How do you deal after a code?

NurseOnAMotorcycle, ASN, RN · Apr 28, 2012

I'm sorry you didn't get an answer sooner.

After a code, we sort of naturally end up huddling for a moment and discussing what just happened. Despite the redundancy of stating exactly what we all just saw, it helps to solidify that it "wasn't a dream" or that we were all there together.

Then we appreciate each other (again, it just happens naturally). ex "I'm so glad you guys came when I called for help!" "Well you were right to call, glad you didn't write it off as something else. If you didn't catch it they'd prob be dead now!" etc.

When I am on my way home sometimes i will stop at my favorite diner and just sit with a coffee for a while or go home and stare at the wall for a bit before telling my spouse "I had a bad day." He knows it's time to shut up and cuddle. (Sometimes i have to tell him so. :) )

You'll relive it for a day or so and after a bit you'll move on. More people to heal/save. Good luck!

emttonurse · Apr 28, 2012

Thanks, nurseonamotorcycle. It took a couple of days to get past, but things are much better and my commitment to patients is that much stronger. I've learned so much this week!

Good Morning, Gil · Apr 28, 2012

I usually see what I can do for the family (if the patient doesn't make it), and then I usually go see my other patient, assess them, see what they need, and once I'm done the paperwork mountain, I eat my lunch. Your first code will affect you more than subsequent ones. I always feel empathy for the family, and for the patient, since dying in the hospital isn't the way anyone would want to go, but you quickly learn to distance yourself from it, and it's just another day at work.

If you've seen the movie "Contagion," (the scene where the scientists in the lab are testing this unknown outbreak, they ask each other how their Thanksgiving was. Just another day at the lab).

wannabecnl · May 9, 2012

My first code was when I was a student, and what struck me was that afterward there was almost no "processing" at all. It was on a unit that doesn't see a lot of codes (the previous one had been years before), and we all had to go back to our patients immediately afterward. People would talk among themselves in the days that followed. There was never a debriefing, a "post-mortem", if you will, or any other opportunity to share our impressions, decompress, or otherwise deal with it. The nurse whose patient coded didn't want to talk about it, so all conversations about it were away from her earshot. It wasn't therapeutic in any way.

I would suggest journaling about it, or talking to someone who either was there at the time or who has been through something similar at your facility. Looking back, if I were still on that unit, I would suggest some sort of meeting to the manager, because it had an effect but was never really dealt with.

GitanoRN, BSN, MSN, RN · May 9, 2012

needless to say, we nurses can sympathize with this topic sooner or later. if the outcome is not favorable i usually, check on the family or significant others and friends, assist in any way i can. however, on those expected outcomes we have previously incorporated the palliative care. although, when it's said and done, i usually go on my own and hit the gym as i exercise i go over the events and this allows me to move on. having said that, i wouldn't be able to work with peds. for this same reason as a father, i couldn't shake it off soon there after. unquestionably, this is the reason why i work with adults only, as i salute those remarkable ped. nurses :bow:

sauconyrunner · May 9, 2012

It sounds crass to say, but you do get used to it. Some will affect you more than others. I found it a ton harder as an ED nurse to watch a DNR die and not intervene...I thought for a minute I would have to restrain myself as my instinct is to start the cpr etc...

But then there are times...where it hangs on. My least favorite is when I have forgotten about something and the Organ donation people send me a letter thanking me for the (legally required) referral....

Are-En-Fla · Jun 9, 2012

I just had my first code experience a few weeks ago. I was put on the code team since I am a new nurse and have fewer patients in my assignment. Outcome was good. I considered it an out of body experience and organized confusion and I was hooked. Put me on the code team every time please! Next code a week later, I knew the outcome was going to be bad. I made it a point while waiting my turn for chest compressions to look at the patient's ID bracelet. I wanted to at least know the name and birth date. I had no emotion and considered it part of my job to try my best and walked away knowing we did everything we could. I think my emotions will be different if (when) it is my patient...

RnfromUK · Jun 15, 2012

My first ever code was as a 3rd year nursing student on a cardiac ward and it was horrific. The patient had bad osophageal varices and they all ruptured at once. I was first on the scene and immediately started CPR while screaming for help. The patient didn't make it and I was covered in the blood of a dead man. I was immediately taken aside and asked if I wanted to talk to a Nurse counsellor about this ordeal which I am glad to say i accepted. As was stated above, this helped me accept that I had done everything I could for the patient and helped me get over the sights that I saw that day.

Talking about these events is always the best way to cope with them but it still took me a week to not see that scene in my dream. But I am still a Cardiac nurse :)

Bec7074 · Jun 15, 2012

Every code is different. If the patient was really suffering, it's easier to know they are in a better place. Its that "there are many things worse than death mantra."

It's harder when family are present, sobbing while you do chest compressions. I've recently learned that very few patients that code will ultimately survive till discharge. The AHA has statistics. This helped me realize it's not necessarily anything the code team does wrong when you don't "get them back."

emttonurse · Jul 12, 2012

Honestly, I love the codes, too. I'm trying to figure out what I need to do career-wise to always be involved in traumas. (How does one get on the code team, btw? Who is on the code team?) But I think after that unexpected code I was just unprepared for my own emotional response. You get hardened, what with all the emergencies that arise. So when the emotions suddenly surface in such a powerful way, it can catch you by surprise.