1st CODE.....

Nurses New Nurse

Published

Alrighty... I dont know how many of you newbies have seen a code yet... or have one happen to your patient... If anyone has i would appreciate your input... it happened last night i am still freaked out...:imbar

I work 3-11.. I had three patients last night and i decided to assess this one first... right at 1500..This guy was a 59 year old... he had had a CABG x4 on the 14th so he was pod #7 he was a 1 pack a day smoker and a drinker.. he had been on ativan protocol and had been halluciating.... but all that had ended the day before.. he was awake and alert and oriented but a little vague.. no hallucinations... He had also been in UCAF 2-3 days ago and they had him on po amiodarone... so he has been NSR for a few days.. nothing else significant except he had been started on dopamine for renal issues.. 3 mcg/kg.. so he had dopamine and 1/2 ns running through a h/L . He was on 6 liter NC.. and sat 91, 92% lungs were junkie of course.. insp ans exp wheezes and scattered rhonchi T/O... anyways so i did his assessment and I put him back to bed... vitals were stabel.. NSR, 70's bp 150's....afebrile.....

I went to see my other 2 patients... at 4 i checked wiht our moniter tech to see what he was doing... still NSR in the 70s.... about 4:45 i went into his room to give him his coumadin... he was sitting up eating dinner.. he was acting a little vague... it took me 5 min to get him to swallow his pill.... he was trying to chew soup without his dentures in... anyways i took his pressure again just cuz i hate dopmamine it freaks me out... i always am neurotic about chekcing bp and hr when pts are on it... anyways he was 100/30... (lower of course than earlier but earlier he had just been started on dopamine... so i expected his pressure to rise a little ealier) hr was 76... i walked out to the nurses station and our moniter tech tells me that .. he had a 2 sec pause and is bradying down the the 30 and 40s but comes right back up... my former preceptor was sitting right there... and i asked her if dopamine can cause pauses... we both walked right into his room and he was slumped over in his chair.... face blue gray.... i freaked.... of course we called a code.. and 30 people showed up.. there was a RT already on the floor as well as 2 docs so there were there immediately... he never went asystole... i guess he had a faint femoral pulse... i didnt really do anything.. i havent taken ACLS yet..... and he didnt have to be vented ... they gave him 1 mg of atropine... and put him on a 100% nrb and he came back.... (although he was still confused when we got him to the ICU) he was stable enough to be transfered to the ICU...

Anyways i was shaking i was so freaked.. i cant get his face out of my head...... he was so blue/gray... i couldn't sleep last night and I am still thinking about it...

anyone else had their patient code?? i have never even seen one before nevermind happen to my patient.... of course i work on a cardiac surgical floor so it happens ... anyways... i need some feedback... Sorry this is soooo long!!!!! :imbar

Specializes in ER, ICU, L&D, OR.

Sorry you had a rough time. The first is the one you will always remember. Ive been in nursing and an EMT and an orderly and a hospital corpsman for well over 3 decades now. I still remember my first code. But back then they werent called a code. But I still remember my first one even his name and all.

Hang in there and keep learning.

Specializes in Critical Care.

Scary huh?? You called the code and got things going before we was asystole, that's great. It sounds like you are keeping on top of things.

Noney

Specializes in Behavioral Health.

You did good.

My 1st code was a patient that I had taken care of 2 weeks prior. Had a couple of stents placed and went home. They found her on the bathroom floor...never got her back. :o

you never forget your first.

now i work ED and we see them roll in often and of course we have a few patients that code on us even though they came in walkie/talkie. doesn't matter how many times i've worked codes, i still remember my first.

hang in there.

My first code was multiple gunshot wounds. Had lots of them in the ED.

Had two this week in our unit.

Each one, you learn something new, and get calmer and your mind stays with it, and you will feel less panicked.

Specializes in tele.

I had my first code on Oct 25,2003 at 0930. My patient was scheduled to be discharged this day and was taken off tele and her IV "fell out" during the night. SHe had been complaining of neasea so I got oral reglan for her. No more then 2 minutes after giving her oral reglan, she complained of lightheadedness and stars in front of her eyes. A few minutes later, she passed out on me. The code light was pulled and rush of people ran to the room. We started CPR for about a minute. She has been fine since then with complaints of rib pain. Admitting diagnosis was exacerbation of CHF. We do not know why this happened but theory is that she had vagal response causing her to pass out. Boy does this all change your relationship really quick with a patient and their family. I was just another nurse in one moment and became a hero in the next. This is one of those days that I realize that I really am a nurse now. Its just amazing what a little training can do.

I have had two patients almost code due to too much narcotic. One had a rr of about 6. She was blue and her skin was so cold. I told the Dr that this all started after her last dose of morphine and she did have impairment in her kidneys and liver. They ignored me since they said she had been getting the medication for awhile. I told them that normally she got the med 2-3 times a day but that day she had it almost 6 times (it was prn). They were doing EKG's and starting fluid but had no idea what was going on. I just had a gut feeling about it and insisted. They decided to try some narcan *just in case*. Within a minute the lady sat right up, grabbed my stethescope around my neck, and began to choke me. It took two other people to peel her off of me. Some way to thank a person for saving their life eh? She ended up becoming one of my favorite patients. Those who are confused have the funniest things to say.

Specializes in ER, PACU.

My first week off of internship I had 2 patients code on me in the same night!!! (I work in ER). One we didnt bring back (he was 105) and the other one was brought back. One of them happened when I was on break, I thought the covering nurse was going to kill me! LOL.

Quick question......this patient was on dopamine without continuous monitoring and not in the ICU?

YEs u are right.. he was on dopamine and not in the ICU.. my unit is almost an ICU minus the vents and the 1-2 pt assignments...

Its a CV surgical floor ... we have patients on every kind of gtt u can think of.. except neo... if they are on neo they have to be in the unit... And they are continuously monitered... u usually dont have more than 1 pt on dopamine.. so u obviously moniter your patient more than you normally would... i take vitals on my patients an average of 3-4 times a shift.. but usually of they are on dopamine we hook them up to an automatic bp cuff and take their bp's q 30 min....

And just as a side note... that patient came back to visit us.. yesterday... looking great... he bought himself a pace maker but it was great to see my code pt.. out of the hospital and walking around ..

Hi,

I still consider myself a new nurse(passed boards in Mar 2001). I wonder if I will be a good as those who precepted me.

I worked in the ER for 8 months(I had been a LPN for 5 years in the ER and my boss allowed me to have an internship after I graduated from my ADN program). My first code was a 3 year old that a dresser fell on. I was still on orientation, and never having done a pedi code, it still makes me think.

You did well. Hang in there, kiddo.

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