My first code

[christvs, DNP, RN, NP]

Even though I've been a nurse for a year and a half now, we don't see many patients go into cardiac arrest on my med/surg/tele unit (thank goodness). But yesterday it happened (not with my patient) on my shift. A RT came out of a patient's room to check on someone and said a pt wasn't breathing-so we scrambled around to see who had her and what her code status was-which was Full Code-so someone yelled to call a code-so I pushed the button and then everything happened so fast after that-and I was the one who was writing everything down...and I was so nervous and trying to write everything down correctly and with the exact minutes they were doing everything. I guess I felt nervous and really slow doing things, because that has never happened to me before-and I was watching the CCU nurses and physicians doing their job so fast that I was in awe of them all. I guess I felt really uncomfortable because I never saw that before and as a result felt like I was moving in slow motion-even though the charge nurse said I did a good job documenting everything. Has anyone else felt inadequate like I am feeling right now? I hope with some more experience I can feel better about how I feel when emergencies like these occur.

[TazziRN, RN]

You will feel more comfortable with it, especially if you work tele or higher. As far as documenting, just list everything that happens on a piece of paper, it can be transposed onto an official record later. The hardest part for me was jumping all over the code record, trying to figure out where each piece of info went, until someone told me about just listing the occurences and charting it properly later.

'Nuther thing......don't waste time trying to find out the code status, if unsure, call the code. If the pt turns out to be a DNR the code can be cancelled, but you can waste precious time if the pt is a full code and you're doing nothing.

[EMSChild]

With my first code, the amblance radioed in and I remember thinking "Someone should call the ER... Ahh, I'm the ER!":eek: I was terrified. But I lived through it, no pun intended.

There are some codes you will look back on and see that you were there at the right time and did everything like clockwork. Others you can look back on and wonder what just happened. It just depends on your team.

Even if you don't get a lot of codes, ACLS or the like might be good for you to take.

Just remember that no matter how many codes you're in sometimes your hands will shake, you'll have to remind yourself to breathe, and it will seem like complete chaos. My advice is take a deep breath (quickly), focus on the ABC's, and know that the chaos will clear.

[mced]

Law III: At a cardiac arrest, the first procedure is to check your own pulse.

Things always run smooth after doing this!

[traumaRUs, MSN, APRN]

I think you did just fine. It does get easier each time you do it.

[lauralassie]

Hang in there , it will get better. I remember when I was a new nurse, codes terrified me. I remember being calm during the code and a ball of nerves after. Now that I've been in critical care/er for almost 28 years, it's less nerve wracking. Looking back , the best thing I found was to watch the nurses that are doing the code, review what they did after you leave work. Think about what you remember, how they did it and the rational behind it. That way when a code happens again you will be one step closer to handeling a code yourself. Who knows maybe we have a potential critical care nurse ! I hope so.

[RunningWithScissors]

Even though I've been a nurse for a year and a half now, we don't see many patients go into cardiac arrest on my med/surg/tele unit

You may not realize it, but by your good nursing actions you may have headed off a code or two. Give yourself some credit for that!

[CCL"Babe", BSN, RN]

It sounds like you did exactly the right thing. Your job of documenting correctly was just as important. Good job.

It does get easier with time and experience.

[Antikigirl, ASN, RN]

IT has been a long time for me, and I will be a mess too...but I know if I am the historian, write the time and what is being done...just that, try to avoid thinking too much or watching in awe (which I do too!!! I LOVE IT!), just get into a kind of robot mode and just record...it is a vital job!

Congrats on your code though...it is good to have those under your belt so each time you get better. THere is no way to gain that experience unless you actually are involved in them. So one more under your belt...learn from it and improve...hopefully you won't have another for a long time :).

[Happy-ER-RN, RN]

Absolutely take ACLS. Your hospital should offer one every quarter or so. I felt just like you when I first started in the ER and after ACLS it took my anxiety level down so much it was unbelievable. ACLS is actually not that difficult if you take the time to learn it and YOU will be the one who knows what to do on the next code, or if one of your patients starts to crash.

[jo272wv]

I too have only been in one code blue situation, I took the documentation part of it also. I watched all the code blue team doing what they were best at doing and wondering how they learned it. I think I could document, push the drugs, do the chest compression but, I dont know if I could ever be fast enough to find and get the drugs ready to hand to the nurse administering them.

I am going to take the advice of the above nurses and take ACLS next time it is offered.

[GregRN]

I've been an RN for only 10 months and have been in critical care right out of school (second career). At our hospital it's mandatory that at least one MICU and one SICU nurse go to each code. My first one was with my preceptor and I just watched, tried to learn as much as possible. Afterwards she said, "What did you learn?" I told her and she said, "Good. Now at the next code I want you in there doing chest compressions." From there on out I got involved as much as possible and absolutely love them now.

I've always been one to be closest to the action and to be as hands on as possible. I also realize the importance of those who choose to document the events rather than throw in lines, meds, assess, etc.

A suggestion to christvs and those who are on the floor when your patient crashes, if I may. I know that the position of RN is different in the ICU vs. on the floor. How well each floor nurse knows their patient is often times different than the ICU. Floor nurses have 4,5,6, or 7 patients they are responsible for and getting to know each one of them in depth is impossible. However, when the code is called, please do whatever you can to dig a bit deeper and find out all you can about the patient. When the code team arrives and we see a patient on the ground with myoclonic activity, whether or not they have a history of seizures is good info to have. Or, when someone is found to have a dysrhythmia, their most recent labs and knowledge of which meds they're on is also good to know. Along those same lines, if a code is called and your patient has no IV access, do what you can to get a line in before the team arrives. The patient will be that much further ahead when we do get there.

If you're more comfortable taking notes and documenting, that's great...we need you! But still be involved by assessing the situation and being ready with any information about your patient that may be helpful.