first code blue

nur20 · Sep 24, 2001

Originally posted by tonia
I have been a registered nurse for only 2 months. I had my first code on 9-15-01 at 1730. I had never done chest compressions or bagged a real person. It seemed like all my teaching went out of my head. I couldn't think if it was 1 mississippi 2 or 1 and2. It seemed like I couldn't remember anything. The code was called at 1755. I cried and cried. I have been in the nursing field for 10yrs but never have I physically been the one to do the CPR. I left that code saying I didn't think I wanted to be a nurse any more. I guess I just needed to vent. I was wondering if it ever gets easier or with time will I feel more prepared or whatever for situations like this? Need input from more experienced nurses please. Thanks alot for any imput.

It does get easier,don't be down on yourself,sometimes it does not help,but you did spring into action. I am an American Red Cross C.P.R. instructor and there are new stipulations in place including teaching persons to to use the smaller Defib machines. They will be located in public places. The rules for C.P.R. are more relaxed now, because quite a few people had the same problem that you mentioned, including nurses.Don't even try to remember that 1 mississippi,2 mississippi anymore. Those strict guidelines have relaxed. The Red Cross now says any attempt for breathing and compressions is a good thing and certainly will help. This is why it is important to activate the EMS system first if possible so they can be on their way. If you haven't heard of the new guidelines yet, i'm sure you will in your next class :confused:

tonchitoRN · Sep 24, 2001

I read the comment about the laughter. Be very careful when you crack a joke or laugh or even smile. A code is a very serious thing and you do not know who is listening or watching. If a family hears or sees you you will come across as insensitive, uncaring and like you did not try. The walls have ears. :cool:

codebluechic, ASN, RN · Sep 24, 2001

During my orientation as a new grad I was sent to EVERY code (and we had a lot of them). After a while I started doing the documentation at every one. It was great experience.When I got my ACLS 6 months later I felt more prepared although it didn't really "click" for a year or two.

Jenny P · Sep 24, 2001

My first code was way back in 1973 when I was an agency nurse floating into an ICU. My patient was turning that funny blue-grey color, making that gaggy-gurgly sound and I tapped another nurse on the shoulder and said "I don't think he looks too good" She called the code; I cleared the visitors out of the unit and stayed out of the way. Afterwards, that nurse told me I did a good job! With that kind of encouragement, I applied to work there and have been in (various) ICUs ever since!

I've been to codes in Psych where they forgot to untie the suicide patient that hung herself; codes in standing water when you are defibbing the patient; nights when 4 patients coded in one ICU unit one right after the other; and many horrendous others. They don't always go smoothly, and even now there are times when a code can ruin your whole shift. We nurses are humans, after all, and even we can freeze or forget what to do in an emergency. That's when being part of a team makes a difference. Find your support team amongst yor co-workers; take ACLS classes, record on your first several codes (or just watch and stay out of the way).

One thing a first year nursing instructor told my class was "if you don't know what to do, take a pulse and try to think what to do while you're taking that pulse." The patient feels like your in control and it gives you a chance to get under control yourself during that first minute in an emergency. That has worked for me in many different situations both at work and otherwise, even when I didn't have a watch on.

deespoohbear · Sep 28, 2001

My first code was an elderly lady who hadn't been doing too well on the day shift, and now she was my problem. Day shift hadn't been able to contact her physcian (switchboard was paging the wrong beeper all day. I got a hold of the doctork and got a cardiology consult. The cardiologist had her moved to ICU and she coded there. She died the nex morning at a larger facility. I was pretty shook up over it , but the cardiologists said she was suffering from cardio-genec shock. It will get "easier" for you once you learn the drugs and the ACLS protocols. Hang in there!! It is always hard when you lose a pt, but that one time ou save one is totally AWESOME!! :)

debbyed · Sep 28, 2001

Like everything else the mechanics of a code will come with experience. Don't worry about counting the right way just do compressions at a steady even rate; if you aren't going fast enough or going to slow someone will say something, Just do the compressions, nice and steady and even.

As far as crying, that doesn't change much. I've been at this for over 20 years. Sometimes I cry. Sometimes for the patient, sometimes with the family. It's ok to let the family see that you grieve too.

Than you will find sometimes you are relieved that the code failed, You see these poor terminal folks whose families just can't let go. You greive for the families but down deep you know that now this patient is at peace and painfree. And you will also find that sometimes you go through the motions of a code just for the families. Right or wrong that's just how it is. I've never had two codes that were the same.

Tonight we had a medic bring in a 49 year old woman who arrested at home. She has breast cancer. We did manage to turn things around and transported this patient to CCU on the Vent but we know she will never wake up, she was down too long.

Usually in cases like this I would personally perfer that the patient be allowed to be at peace but as I say all cases are different. This woman was newly diagnosed and coded at home in front of her husband. On arrival he was beside himself because:

a. he felt he failed because he didn't know CPR. He felt if she died it would be his fault. and

b. Some of her family had not gotten to say the things they needed to say to her because they were not prepared for things to happen so fast. As I said I don't believe she had be diagnosed long and I am not sure that all the family knew that she was terminal.

Now that she was technically alive the husband no longer felt guilty (he was assured by staff that he had done exactly the right things when he called 911) and her family was enroute and would be able to say what they needed to say to her. Families are always told that even though the patient can not respond that the patient can hear them. They are encouraged to talk with the patient and to hold her hand. I think in this case things turned out the best that they could.

This was one time that I didn't cry.

Don't give up. Empathy is important. It's when you can no longer feel the sadness that it is time to leave the profession.

Sounds to me like you did just fine.:)