How was your first code blue? What role did you have? - page 3
The first code blue I ever participated in was at my first nursing job, while I was still in orientation. The patient was not mine. It was an older woman with breast implants. The nurses in the room... Read More
Dec 12, '15Joined: Mar '10; Posts: 2,233; Likes: 7,045My first code was on a premie. I was on my OR rotation during orientation in L&D. We had an antepartum patient with a lot of stuff going on and were continuously monitoring fetal heart tones. Gestational age was 26 weeks, but baby was measuring small by ultrasound.
Anyway, sometime in the afternoon--just as we were about to take a scheduled C-section back, of course--this other nurse and orientee come crashing down the OR hallway and into OR1 with this patient, a doc, and anesthesia close behind. My preceptor shoos me into the OR, telling me she'll keep an eye on our scheduled section.
I run in there and anesthesia is putting mom under. I find out that they lost fetal heart tones about 5 minutes prior. A few minutes later, they deliver this 26-weeker by c/s and NICU goes to work. Baby was born with no signs of life. I'm standing there watching and the NNP calls out for a recorder and starts yelling times and interventions. I record and watch everything for a full 20 minutes. In the meantime, mom's IV goes bad in the middle of the section and they almost call a code on her.
In the end, NICU calls it and our OBs get mom sewn back up. Baby is left in the warmer wrapped up under a blanket for us L&D nurses to tend to and mom rolls out to ICU. Just another day in L&D.
Dec 12, '15Joined: Jul '12; Posts: 318; Likes: 394I was a nursing assistant in the PACU, actually just passed nclex but didn't get hired as an RN because they don't take new grads. This guy sat straight up and gasped for air and ended up having an MI right there. I was watching and overwhelmed, bunch of people. Then my boss says "where are you going you're a nurse now, grab the EKG machine." Everyone saved him and I got to wheel him up the the CCU. That was my last day as a nursing assistant, went out with a bang!
Dec 12, '15Joined: Jul '12; Posts: 725; Likes: 1,304My very first? I was a nursing assistant in a very large teaching hospital. I ran for supplies and ran labs to the lab (tube system was down and ABGs had to be hand delivered to respiratory in the ICUs because central lab was performing maintenance on their machines). As it would turn out, as a float tech/assistant, I was the only one who knew which ICU was closest and where respiratory was...so I ran labs. I was just fine with that job. I believe we transferred the patient to ICU...
My first as a nurse? The patient was my patient's husband. We found him down pulseless... We revived the patient, they were admitted via the cath lab, and were sent to ICU. In ICU they stabilized the patient, ran a million tests and found metastatic cancer literally everywhere. They were able to extubate...and the family chose comfort measures only. The house sup arranged for him to be transferred back to our unit (so family only had one place to visit), and the patient died on the third day on our unit...
Most of the codes I've been in, since I started in the OR? I've been involved in patient care in another way. One I was scrubbed during, and had to keep passing instruments and working (we only paused when anesthesia attempted needed us clear of the patient for our own safety). Another, a coworker and I were in charge of checking blood (we were on massive transfusion and infusing blood/products as quickly as we checked it). If we had been in a prolonged code situation, my coworker and I would have rotated through turns with CPR. As it was we ran that code for something like 11-15 minutes before the trauma attending called time of death. That was like the 4th or 5th witnessed event, and the patient's neuro exam suggested devastating neurological injury (not considering other injuries which were life threatening in their own right).
Dec 12, '15Joined: Aug '09; Posts: 6,328; Likes: 26,048My first code was a cancer patient.. that never should have been "coded". It went on for way too long, the rest of the unit was in shambles.
Realize that 95 % of codes are for show. Around 5 % of patients survive and return to baseline.
Your coworkers were deflecting their anxiety , by mentioning her implants. Not professional but understandable.
You cant fix dead.
Dec 12, '15Joined: Nov '13; Posts: 82; Likes: 95I walked into a CVICU during my last semester of school and was immediately greeted with people starting the code. I had worked with the nurse I was assigned to and she knew I was shy but that I wanted to participate, so she grabbed my arm and lead me to the bedside and put me in line for compressions and stood beside me explaining everything that was happening, what to look for what to expect etc. The pt was a 50 something post CABG x3 days or something like that and she had thrown up and aspirated which caused the code. Her wound was dehisced and I clearly remember the single staple that hadn't ripped yet that was the last one holding the wound semi-closed.
I'm really grateful to have had that nurse teach me at those clinicals.Last edit by Vana21 on Dec 12, '15
Dec 12, '15Joined: Jun '02; Posts: 14,901; Likes: 8,058I was a CPR instructor and as was cleaning our neighbor's store when another neighbor told the proprieter that her next door neighbor was on the ground passed out. She told me to go help him, so I began one man CPR on him, and kept it up until the ambulance and crew arrived. They took over and loaded him on the ambulance a few minutes later. I asked one of the crew members if he made it, and that crew member said he didn't. I was invited to join the ambulance corps after that incident.
Dec 13, '15Joined: Oct '14; Posts: 11; Likes: 6My first code blue did not occur until 19 years after I became an RN. The code lasted approximately 30 minutes. It was my patient and the resuscitation was successful. After presenting the patient's history, I stood there in disbelief. The patient had just been up walking in the hallway a few hours earlier. I believe it was caused by a PE because he had just been transferred to my transitional unit after spending several days in the ICU.
Dec 13, '15Joined: Jan '07; Posts: 528; Likes: 1,520I'm bummed that I can't recall my own first code, darn.
Dec 14, '15Joined: Aug '12; Posts: 718; Likes: 912New nurse on orientation in the ER. 6 month old baby in cardiac arrest. ROSC, but baby was brain dead. Mother was in denial, boyfriend was charged and jailed for first degree murder. The whole situation was a hot mess. Welcome to the ER!
Dec 14, '15Joined: Jul '15; Posts: 10; Likes: 4I don't really remember my first code, been so long ago! But 3 codes come to mind. I worked in a teaching hospital and the hallways were always full of resident doctors. I had a sweet little old lady that had told me she didn't want to be coded, but this was way before "Living wills" and DNR status. I remember cracking her ribs and feeling the bones gritty feel with each compression and I SWEAR I heard her curse me with each compression while the resident was yelling "push harder!". Luckily, my sweet lady went on the better things that day. Another was a frequent flyer, had multiple vascular surgeries. We had already coded 3 times in past couple of weeks, but her husband insisted she be coded. Her last code, the physician pulled the husband into the room to watch. The code that i remember that hit the hardest was a 35 yr old mom of 3. She had gastric bypass for weight loss and was going home. She was in the bathroom, getting ready for her family to pick her up when I heard a loud bang at her door. There was a tiny LVN and aide in the room with her. She had fallen against the room door and we could not get the door open! The patient weighed over #300. Between the two pulling her and a couple of us pushing from the outside, we were able to get her over by the bed, but we had to code her on the floor. The ICU nurses asked why we didn't get her into bed. Patient had massive PE. And when the code was called, I walked out the door and there stood her husband and children. Heart breaking!
Dec 14, '15Joined: Oct '11; Posts: 11; Likes: 14I was working in a correctional facility, and we were taking care of a patient we initially thought was anxious about an upcoming court date. As the corrections staff was getting ready to move the patient to be watched more closely, the patient slumped on the bed and didn't respond to the correctional staff via intercom. The funny part is when corrections called for medical over the radio, the only thing I heard was medical's call sign and the pod the patient was in. The rest was static. The pod was close to the nurse's station, so rather than wrestle the radio, I walked over to see corrections staff attempting to move our patient, who required more than one person to move, to put it kindly. We did the best we could with our BLS equipment, but the patient didn't survive. We found out later that even if a surgeon had the patient already opened, the patient would not have survived. I remember crying in a corner for a bit, and then getting called over the radio by one of the sergeants. Sgt. Showed up at the medical office door with a man in a suit (at about 0400), who I assumed was psych. Nope, the facility head honcho. The news of the diagnosis helped, but I felt very conflicted for a long time. Now I work ICU, and codes or crashing patients aren't uncommon things. But I don't think I'll ever forget my first one.
Dec 14, '15Joined: Jul '08; Posts: 16; Likes: 37I was a student in the ER when a young man came in after a motorcycle accident less than a mile from the hospital. That was my first time doing CPR. A decision was made after a certain amount of time during the code to continue CPR and treatment to keep his organs viable while the transplant team flew in. His family arrived and after much discussion, refused to allow his organs to be harvested. The doctor called it and the silence in the room was deafening. Seasoned nurses were in tears. My teacher wrote for aback then (1991) and described these events in an article.
This was before 'donor' was placed on drivers licenses or before the donor registry. Things have certainly changed.
Dec 14, '15Occupation: Registered Nurse Specialty: 5 year(s) of experience in ICU, PCU ; From: US ; Joined: Oct '13; Posts: 459; Likes: 1,460I posted here after my first code about 6 months ago. I already forget some details, but at the time it did affect me emotionally so I'm sort of relieved by my failed memory. 80 some year old nursing home guy with pretty bad CHF and urosepsis started tanking his pressure. Didn't respond to the baby 250 boluses we opened up, so the docs started working on a central line while I went to mix some Neo. As I started the drip I looked up and noticed his rhythm change from a clean sinus tach bradying into this ugly wide complex rhythm probably idioventricular. He had no pulse so the resident started compressions and I started bagging. Then respiratory took on bagging and I got on the chest.
I do remember breaking a sweat and my glasses sliding off onto the bed. I remember two people being subbed out because their compressions were crap. I also recall that the room was so crowded that you could've probably gotten a good color change on an ETCO2 monitor just by holding it up in the air. It was futile, and really we shouldn't even have had to code him.. but it was the wish of his wife. Ultimately some silver lining was that he was able to see his wife and be with her just moments before all this went down.
I've been in about a half dozen codes since then after moving to ICU and have played in each of the other roles - CPR, meds, writing - and I by far like doing meds the most. You can see the whole thing going down while being right in the middle and playing a crucial role. Plus the interns and 2nd years usually need help working the Zoll :P I do not like being the first in the chest and smashing their ribs and sternum. I won't ever forget that crunch.
In in my limited experience with codes, involved or following post-codes, I would say that some people who we get back shouldn't have been gotten back. Therapeutic hypothermia and watching those seizure-like twitches people get when their brain is cooked after the inevitable anoxia... it's ugly.
Agree with what Dranger said about black humor. Empathy is important in our line of work, but you have to find a balance and let that stuff go otherwise you'll be unable to function. For instance, my one coworker and I joke around about some of the minor BS we have to do versus the serious stuff as ICU nurses. So after we lost our last guy he goes "I wonder if his MRSA swab was positive" and I joke back "do we have to enter his IVs into the computer still?"