for the patient, it was a cool experience.

ImThatGuy, BSN, RN · Mar 27, 2011

The other thread asking questions on certification and some of the responses got me thinking and curious.
Take out the human side of it, as a student, would you be excited to get to jump in on a code and do compressions? Like the first time or two you saw it, do you think you would hope to get to jump in and help or do you think you would be the one off to the side praying no one sees you and asks you to do anything?

I can think of two people in my cohort who savor the opportunity to perform CPR. Taking myself out of the picture that leaves 11 others who would develop wall paint colored skin and somehow melt into the wall.

I, on the other hand, couldn't care less about doing CPR. It's a chore, and it's not fun. I've done it plenty, and I've broken enough ribs in the process. Did I at one time look forward to it? Dang skippy! I wanted all the opportunities I could get to defib people, shove tubes down their throats, stick needles in their chest (never got to do that yet), cut their throats (did get to do that once), and do whatever else I could to someone. Everyone in EMT and Paramedic school was like that.

It's interesting at the differences between the mentalities of the five of us who went through paramedic school together back when compared to the kids in my RN/BSN program.

~Mi Vida Loca~RN, ASN, RN · Mar 27, 2011

Yea I would imagine as a Paramedic you have done it tons and the excitement of it would wear off. I know when I saw it the other day some of the nurses were like NOOOOOO not again.

I remember my first injection I was excited to do it, now when a nurse acts excited for me and asks if I want to give Patient A his lovenox I am like, OK and I don't think twice about it, it's just another task to do and nothing exciting.

ImThatGuy, BSN, RN · Mar 27, 2011

I remember my first injection I was excited to do it, now when a nurse acts excited for me and asks if I want to give Patient A his lovenox I am like, OK and I don't think twice about it, it's just another task to do and nothing exciting.

I remember my first EMT ambulance run. A girl was "beat up," but later admitted to us and the deputies she was lying.

I remember my first run as THE paramedic. A woman overdosed on more pills than I knew what to do with. I remember looking at all these empty pill bottles thinking "What the **** is all this?" Narcs were in there. Antibiotics. 800 mg ibuprofen. Whatever was laying around the house. Even birth control pills. :rolleyes:

I remember my first code. I'd seen them in the hospital as an EMT student, but the first one I knew enough to do anything with was as a paramedic student. A family found the husband/dad dead by the trash can. He took out the trash and kicked off right there.

Past that it all runs together.

I just starting nursing school last August and can't begin to tell you my first nursing patient. No clue. I can't even remember my first clinical from this semester, lol.

I also remember my first arrest, lol. Felony child endangerment. Sent that sucker to prison. Much more rewarding actually. :yeah:

~Mi Vida Loca~RN, ASN, RN · Mar 27, 2011

I remember my first EMT ambulance run. A girl was "beat up," but later admitted to us and the deputies she was lying.
I remember my first run as THE paramedic. A woman overdosed on more pills than I knew what to do with. I remember looking at all these empty pill bottles thinking "What the **** is all this?" Narcs were in there. Antibiotics. 800 mg ibuprofen. Whatever was laying around the house. Even birth control pills.
I remember my first code. I'd seen them in the hospital as an EMT student, but the first one I knew enough to do anything with was as a paramedic student. A family found the husband/dad dead by the trash can. He took out the trash and kicked off right there.
Past that it all runs together.
I just starting nursing school last August and can't begin to tell you my first nursing patient. No clue. I can't even remember my first clinical from this semester, lol.
I also remember my first arrest, lol. Felony child endangerment. Sent that sucker to prison. Much more rewarding actually.

I imagine so. That was the reason why I wanted to be in the FBI. I didn't learn about EMT-B's working as ED techs until I was in nursing school. I wish I had, I would have gone that route while on the waitlist.

ohgreat · Mar 28, 2011

I did compressions on a code a few weeks ago in clinical. When I heard there was a code coming in, I asked the nurse I was assigned to if it was ok for me to participate. It was definitely an adrenaline rush, but it was very sad at the same time because one of the patient's family members was watching the whole time and was obviously very sad and hysterically crying as the team performed ACLS. Unfortunately, the patient did not make it. I don't know any students who would not want to participate in a code even if just for compressions or ventilation. I don't understand why any student would run away from such a great experience (trying to bring someone back to life!). CPR is something that is required to even apply to nursing school, we all know how to do it!

Grandy · Mar 30, 2011

When I was a second year student I was on a placement in an adult surgical ward in a medium size suburban hospital. I arrived early for my day shift, it was before 7am and we were milling around the nurses station waiting to receive handover from the outgoing night shift staff. One of the night nurses had a patient on a bedpan, it was an elderly gentleman with a hx of NIDDM and a very bad ulcerated wound on one of his feet and some necrotic tissue on his toes that the surgeons wanted to excise. I had looked after this gentleman the previous day and can clearly remember the serous exudate dripping from his foot as I assisted him in the shower.

Well the night nurse steps into his room to check on him to see if he is done with the pan while we are waiting at the nurses station for handover. Next thing she calls out "Code". Even though I was a second year student I had a background in prehospital care and had managed a few cardiac arrests, I was well drilled in CPR and emergency procedures. From where I was in the nurses station I grabbed the arrest trolly (I believe in the US it is called the 'crash cart') and pushed it to the patients bedside. Night nurse had her knees up on the patient's bedside and was doing chest compressions. She was an older nurse and she looked clearly stressed and having difficulty doing compressions. So I simply stepped up and said it's ok, take a break and let me do the compressions for you. She gladly handed the compressions over to me. Back in those days we were taught to measure the sternum to ensure proper hand plancement on the lower half of the sternum. So I kneeled up on the bed, leaned over him, measured up his sternum and began pumping away. Within minutes the room was full of people, at the time it surprised me how many people turned up to have a look. Once a code is broadcast over the paging system every medical student, resident, registrar, nurse administrator etc turns up.

My Clinical Facilitator turned up as well and when the nurse from the ICU team finally took over the compressions from me my facilitator gave me a pat on the back and said job well done. She mentioned it in my report and my lecturer at university congratulated me on doing so well. My fellow students were stoked that I got to do CPR and wanted to know all about it.

Well the patient died unfortunately, it was an asystolic arrest so he was probably laying on that bedpan with no pulse for too long before being discovered. But I have to admit it was a great learning experience. After the arrest I got to assist in laying out the body and preparing to take him to the mortuary. His relatives turned up at the hospital about an hour later expecting to visit him and the Nurse Unit Manager had to break the news to them, I can remember them crying. Relatives were allowed to spend some time with him and then the wardsmen came to take him to the mortuary, of course standard protocol is that an RN always escorts the body to the mortuary and signs the mortuary book to confirm the body arrived safely without being dropped or bruised or tampered with. So I got to go along with the wardsmen and the RN to the mortuary. I assisted the wardmen to transfer the body onto the drawer of the refridgeration unit and watched as he was slid inside and the door slammed shut.

I was thinking how yesterday I was having conversation with this man and now here I am watching his mortal remains being slid into the mortuary refridgerator. It was a real learning experience, even as someone who had seen a few cardiac arrests before, this was the first time I had seen one in a hospital. To follow the whole process from CPR to termination of resuscitation, to shrowding the body to escort to the mortuary was very interesting.

Let me encourage nursing students to assert yourselves, remember that you are in hospital to learn so make the most of the opportunities you have and be proactive. Don't be scared to step up and ask if you can do some compressions. If it is your patient and they do not survive then remember that providing dignified and professional post mortem care, such as washing, shrowding and escorting the body is an important part of nursing care and our final duty to that patient. It is a good thing to learn as a student as I did so it does not hurt to ask to be involved, involvement and gaining experience is what you are there for.

billyboblewis · Mar 30, 2011

The proper way to relieve someone doing compressions in a code is to just step in and start doing the compressions. You will never see someone else refusing to stop so you can relieve them. It is not a matter of loving cpr or codes but a matter of saving lives and we all know that the survival rate of codes is very low. It is much more important to take actions in advance to prevent a code from occurring. This is what separates the the best practitioners.

JustMe · Mar 30, 2011

As a clinical instructor I look for learning opportunities for my students--that includes doing compressions during a code. The nurses are more than willing to let the students "jump in" and learn-by-doing. They ALL admit that it's a lot different doing compressions on a human being than a dummy.