Has anyone ever coded for you at clinical ?

allnurses Guide · Oct 23, 2012

That patient you had was not well.

You didn't "fail to keep him well".

You are a student and you are learning.

Do not beat yourself up over this.

You probably learned a lot from what happened and that is how this nursing school thing works.

We learn by experience and not all of those experiences are going to be happy ones.

You didn't give much detail, but I would suspect that patient turned so quick that you didn't know what you didn't know until it happened.

I'm sorry you had a rough day and I hope you got some good support from your instructor.

mchssrn8813 · Oct 23, 2012

That patient you had was not well.
You didn't "fail to keep him well".
You are a student and you are learning.
Do not beat yourself up over this.
You probably learned a lot from what happened and that is how this nursing school thing works.
We learn by experience and not all of those experiences are going to be happy ones.
You didn't give much detail, but I would suspect that patient turned so quick that you didn't know what you didn't know until it happened.
I'm sorry you had a rough day and I hope you got some good support from your instructor.

Thanks, he was pretty sick but his vitals were normal and his assessment was normal too (normal for him anyway) he had a hx of CHF, renal failure, EXTREME edema, DM II ,was A&Ox1, fluid overload, needed a pacemaker etc... in general he was a sick man. I just feel like I should have monitored him more, but at the same time, his assessment and vitals didn't give me a reason to be extra alert on him.

classicdame, MSN, EdD · Oct 23, 2012

this will happen again sometime in your career because, believe it or not, you are not a miracle worker. You do not have the power to "save" everyone. People die in spite of all we do for them. Your job is to make them as comfortable as possible in the interim.

Sun0408, ASN, RN · Oct 23, 2012

3rd semester I had a very sick pt. At the end of the day as we were finishing up to leave for post conference I went in to get my last set of vitals. My pt was still the same as he had been all day, uncomfortable, talking but not making any sense moaning etc.. I was unable to get a BP on him, went and told my clinical instructor and she sent another student in with me to try. He was also unable to get a set. Told the CI again and she said just let the primary RN know. So I did and within 20 minutes he was being coded. He did not make it..

As a student it is hard because our education and assessment skills are so limited at that time but it was a huge learning curve. No one really knew what happened to him, he was very sick but they couldn't figure out why. Liver issues were suspected because of his very high ammonia levels but nothing could be pin pointed..

Your pt like mine was not well and death happens..Sometimes there is a warning, sometimes there is no sign of it at all. The later is the hardest. Hugs to you...

mchssrn8813 · Oct 26, 2012

Thank you !

rubato, ASN, RN · Oct 26, 2012

DO NOT beat yourself up over this. You are a student, not a nurse. And, guess what, it happens to nurses too. Use it to learn that you just never can tell sometimes. Hope you're doing better.

P B and J · Oct 26, 2012

While I've never had a pt code, I will share an experience I had. At report, it was passed on that so-and-so in 15 was just a drug seeker. She had been post-op for 24 hours + and refused to ambulate farther than the bathroom, all she wanted was her pain meds q4 on the dot and to sleep. I had total care for her, and she did evidence pain (grimacing, elevated HR & BP), so she got her pain meds as requested. I spoke with the nurse about my concerns, but she wasn't concerned, so I thought I was just being overly-cautious. We were getting ready to hand off, and the nurse wanted to know why she hadn't been ambulating all day, and told me to go make her get out of bed and down the hall--now. She was a larger lady, so I got a fellow student to assist, and away we went. She was a little unsteady, but seemed to be ok. We got about 3 feet past the bathroom door, and she said she was getting dizzy, so we put her back to bed, I reported to the nurse about what had happened (I also got an eye-rolling dirty look, which made me feel guilty, like I hadn't tried hard enough) and we left the floor for post-conference. Maybe 10 minutes later we're in post, and I hear "RRT to 15, RRT to 15". I got the go-ahead from my instructor, and ran up 3 flights of stairs to see my pt unresponsive on the floor just inside the doorway. The nurse had attempted to ambulate her after I left, told her she was fine when pt complained of dizziness, and of course the pt promptly passed out cold before they even got out the door.

I never did hear exactly what was wrong with pt, but there was some sort of complication from the surgery, and they ended up going back in to repair. Bottom line: Trust your gut, even if you get a dirty look... you may be wrong, but then again, you may be right :)

mjbarnes · Nov 1, 2012

It happens. You are a student and are learning. It is not your fault. They were obviously sick (and student nurses are generally given the "sickest" patients). I've had a pt code that could not be revived. Sad incident, but even moreso for the family who is left to grieve for the loss.

KelRN215, BSN, RN · Nov 2, 2012

Your patient was in the hospital because he was sick. Nothing you did or didn't do caused him to code. He wasn't solely your responsibility- you are a student. He was the nurse's responsibility, he was the doctor's responsibility, he was your clinical instructor's responsibility, he was the nurse's aide's responsibility, etc. Even if you do everything right, patients will still code sometimes.

The one true code I experienced (or at least the one that I recall) in clinical was semi-expected. It was on the floor that I would later be a nurse on for 5 years- inpatient neurology. Patients with severe seizures were admitted electively, taken off their meds and monitored on continuous EEG to try to pinpoint the exact area their seizures were coming from/to see if they were surgical candidates. The child I recall coding in clinical was a child who was known to respiratory arrest every time she seized. Anesthesia was aware of her and knew that they could be called to intubate at any minute. She was off her meds so they could get an ictal SPECT on her... she seized (which they wanted her to do so she could get the scan) and then she respiratory arrested. A code was called immediately in this case because there was an action plan in place for when (not if) she seized. They were able to stop the seizure and bag her for long enough that she didn't need to be intubated. I know that all I did was watch when this happened but, as a student, sometimes that's the most important contribution... the professionals actually know what they're doing and sometimes the best thing to do is to stay out of the way.

Blackcat99 · Nov 2, 2012

I use to work in hospice. One of the patients died immediately after the "nursing student" gave her the insulin shot. She was not a code but I can only imagine how awful that student must have felt about the whole situation. :crying2: