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Discussion

First Code

Hey everybody, I'm a new grad working in a 31 bed renal/pulmonary unit with a 6 bed step-down at a teriary care hospital. Today near the end of my shift a patient that I have been taking care of was found on the floor not breathing and no pulse. We immediately called a code, and began CPR. I performed chest compressions for 25 minutes. When the code team arrived the patient was in asystole, we managed to get her into V-fib with epi and atropine, but when we shocked her it went back into asystole. Eventually we got her into PEA, before she went back into asystole. At that point the code was called and the patient was pronounced dead.

I must confess that being the naive new grad I have been hoping to see a code happen. However, I really like this patient, I cared for her on previous admissions. She always asked for me to be one of her nurses, and I genuinly enjoyed taking care of her. She was very depressed and tried starving herself, we didn't give up on her even when she gave up on herself, and only recently she had decided she wanted to live. After she was pronounced I went and cried with the family.

Thanks for letting me vent, I still am really upset over her death. At this point tonight I don't care if I ever see another code.

Featured Replies

Thanks for letting me vent, I still am really upset over her death. At this point tonight I don't care if I ever see another code.[/quote

Wannabe3...The first code is ALWAYS the hardest. I am not going to say something stupid like "you have to suck it up and move on." That is not a good way to be. If you are having trouble, see your supervisor and ask about a CISM(Critical Incident Stress Management) debriefing. This is a VERY GOOD way to get help. I have been in E.M.S. for several years and have used it myself. It is HIGHLY recommended.

My first code was a three year old who fell in the river in my home town. I knew him...His mother...father. I almost left E.M.S. HANG IN THERE Wannabe...you ARE!!!!!:)

My first and only code was my dad. If I never am part of another one, I'll be happy. I truly feel for you, and know you did all you could. ((((HUGS)))) to you.

  • Author

I really appreciate the kind words of encouragement. Its just that I never witnessed a code in nursing school, and I have never seen anyone die in front of me. I know that I'll feel better in the morning. My co-workers were supportive and one of them who is a BLS instructor, said I did picture-perfect chest compressions. The code team was happy since they felt a femoral pulse with each compression.

I feel really bad for the family, her son is only 21.

I would say the motto of the story is "be careful what you wish for."

I've been a RN 10 years....never seen a code and never want to. (Knock on wood.)

I'm sure everyone can remember their first situation like that. I know I do. You'll find your own way to work through these feelings; sometimes it just takes a little time. Certainly talking (typing!) about it can help.

What touched me the most was your statement about "crying with the family". I have shed tears on multiple occasions with family members. It's that compassion that will help you to be a successful nurse.

You know, you did very well. You can't even say that codes get easier. Sometimes you wil be attached to a patient and that makes it hard. You did what you could do, bless you for that. :)

You will get thru this. Never be afraid to talk about your feelings to someone. Just know that you did the best possible job you could.

  • Guides

I can't add much to what's already been said here, except this: You NEVER want to 'get used to' codes. There's nothing worse than a nurse who can't feel. I've participated in several codes and seen a number of people die in the 10 years I've been in the field, and every one of them affected me on some level........some more than others, of course, because like most nurses, I get attached to certain patients, and they take a little piece of my heart with them when they go.

I hate crying, but sometimes I can't help it; I just don't allow myself to fall apart completely in front of the patient's loved ones. But if I ever get to where a patient's death DOESN'T affect me, even a little bit, that's the day I walk away from nursing forever.......I wouldn't want an emotionally devoid nurse caring for me or my family members, any more than I'd want one who loses her head during a crisis and needs to be supported herself.

You deserve a pat on the back for getting through this experience.....the first code is ALWAYS the hardest. Don't give up on nursing because this hit you so hard; we need compassionate and caring people in this business, and you sound like a wonderful addition to our profession. :)

WOW! chest compressions for 25min? I do good to do them 5min. Usually, when someone is in asystole, their chances of being saved are very slim. Asystole is a BAD sign. You might get some v-fib because of all the medicines you're pumping in the pt, but chances are that they will go back into asystole. Ive been nursing 13 yrs (I worked in er), I dont know that I ever had a pt live who was in asystole. It sounds like her body was tired. Next time you're in a code, take a different role like doing the documentation, drawing up and giving meds, etc. This way, you will get experience in every aspect of a code. During my first few codes (right out of school), I did the charting - I was scared to do anything else. My charge nurse helped me get comfortable with other roles in the code.

to change your screen name you are no longer a wannbe...

I am only a student but have been in the fire and EMS field for years. I have been "there" several times both in the field and in the ER as an EMT. It still bothers me every time.

When my fire pager goes off for a jaws of life call I always know I am going to lose many hours of sleep...

You never get used to it...unfortunately it is part of the job. There are many stress debriefing teams available in every part of the country. reach out if you think you need to chat. If not we are all here to share your pain.

By the way, you sound like a great, caring nurse who cares very much for her patients. The woman that died was lucky to have had you as her nurse, you should be proud of yourself...

Good luck and best wishes, dave :)

You're a good and compassionate nurse. :)

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