The worst happened, a co-worker arrested at work, taken to the ER, then sent to our ICU. As you might imagine, it was a challenge, as no existing IV or attending doc, the pure shock of treating one of your own... the staff that came from everywhere, and the tough task of reigning it all in.
Has anyone else been through this?
Even though we care greatly for each patient, the element of having to code one of our own, presented much more stress, chaos for the code situation and emotions increased in an unknown situation of lack of medical history.
Although everyone did the best care they could in this tough situation, I'm left pondering how we could have improved, I suggested a post code conference for all involved. However as can be imagined, staff was emotionally exhausted, two hours behind on their patient care and even though it was meant to happen and planned it didn't due to the acuity of multiple admissions and possible avoidance of the situation.
Things did not go smoothly (although best care was attempted) and there are always areas we can improve our practice, and the area the staff member coded was not one that does this routinely. So even if it was an inhouse patient, there are areas to discuss to enhance future care.
So now I don't work for several days, I had attempted for this to be a teachable moment and possibly change some practices, but I am a traveler, and this is a tight knit group that seems to be shutting out my suggestions, while I only want everyone to benefit from hind sight and improve on practices... but as this is not my home, and I am a "stranger", I feel I am not being listened to.... as everyone is obviously in shock and grieving and not seeing the benefit of a post code gathering.
Suggestions? Does gently pushing a request for a group discussion interfer with the existing dynamic and I should let everyone deal on their own, and my suggestions for improvement are inappropriate for the situation?
I just need to know how to support a new work family and not ever, ever make it seem that I find any fault, only a few suggestions but we need a better plan as this could happen to a visitor or staff and i really wish the best outcomes that we can provide.
Thank you both, going to sleep on it and take your advice. I love my peers and trust them to do what is right by them. I obviously feel a need to push this a bit, but know that I am not the one to know what is best for them. Thanks to all who wish to give advice after, this, I respect you opinion and will read soon.
Why do you feel the need to push for anything, will it help yourself or others? Not everyone wants to replay stressful/traumatic expereinces over and over. some people like to talk about these and find comfort in it, others do not, ever, and that is as valid and realiable a coping mechanism as any other. If the staff did not professionaly handle the code well, by that I mean, people were fumbling along, clueless, maybe you can address these areas with a manger/educator. If the person coded in an area where codes are rare than I am not suprised this did not go smoothly, nor will it ever, even if everyone is ACLS certified etc, if you do 1-2 codes every few years or 1-2 in a 20 year career , codes will never go smoothly esp if they catch you completely off guard. Is there a code team? Of course most people will be more emotional if they are coding someone they know.
Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.
I have coded a fellow coworker. The outcome was less favorable than yours. She died on the unit. She coded as she came on to the change of shift ( 11 PM). It was horrendous and chaotic. I don't think it could have gone any other way. This is one of your own. You try to keep focused on what's going on, but inevitably your emotions are enmeshed in the whole situation. Staff from our neighbor units came, as well as administrators. This was 24 yrs ago before there were code teams. We were the code team. We did have anesthesia and resp up as well as other residents. She couldn't have coded in a better place. If she arrested 5 minutes before in the parking garage, she wouldn't have even had any chance. We did everything there was to do, and probably more so, as she was family. All the patients knew what was happening as it was a very small unit and the code happened in the middle of the floor. The next morning our ADNS came in. Just about every patient was discharged. Administration basically closed the unit down for a few days so we could debrief and regroup. Everyone in the hospital was very supportive to our staff and unit. By the way, this is a very big, well-known teaching hospital. I think our small tight-knit unit did well to recover. It did take some time. I don't think it would have been appreciated if an outsider took the initiative to organize a post-code meeting/critique/review of the situation. A critique on 'room for improvement' really isn't appropriate at this time, and it's really not your place. The best thing you can do is just to be there for those who are having a difficult time getting through it. Let the staff be. Healing needs to occur.
I agree with some of the others. Trying to push for a meeting right after the code and using it as a teaching lesson was inappropriate IMO. Continuing to push the issue is not going to work if they aren't accepting of your suggestions. People can't be forced into accepting the opinions of others. The staff was obviously upset, drained and still behind on their work like you stated. Codes are always hectic and stressful and there is no perfect way to act during a code. Personally, I think a code team may have been more effective due to not being emotionally involved. If a code team is not available, the nurses have to do the best they can, regardless of the situation. I'm not sure what could be learned by the situation of coding someone they know.
I think this would be the job of the NM to address the code and how things went if he or she chooses to do so. I don't think there is any way to prepare for coding a person you know personally; there's no real way to prepare for a code-period. It's still scary and you're going to fall apart after the code is over. It's human nature.
as a cna, i had alot of respect from my nursing piers. so when they where back in the er of a hospital/nursing home that i had been employeed at, there was a time where i was called back off the med/surg unit to assist in a code of a fellow co-worker, and when i stepped into er room the adreneline immediately kicked in and she was no longer my co-worker, she was a patient as like many others that had been in and out of er. she had a massive mi at home but her husband had called ems to come into the home and do what they needed to do in order to bring her in to er. it was hard on me and all the other staff members that took part in preforming life-saving techniques until the attending er dr. had called the code.
as a cna the only things that i was allowed to do was to rite down meds given, how much, were it was injected and the time, and it all had to be precise and if not understood correctly a stand by would repeat what i needed to know, like time or injection site. then after all nursing staff had done compressions and were exhausted from doing those, i stepped up on a foot stool and took over, compressing as hard as i could and saying "come on you can do it may. it was long after when i got up there is when the dr. had called the code. then the reality of her being a co-worker had set in, and the rest of my day was hell, but i had a job to do. it was hell but i made it thru the rest of the day.
so with all that being said, i never did anything that wasn't in my scope of practice as a cna, but i was capable of doing what i had to do and my nurse's i had worked with so many times knew that, they had alot of trust in me and didn't have to worry about anything when i was on the floor while they all had something going on in the er dept.
i hope that this helped out for you, one day we will all have these expierences once and maybe more then you'd like in your career as a nurse.
i moved up the ladder and am now an lpn, and hopefully sooner rather then later i would like to take an online rn-bsn course if those are avaliable.
take care zookeeper, you will do alrite when in this situation...gotta have faith [color=#ee82ee]:heartbeat
Specializes in SICU, MICU, BURN ICU, Trauma, CTICU, CCU.
Yep. One of everyone's favorite guys in the cafeteria coded right in the middle of the day in the cafeteria. He had been there forever, really, really great guy. But also, one of those people that when you met him, you knew he was one bite away from a massive coronary.
It was chaos. Luckily, it was the caf - so there were docs, nurses, respiratory therapists... but it was bad. Full CPR, aspirated, couldn't get an airway, lost his pulses several times. Bad outcome.
... It really shook everyone up.
Another time, an RT lost consciousness at the bedside and we had to rush to the ER... Found massive brain cancer. So sad...
Although, I gotta say - if I'm going to code somewhere, let me code at work instead of my bed at home where no-one will find me for hours.
Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.
first of all, i'm sorry that this happened to your colleague and you had to be a witness. having said that, i would let the proper staff in-charge handle the tedious work and address all concerns that patients family members may have. furthermore, if you keep insisting on a meeting you will only place a barrier between you and the staff in questioned. wishing the best outcome out of this sad situation.....aloha~
anotherone, BSN, RN
1,735 Posts
Why do you feel the need to push for anything, will it help yourself or others? Not everyone wants to replay stressful/traumatic expereinces over and over. some people like to talk about these and find comfort in it, others do not, ever, and that is as valid and realiable a coping mechanism as any other. If the staff did not professionaly handle the code well, by that I mean, people were fumbling along, clueless, maybe you can address these areas with a manger/educator. If the person coded in an area where codes are rare than I am not suprised this did not go smoothly, nor will it ever, even if everyone is ACLS certified etc, if you do 1-2 codes every few years or 1-2 in a 20 year career , codes will never go smoothly esp if they catch you completely off guard. Is there a code team? Of course most people will be more emotional if they are coding someone they know.