First Code Blue

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Hi Everyone,

Today I started my rotation in the ED. I got the opportunity to be paired with an amazing nurse. She's a natural born teacher and made sure I got a lot of hands on. After assisting with getting a woman in severe respiratory distress stabilized, I walked into a code. I stood off the side quietly watching the chaos. The team work was awesome. I was only in the room a few moments before I was offered a whack at doing compressions. I agreed with hesitation because as bad as I wanted to help, I felt my compressions would mean nothing to a man who was at least 275 lbs ( I'm pretty small) . Once I got into action, I came to find it wasn't as bad as I thought it would be. Unfortunately, he didn't make it, he was already too far gone. My biggest concern is that in all the chaos going on around me, I was completely calm. I kinda feel like a bad person because I didn't feel anything... The nurse said it was a good thing that I wasn't all over the place, but now I feel like I might have some kind of mental disorder, Like my response wasn't normal.

So, I ask, is this normal? How did you make out during your first code?

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!

Specializes in Physical Medicine & Rehabilitation.

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.

Specializes in NICU, Trauma, Oncology.

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 :)

Specializes in Emergency.

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.

Specializes in SICU, trauma, neuro.

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.

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