Had my first code last night...

  1. Hi all. I am an LPN on a med-surg floor (just graduated from RN school) and have been working med-surg for about two years. Last night was my very first code and I am still shook up. I know it had to happen at some point in my career, but I still feel so anxious. Luckily my coworkers were by my side the entire time and guided me through what I didn't know. I just keep going over again and again in my head what I could have done to prevent this. The patient was admitted with chest pain but an MI was ruled out. At the beginning of my shift he was A&Ox3 and only having mild pain. Then, near the end of the shift, he had a fall and afterwards became diaphoretic, dyspneic, tachycardic, and just didn't look good at all . Called doc and nsg supervisor after assessing him. Asked coworker to restart IV that had came out during fall while I talked to doc on phone. Five minutes later he wasn't breathing and luckily the other nurse was with him and we were able to react very quickly. I still feel so anxious though. I know in my heart I did all I could do, but I still wonder if I had just checked on him five minutes earlier than I did (I had checked on him and then went into the room next to his. Ten minutes after being in that room I heard a thump and rushed to his room) or stayed with him longer could this had been prevented. How did you all cope with your first code???
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    About Ahhphoey, ADN, BSN, MSN, CNS

    Joined: Apr '02; Posts: 384; Likes: 226
    RN; from US
    Specialty: 16 year(s) of experience in ICU, M/S,Nurse Supervisor, CNS


  3. by   traumaRUs
    It sounds like you did everything you could do. The only question I would ask is how were you treating his chest pain? With nitro? Perhaps maybe an EKG after the fall unless he specifically said he tripped over something. Arrythmias can cause syncope. I'm sure you did fine.
  4. by   graysonret
    My first code was when I was working in a homeless shelter. I was the only nurse on duty that night, so I had to work alone on him. It was a big adrenalin rush...which is probably why I could keep it up for about 30 minutes, until the ambulance arrived. Had 2 NAs but neither one was CPR qualified. Patient was still alive when he arrived at the hospital, but died, several hours later. I was exhausted and sore, but I felt good that I did something to help someone in trouble. Needless to say, my stature as "doc" in this shelter of 1200 people, went up quite a bit. LOL. Since then I've had only 1 incident in a nursing home. It was fruitless but had to be done, because the patient was a code. I don't think the patient would have cared, as sick as she was. Such things will happen in nursing. Go by "the book" and do the best you can in the circumstances you have. Remember that you're the most qualified to do the job at that particular time.
  5. by   BBFRN
    It's not your fault. Times like these call for teamwork, and it sounds like you guys followed protocol correctly. It's not at all unusual to feel somewhat traumatized after your first code, but that will go away, and you can use this experience and call on it when/if it happens again. You had checked on the patient, and you work med/surg, so I can imagine what your patient load was. These things happen, no matter how thoroughly we assess the patient, and how many times we check them. We had a guy just keel over about a month ago. He had been up walking and joking around at the nurse's station 10 minutes earlier, and was going to be D/C'd home in the A.M. He was fairly young, and none of us expected this. He went to bed after saying good night to everybody, had no complaints, and then had an MI when he went to bed. He was gone 10 minutes later when the Tech went in to do his vitals. We were all stumped, and his nurse felt awful. Sometimes there are things we could do to prevent codes, and sometimes it's just their time to go. I hope you are getting the support from your co-workers- I think I never felt more loved than after my first code (The patient didn't die, but he almost did, and I felt responsible for not catching a PE earlier than I did), and instead of everybody pointing their finger at me, they gathered around me and offered a shoulder to cry on, and pointers on how they dealt with it when it happened to them. One of the most valuable lessons I learned from this was from my preceptor who told me, "Remember what this looked like. Remember the signs this patient exhibited and how quickly they progressed. Process this in a way that will allow you to use it in the future to save someone else if you can." It was good advice, and you can bet that now I will act in a heartbeat if I suspect a PE!
  6. by   MandyInMS
    I guess every nurse quizzes his/herself after a code..especially if it is YOUR pt..did I do this?..should I have done that?..Haven't had a pt of mine to do the "C" word as we call it for a while..-knocks on wood-...I better hush I have to work tonight..don't wanna jinx it...lol...I can still remember my 1st code..was on a different unit and I responded to it...I was terrified..and was shaken up for quite a while...no matter how much you were taught in school I don't think it prepares you for the reality of it...but, after many many codes you do become more confident...sounds like you did everything you could for your pt lovelylpn...hang in there, it will get easier to deal with the more experience you have ((((hugzzzzz)))
  7. by   HARN
    Having one of your patients code for the first time is a real hard thing to deal with. Nurses tend to be so objective of there selves. We all do it & only when it's our patient. It sounds like to me you did everything you were required to do. Like others have said as time goes on & more experience comes this will be an easier situation to handle. Or at least you will feel more secure with your actions
  8. by   Tweety
    You did great!

    I'm very encouraged that you are turning this into a learning experience and questioning what is there to learn about this situation. Don't ever loose that. There's always something to learn. Just don't agonize.

    I remember shaking so hard during my first code, trying to be cool, I thought they were going to have to code me next.
  9. by   bubble
    Those feelings always happens to new nurses I have noticed.
    If you did not feel that way is another viewpoint. I recall my first time to give MS04 to a DNR, DNH patient ---in less than 15 min. the patient was dead when I went in to room. I cried--Iwas sure I killed the patient.my supervisor calmed me down before the family arrived.I still yet get emotional sometimes when a resident passes away.[ Iwork in LTC ]. You did all you could do.Keep up the good work. Keep asking yourself questions. Trust in yourself and God.