First code

[MrsJt]

Hi all! Let me start by giving you a little background about myself. I am a new nurse, off of orientation for 6 months now on a busy ortho-surgical floor. I had my first code last night, which the patient did not make it. I am having a hard time dealing with this. The patient was older, with a laundry list of co-morbidities. Family was grief stricken, but were not completely caught off guard because the patient had been sick for awhile and only getting worse. Death was ruled cardiac arrest and found to be natural causes. I am just having a hard time with this. Is there something I missed? I just feel that something needs to change in nursing. How are we to notice of a decline, with 4-5, sometimes 6 other patients to care for? We are a non-monitored unit. I work night shift, so sometimes the slightest changes are hard to notice when someone is sleeping. Vitals, bs, and labs were normal. H&H was a little low, but doctor was not concerned. I have been struggling with nursing in general (patient ratios, amount of pain meds given, short staffed, etc) and now this makes me never want to return:(

[HeySis, BSN, RN]

And I hate to say it, but my daughter had volleyball practice that morning and I didnt want to let her down by being late. I just felt like I was being pulled in all directions. Please don't take anything I say as being insensitive. I have thought about this everyday simce it has happened.

I don't think that's insensitive at all. It would be foolish to think that when we enter our workplace and put the nurse hat on that we take off every other hat we have (spouse, parent, child, friend). I've been in nursing for about 25 years now, it's been a running joke that you can't let someone die because it's too much paperwork. (some may feel that dark humor is insensitive.... dark humor is how I deal).

It's too bad there wasn't anyone that you could have asked for help from in getting everything done and in order, it's hard to do all that if your not familiar with the system, even if it's not your first code.

[MrsJt]

Thank you for your encouraging words amd not making me feel like a horrible person. I am just taking it one day at a time. Had a small emotional break down yesterday before work. I am really struggling with nursing and the stress and demand it puts on us. I am afraid to talk to my manager and others at my facility. I fear I will lose my job, be judged, and not receive the support I need.

[Cowboyardee]

See if you can find a kind and non-judgmental doctor involved in the case and ask him or her to review the code and events leading up to it with you. Failing that, maybe an experienced and knowledgeable nurse. Understanding the situation and its complexities is good for you and good for your continued practice. Second guessing everything you did and getting no answers is not.

For a while, it was pretty common to have a huddle and debriefing after a code or other serious event. I know some places still do these, but it's often fallen by the wayside it seems. Which is a shame. Because when done right, they help staff recognize things they could do better, things they did well, and things they ultimately had no control over. They help newer medical professionals especially deal with the realities of the job and not feel traumatized when bad things happen to sick people, as they inevitably do.

You do your best, learn from it, and let it go. That's all any of us can do.