Help- Working Codes as a Nurse

[Carmen12345]

Help!

I've been an ER nurse for a little over a year- and I (luckily?) have yet to have a patient code. I have assisted in codes as far as taking notes, compressions, getting epi ready... but I do not know how to run a code as a nurse. We are supposed to be mock code tested and I do not feel comfortable at all.

Do you have any information about how to function/perform as a nurse during a code. Any places that offer mock code training? Online resources that are helpful? Literature that is helpful? How can I get information about what meds I should know specifically and where to find them. I know everyone says "just watch and learn" but that has not been very helpful for me.

Any help is greatly appreciated!

[NRSKarenRN, BSN, RN]

One of the thing that helped me as a new nurse, was to thoroughly review and understand the code sheet along with daily crash cart check ensuring everything in its place  (required prior to crash cart locks). Next code you assist in, check out the crash cart prior to being sent for restocking will increase sense where items located.

Review your ER protocal for Codes and assigned roles, along with ACLS algorithms 2022 -- many Youtube videos like:

Some resources:

Code Blue What Do You Do

Nursing Simulation Scenario: Code Blue

Code Blue: What to Expect, How to Contribute as a New RN

AHA:  Highlights of the 2020 AHA Guidelines Update for CPR and ECC

ACLS Algorithms

Pharmacy: Code Blue Medication Cheat Sheet

Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses

Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes

[Nursemateo, RN, EMT-B]

As a new nurse I had the advantage of having run codes in the field with only a second partner, this allows you to see how efficient a code can be. However, I remember being overwhelmed the first time I had a patient code in the ED because the team is so large and so comprehensive. My recommendation is to actually memorize the ACLS algorithm, if you truly want to be confident in a code this will help. Don't memorize to get through a mock code but actually run through the steps over and over until you know; I'm at my 3rd pulse check with PEA what happens next? 

Is this a requirement to be an ED nurse? No. Will most of your coworkers do this? Also, no. You though will be confident and knowledgeable in a code, before you know it you will be a resource for your coworkers. Also, @NRSKarenRN makes a great point about learning your crash cart. If you're the nurse assigned to the cart it will greatly improve the efficiency of the code. Just remember not all carts are the same in every hospital, and sometimes not even in every department!

[Valcorie34, BSN, MSN, RN]

On 10/2/2022 at 7:28 PM, NRSKarenRN said:

One of the thing that helped me as a new nurse, was to thoroughly review and understand the code sheet along with daily crash cart check ensuring everything in its place  (required prior to crash cart locks). Next code you assist in, check out the crash cart prior to being sent for restocking will increase sense where items located.

Review your ER protocal for Codes and assigned roles, along with ACLS algorithms 2022 -- many YouTube videos like:

Some resources:

Code Blue What Do You Do

Nursing Simulation Scenario: Code Blue

Code Blue: What to Expect, How to Contribute as a New RN

AHA:  Highlights of the 2020 AHA Guidelines Update for CPR and ECC

ACLS Algorithms

Pharmacy: Code Blue Medication Cheat Sheet

Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses

Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes

Thank you!!

 

[NRSKarenRN, BSN, RN]

11 hours ago, Valcorie34 said:

Thank you!!

 

Your welcome.  I was in the ER for hip Xray as hospital main dept had closed for the day yesterday, parked outside nurses station awaiting copy of films --across from the crash carts. I thought of this thread.  Bought back memories of many times as night RN I was responsible to check--before plastic breakaway locks invented; along with the time in 1979 a patient stole sodium bicarb syringe from top of cart, afterwards we kept cart INSIDE head nurses office behind desk.

[Serta]

I too am a new nurse (though much newer than you haha) and only been working in the ED for 3.5/4 months. However, my hospital had us in an orientation program in which we had to show up and work through around 5/6 weeks worth of class time. We covered everything from strokes to splints to various codes and scenarios. I personally learned a TON in this process and got certified in a bunch of things.
 

Nonetheless, I found that when we covered TNCC, ENPC, PALS, ACLS, and the like; learning and memorizing the algorithms was the best thing that I could have learned. Specifically TNCC and ACLS. Just by knowing those 2 algorithms you will know what to do in any code/trauma situation. TNCC itself has shaped my entire nursing process and honestly is the reason I thought NCLEX was so easy. It's that good. But, my advice would be to look into the algorithm sheets, read them, memorize the steps, THEN think back over them and imagine scenarios where you talk to yourself about whats happening and whats next. Given you've participated across a variety of these scenarios you can also use those for reference. Though you didn't necessarily know what all happened DURING the event, you do know what happened BEFORE and can use that as your practice scenario. I do this for just about every procedure or skill I am new at so when I see it again I remember exactly what to do.