First Code

akulahawkRN, ADN, RN, EMT-P · Mar 7, 2014

Sometimes this just happens. I've also felt the crunching of ribs when doing compressions. If you do it often enough and it will become part of the normal course of things and it won't bother you so much. Yes, it's completely normal to feel unsettled about it after your first code. Now I'm not a lawyer nor do I have any particular insight into some things, but I would imagine that they're simply doing their own due diligence with this death investigation so that they can be sure that everything was done according to policy. I would imagine that the code was run the way it should have, so they're probably going to wonder about the chain of events that led your patient to be on your floor, not on monitor.

I know this: You'll remember your first code, and after a while, you'll remember your most recent one and the rest will blur unless something sticks out. Hopefully you won't have that many that the blurring takes place.

Here.I.Stand, BSN, RN · Mar 7, 2014

I'm not sure how standard a mortality review is, but it sounds like you did just fine. His symptoms were being addressed, you were doing your hourly rounds, and you initiated the code when he was found unresponsive. If every nurse's job security was in danger every time s/he was on the clock when a pt arrested, a great many of us would be in trouble! Hugs!!

UnbrokenRN09, BSN · Mar 7, 2014

It's normal to feel that way after a code, especially under those kind of circumstances. I would be more worried if you didn't feel like that! It sounds like to me you didn't do anything wrong. Other than being pale, it doesn't sound like he was showing any kind of symptoms that would've warranted some kind of immediate intervention at the time. Without any telemetry, there's not much you could've done to prevent it, that's why when there's any suspicion of a cardiac issue, they should at least be on a tele floor for observation. Often times an EKG will be normal during the initial stage of an MI, if that was the problem. They should've at least done 2 more sets of enzymes and either repeated the EKG or put him on tele to fully r/o a cardiac event.

Bottom line, you responded appropriately to the situation, so just stick with the facts and everything will be ok. You have no control over what happened before you got there, sounds like you sort of just walked into a mess that wasn't handled appropriately.

Esme12, ASN, BSN, RN · Mar 7, 2014

All codes are usually reviewed. It is for QI purposes.

It's ok to feel this way codes are not easy....((HUGS))

nrsang97, BSN, RN · Mar 7, 2014

Normal for it to be reviewed. I know a code in my hospital that happened last year was reviewed but the nurse was not found of doing anything wrong.

Sounds like you took all the appropriate actions. I agree another two sets of cardiac enzymes should have been done, as well as placing the pt in a monitored unit.

ohiobobcat · Mar 7, 2014

They review all codes at my facility, too. Based on you post, it sounds like you did what needed to be done. I remember my first code, too, and that was 8 years ago.