First Code Blue

Sometimes you're okay with what happened, and that's okay. Sometimes it hits you later and out of nowhere you kind of fall apart a little (or a lot). Everyone has a different reaction to "the big things" in nursing, and not everybody reacts like they think they "should." Here's an example: once I stopped to assist at the scene of an accident. I was one of the first on the scene, at a pedestrian vs. minivan accident. The gentleman's brain tissue and skull fragments were hanging out, and he had agonal breathing. I was cool as a cucumber, and trauma is SO not my thing. It wasn't until I got home, walked in the door, and tried to tell my husband what happened that I started to shake and cry.

You didn't have any sort of a bond with this man who coded, and hadn't spoken to him (it sounds like), so your less than emotional response sounds pretty normal if you ask me.

I don't think there's anything wrong with you. Really, I don't.

Thanks Quazar! It makes me feel a lot better about it all. That person was lucky to have you jump into action like that! The whole experience really made think about how quickly life can turn to death. Since this is my first " big thing " it's probably way too soon to know if this will always be my response!

I think it'll get "normal" over time, but good thing you stayed calm on your first one! I was quite calm too on my first code when I was a tech doing my rounds in ICU. I remember them calling for help, part of me didn't want to, but my partner told me to go. All I remember was doing compressions while staring at the patient's face and saying to myself in my head, "please open your eyes." Patient ended up passing. We finished up our rounds as a lift tech and went down to the department. I sat down and had a long gaze at the wall thinking about how that was the first death I've experience in person right in front of me. No emotions came over me, but just had thoughts roaming around. This was actually before I started nursing school. Now, I just jump right in for codes feeling normal, but with always the thought of hoping the patient will make it, but moving onto the next if he/she doesn't.

Maybe ED/trauma is your thing. As a tech in the ED I was almost paralyzed watching my first code - of course it was a 3 month old whose twin had just been d/c'd from the ED an hour prior with RSV

Thanks Barcode! I was hoping the same thing, that by some miracle this guy wouldn't pass. I'm actually glad that I got the chance to help out. It was a great chance to get experience, although I can't get the song " staying alive" out of my head -_-. It actually made my BLS experience stick for sure. I'm looking to find out if I can get into an ALS course as a student!

Maybe ED/trauma is your thing. As a tech in the ED I was almost paralyzed watching my first code - of course it was a 3 month old whose twin had just been d/c'd from the ED an hour prior with RSV

I considered that, I actually really enjoyed it. A lot of moving and meeting people. It makes you use your thinker "NOW!". People have some pretty cool stories, even the grumpy and stoic one's :)

I had ED for my preceptorship and I was nervous with complete excitement. Only one patient ever survived the codes and I was completely fine with them dying. But, when the family came in and started balling, that's what got me.

That's great you were able to keep your cool! That's exactly how the coding pt needs his RN.

I'll tell you as an ICU trauma nurse that seeing that pt in the bed usually isn't devastating. What tugs at my heartstrings is seeing the devastated family. I hurt for them.

Also if you ever work in ICU or LTAC, you'll learn that there are worse things than an "unsuccessful" code.

*LTAC=long term acute care...where pts go for continued medical management, and vent weaning after leaving ICU but not stable enough for floor or stepdown. Just in case you're not familiar w it.

HereIStand I could imagine that a devastated family would probably pull heavily at my heart strings. We have a LTAC in my town. I considered working there after graduation, but then was told that they usually only look for icu nurses in that kind of facility.

My first code was working (as a CNA, which I currently am still) in a Skilled Nursing Facility. It was 5 minutes before shift change and another floor called code blue, which we didn't have a code system at that facility, but I knew what it meant and went down to that floor. I walked in the room of a patient I had taken care of multiple times and she was unresponsive, a coworker (RN) and I initiated compressions and rescue breathing. Once initiated, we carried out that CPR until EMS arrived, which in the city we are in can take a long time sometimes. There was a 5-second delay in my mind as soon as I walked in the room. "What's going on? And what's my first step right now, given my experience?" So that's when I knew what to do and jumped right in. The feeling of that brittle, elderly patient's bones cracking under my palms was something I'll never forget. Unfortunately it was too late. But I truly feel privileged to have been involved in a critical situation and knowing I did my best for the patient. And also, working in LTC you don't have as much of a chance for team work as you would like to, and there was a certain team work displayed that night I had never seen in that facility before between the people who responded.

Think I seen 15 people pass away and can't recall how many code blues. They are what they are less work the better so I just hope no codes for me. I usually feel worthless in them now being on psych. Hopefully as a nurse I'll have a larger role in Codes.

My first code is the same as the last one (working in oncology & ICU, I've had a lot) -- I'm able to keep calm and focused during the code(s) and the rest of my shift. I can be there for distraught families no problem. But after work I can't talk to anyone, I need some quiet time to let it drift out of me slowly. No funny movies or "cheerful" things. I usually walk if I'm not too tired and/or have a long shower.

But you're definitely NOT a bad person because you didn't get emotional. If you did get upset about it at the time, you wouldn't be able to go to work! As a nurse you process it differently than you would as a family member or friend. You see it clinically and focus on the tasks that need to be done, you're separate from what is happening (I call it going into "nurse mode"). It doesn't mean you don't care -- if anything, it means you care a lot that you put yourself and your feelings aside in order to try and save someone's life. It's not easy to do. Be proud of the work you did & know that you did everything you could to help that person.

Make sure you take care of yourself after these hard experiences. You may have kept it together during the event and kinda went a bit numb, but it doesn't mean it's not affecting you underneath. Debrief with other nurses or chaplain and reflect on the experience. Get sleep, eat well, exercise -- be kind to yourself.