did the Dr. have a right to scold this nurse?

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first let me say that i have no nursing experience..i do computer work for the huge local teaching hospital. 2 days ago i was told that i could become a "code" recorder. a "code" was announced yesturday for the Cardiac ICU and i had to be there to record the events. when the whole team showed up,the patient was awake,alert and breathing fine. it ended up being a false alarm. what happened was the new nurse just started her shift and she noticed on the monitor that this pt. had a severe bradycardic heart rate of 20 BPM. nurse said that she shaked the pts. shoulder and got no response,so she panicked and pushed the code button. as it turned out,this pt. is a very heavy sleeper and her baseline HR is very very low during sleep. after this false alarm was over,i noticed the team leader dr. talking with the nurse face to face and the nurse was wiping a tear from her eye. i'm guessing that the dr. was scolding her. i am a sensitive person and i felt very sorry for the nurse..i would have hated being scolded. would any of you call a "code" for a pt. with a HR of 20? and was the Dr. right in scolding this nurse??

i didnt know that this thread would turn out like this..so,let me say that i am not an official "code" recorder. my supervisor mentioned that since i can type and write fast that i should go to all the codes that are called and if i happen to arrive there fast enough,i can start recording,but if a nurse or resident has already started recording,i can go back to my "day" job. and honestly,i am sorry if this comment seems that i am full of myself,but it does not take a medical pro. to write down the events. i think anyone with a HS education can do it..for example..the dr. says give some epi. and you write down 2:28 - epinephrine given. then the dr. says to check for a pulse and the nurse checks and says no pulse..you write down 2:29 - no pulse. there is nothing complicated about it.

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i didnt know that this thread would turn out like this..so,let me say that i am not an official "code" recorder. my supervisor mentioned that since i can type and write fast that i should go to all the codes that are called and if i happen to arrive there fast enough,i can start recording,but if a nurse or resident has already started recording,i can go back to my "day" job. and honestly,i am sorry if this comment seems that i am full of myself,but it does not take a medical pro. to write down the events. i think anyone with a HS education can do it..for example..the dr. says give some epi. and you write down 2:28 - epinephrine given. then the dr. says to check for a pulse and the nurse checks and says no pulse..you write down 2:29 - no pulse. there is nothing complicated about it.

Another part of the recorder is to write down the dosages (and to help double check them to make sure they are appropriate) and to keep time so you can tell them, okay it's been two minutes, time to rhythm check or okay we can give another dose of Epi. You have to be medical to know the correct times and dosages. I couldn't be a recorder until I was ACLS certified. Pretty sure Joint Commission and OCHA regulates codes (meaning they can audit them). P

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

I find it very hard to believe a tech is scribing at a code.

The wouldn't even be entertained in Australia.

Let me tell you a story about seeing events from the outside and assuming things:

A past friend of mine was told her hubby had been seen with another woman at a cafe. She was devastated, cos they had'nt been married long. Well after all was said & done & divorce was threatened, the hubby was upset, cos their friend saw him with a woman who turned out to be his long lost sister he'd been trying to find apparently for years and years. He'd been so delighted to see her that when he was spotted in this cafe, he was hugging & kissing her, then he was going to introduce her to his wife once they got acquainted better as it was a big shock for him meeting his sister. Of course his wife didn't believe him until she saw all the paperwork. I suppose the friend that told her meant well, but hell, it caused A LOT of trouble just because this friend assumed he was having an affair.

Don't ever assume!

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Looks like everyone's being scolded now!

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another part of the recorder is to write down the dosages (and to help double check them to make sure they are appropriate) and to keep time so you can tell them, okay it's been two minutes, time to rhythm check or okay we can give another dose of epi. you have to be medical to know the correct times and dosages. i couldn't be a recorder until i was acls certified. pretty sure joint commission and ocha regulates codes (meaning they can audit them). p

yes, yes, and yes. and the recorder, while timing, also suggests the next drug on the algorithm, if appropriate, based on the problem at hand, the medical diagnosis, the cardiac rhythm as expressed on the monitor, etc. the fact that s(he) doesn't know this as expressed below is what is so scary about this scenario and is exactly why a person with no medical background, much less not acls certified, should not be recording a code unless it is strictly a matter of technical records and is in addition to, not as a substitution for, an acls certified medical professional who is recording and monitoring the event with all acls protocols in mind.

i didnt know that this thread would turn out like this..so,let me say that i am not an official "code" recorder. my supervisor mentioned that since i can type and write fast that i should go to all the codes that are called and if i happen to arrive there fast enough,i can start recording,but if a nurse or resident has already started recording,i can go back to my "day" job. and honestly,i am sorry if this comment seems that i am full of myself,but it does not take a medical pro. to write down the events. i think anyone with a hs education can do it..for example..the dr. says give some epi. and you write down 2:28 - epinephrine given. then the dr. says to check for a pulse and the nurse checks and says no pulse..you write down 2:29 - no pulse. there is nothing complicated about it.
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Specializes in Med/Surg.
i didnt know that this thread would turn out like this..so,let me say that i am not an official "code" recorder. my supervisor mentioned that since i can type and write fast that i should go to all the codes that are called and if i happen to arrive there fast enough,i can start recording,but if a nurse or resident has already started recording,i can go back to my "day" job. and honestly,i am sorry if this comment seems that i am full of myself,but it does not take a medical pro. to write down the events. i think anyone with a HS education can do it..for example..the dr. says give some epi. and you write down 2:28 - epinephrine given. then the dr. says to check for a pulse and the nurse checks and says no pulse..you write down 2:29 - no pulse. there is nothing complicated about it.

Therein lies the problem.

It sounds like it would/should be easy in theory. However, a code is chaotic. It would be IMMENSELY more difficult if someone has no knowledge of the meds, dosages, pathophys, etc. I've only really seen codes as an "outsider" (I worked on a general floor, so the extent of my involvement was initiating the code, once the team shows up they take over), and I think I would have a hard time recording the events accurately....and I've been an RN for 10 years.

There are several things going on at one time during a code. It's hard to follow when you're watching. I wouldn't want to leave that to a lay person, something IS going to get missed.

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i am sorry if this comment seems that i am full of myself,but it does not take a medical pro. to write down the events. i think anyone with a HS education can do it..for example..the dr. says give some epi. and you write down 2:28 - epinephrine given. then the dr. says to check for a pulse and the nurse checks and says no pulse..you write down 2:29 - no pulse. there is nothing complicated about it.

You could not possibly be more wrong.

Do you know what medications are used in code situations and why? Do you know the dosages? The interval between doses? Max. dosages? Can you recognize rhythms on the monitor? Do you know when a shock is indicated and when it is not?

The recorder is more than just a scribe. The recorder is responsible for watching the clock and keeping track of what has been done, as well as knowing what is appropriate to try next. The recorder is part of the Code Team, and has a responsibility to collaborate with the rest of the team.

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Specializes in OB, Med/Surg, Ortho, ICU.

Ahh, the twisted threads we spin. This particular thread had some interesting points made by many, but a whole lot of nastiness. This particular issue is what has turned me away from AN lately. It makes it harder to glean the valuable info and valid viewpoints. Thank you moderators for your time spent reading our threads and redirecting, if necessary. Thanks to those who value constructive argument and sharing information. Humor is always appreciated, too!

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Specializes in Pediatrics.
Ahh, the twisted threads we spin. This particular thread had some interesting points made by many, but a whole lot of nastiness. This particular issue is what has turned me away from AN lately. It makes it harder to glean the valuable info and valid viewpoints. Thank you moderators for your time spent reading our threads and redirecting, if necessary. Thanks to those who value constructive argument and sharing information. Humor is always appreciated, too!

Not only that, but this isn't even what the original thread was about. It was about the (perceived) interaction between the doctor and the nurse. If the OP is a 'coder', and someone chose to appoint her to this position (whether officially or unofficially), don't tell HER that she shouldn't be doing it. Take it up with her supervisors. I happen to agree with many of you that the qualifications need to be much higher than what the OP possesses, but don't slam HER (or him) about it.

I too, agree that the tone of this (and many other) threads here have gotten way out of hand. It's the internet in general; a great representation of an angry and bitter society :o

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Professional never scold other professionals in public. They just don't.

Doesn't mean it doesn't happen.

Professionalism be damned, what happened to simple etiquette?

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Ahh, the twisted threads we spin. This particular thread had some interesting points made by many, but a whole lot of nastiness. This particular issue is what has turned me away from AN lately. It makes it harder to glean the valuable info and valid viewpoints. Thank you moderators for your time spent reading our threads and redirecting, if necessary. Thanks to those who value constructive argument and sharing information. Humor is always appreciated, too!

I too, agree that the tone of this (and many other) threads here have gotten way out of hand. It's the internet in general; a great representation of an angry and bitter society :o
Because this thread has diverged so far afield from the original topic and developed a hostile tone besides, there is no point in letting it continue.

Thread is now closed.

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