How was your first code blue? What role did you have?

[journey2success]

The first code blue I ever participated in was at my first nursing job, while I was still in orientation. The patient was not mine. It was an older woman with breast implants. The nurses in the room were mocking the patient bc of her breast implants and old age, and I felt strange, at the lack of seriousness, in this very serious setting. I had participated in many other code rescues before but the code blue was scary. I awkwardly stood back while the experienced nurses did their thing, and then one of the charge nurses told me to do compressions on the patient while the other nurse rested. I was so caught up with the adrenaline and making sure to give good compressions that I failed to notice I had cut my wrist with a bracelet I was wearing from how hard the pressure was during the compressions!!! Luckily, I had gloves. Whew!

The patient did not make it.

After the code, my preceptor and I got back to business.. Well at least my preceptor did, and all that time, I was just thinking to myself, "wow, I just gave compressions to a dead person, and they didn't make it"... I felt pretty sad the rest of the shift. This was the first dead patient I had seen It took me a couple days to get over it, but I felt overwhelmed by the whole thing...

What about you guys.. What was your first code blue like?

[cmryan12]

I was working in a correctional facility, and we were taking care of a patient we initially thought was anxious about an upcoming court date. As the corrections staff was getting ready to move the patient to be watched more closely, the patient slumped on the bed and didn't respond to the correctional staff via intercom. The funny part is when corrections called for medical over the radio, the only thing I heard was medical's call sign and the pod the patient was in. The rest was static. The pod was close to the nurse's station, so rather than wrestle the radio, I walked over to see corrections staff attempting to move our patient, who required more than one person to move, to put it kindly. We did the best we could with our BLS equipment, but the patient didn't survive. We found out later that even if a surgeon had the patient already opened, the patient would not have survived. I remember crying in a corner for a bit, and then getting called over the radio by one of the sergeants. Sgt. Showed up at the medical office door with a man in a suit (at about 0400), who I assumed was psych. Nope, the facility head honcho. The news of the diagnosis helped, but I felt very conflicted for a long time. Now I work ICU, and codes or crashing patients aren't uncommon things. But I don't think I'll ever forget my first one.

[Hospicegal90]

I was a student in the ER when a young man came in after a motorcycle accident less than a mile from the hospital. That was my first time doing CPR. A decision was made after a certain amount of time during the code to continue CPR and treatment to keep his organs viable while the transplant team flew in. His family arrived and after much discussion, refused to allow his organs to be harvested. The doctor called it and the silence in the room was deafening. Seasoned nurses were in tears. My teacher wrote for a nursing magazine back then (1991) and described these events in an article.

This was before 'donor' was placed on drivers licenses or before the donor registry. Things have certainly changed.

[TU RN, DNP, CRNA]

I posted here after my first code about 6 months ago. I already forget some details, but at the time it did affect me emotionally so I'm sort of relieved by my failed memory. 80 some year old nursing home guy with pretty bad CHF and urosepsis started tanking his pressure. Didn't respond to the baby 250 boluses we opened up, so the docs started working on a central line while I went to mix some Neo. As I started the drip I looked up and noticed his rhythm change from a clean sinus tach bradying into this ugly wide complex rhythm probably idioventricular. He had no pulse so the resident started compressions and I started bagging. Then respiratory took on bagging and I got on the chest.

I do remember breaking a sweat and my glasses sliding off onto the bed. I remember two people being subbed out because their compressions were crap. I also recall that the room was so crowded that you could've probably gotten a good color change on an ETCO2 monitor just by holding it up in the air. It was futile, and really we shouldn't even have had to code him.. but it was the wish of his wife. Ultimately some silver lining was that he was able to see his wife and be with her just moments before all this went down.

I've been in about a half dozen codes since then after moving to ICU and have played in each of the other roles - CPR, meds, writing - and I by far like doing meds the most. You can see the whole thing going down while being right in the middle and playing a crucial role. Plus the interns and 2nd years usually need help working the Zoll I do not like being the first in the chest and smashing their ribs and sternum. I won't ever forget that crunch.

In in my limited experience with codes, involved or following post-codes, I would say that some people who we get back shouldn't have been gotten back. Therapeutic hypothermia and watching those seizure-like twitches people get when their brain is cooked after the inevitable anoxia... it's ugly.

Agree with what Dranger said about black humor. Empathy is important in our line of work, but you have to find a balance and let that stuff go otherwise you'll be unable to function. For instance, my one coworker and I joke around about some of the minor BS we have to do versus the serious stuff as ICU nurses. So after we lost our last guy he goes "I wonder if his MRSA swab was positive" and I joke back "do we have to enter his IVs into the computer still?"

[Ageta]

My first time seeing ACLS was in ICU working as a caregiver at first year in nursing studies. I just looked and didn't to anything. Next one and the one I think as my first was a month after I started working in an ambulance. It was a long ride to go, so at first the EMT asked our team leader what he is supposed to do, as it was his first ACLS. Right after him I asked the same. We had 92yo man wth lots of diagnoses but the relatives had been doing CPR so we continued for minimum time and then called it. I've worked in ambulance for two years and have had 7 ACLS, only one we resuscitated.

[citylights89, BSN, RN]

Wow, these tales are really descriptive. Although I appreciate it, I have to stop reading this thread. I'm about to cry. Too many bad memories about my Mom.

[Carolid]

My first code was actually just this past Saturday. I'm not even a nursing student yet (though hopefully being admitted to a wonderful school in the next couple of months :) ), but I am an EMT. Older guy, COPD and dialysis pt. Got called out as difficulty breathing, then shifted to a code. Upon arrival he had gurgly respirations and did have a pulse. They paced him, but he went down and we started compressions. No shockable rhythm. I managed airway throughout and got to drop the king airway. It was a really exciting moment for me! First time I got to drop the king, suction, and drop an OPA. Unfortunately, the pt did not make it.

[HopefulRN7]

My first code was as a 3rd semester nursing student at a LTC center. I was running the treatment cart as two CNA's flew down the hall past me from the dining room pushing a very limp and cyanotic resident backward in her wheelchair yelling "Code! Code!!" I followed them into the residents room as they thrust her down onto her bed as two facility nurses (one being the DON) entered the room with the crash cart and immediately started compressions and bagging for what seemed like an eternity. I didn't notice the chest rise and fall so suggested checking the airway, grabbed the suction and pulled up a large piece of partially chewed steak from DEEP. DON suggested I take over with compressions after airway was clear between shocks and did so until EMS showed but by then she had no shockable rhythm and was gone despite our efforts.

Definitely opened my eyes as an observer and lesson was learned to ALWAYS check the airway before bagging, even the most seasoned nurses can get caught up in the chaos and forget the basics.

Haven't had a code as a licensed nurse yet but that image will always be in the back of my mind.

[wanderlustnurse88, RN]

Just had my first code tonight after being a nurse for almost 5 years. It was my coworkers pt. We heard the pt groan loudly so went to go check on pt. Still had a pulse but no respirations. We started bagging and then MD came in. Then we had no pulse so compressions were started. I took over bagging since I at least knew how to do that and let the more experienced staff take over. Pt didn't make it and we called it after 20 mins. I'm glad that I was there at next time, I will be more comfortable and more helpful. I was surprised at how calm I was (on the inside I was freaking out).

[mindofmidwifery, ADN]

I work in the ER so no code blues but it was maybe my second day (as a tech, I'm not a nurse) and we had a heroin overdose come in where I got to do chest compressions. My adrenaline was rushing like never before. It's an amazing experience to participate in codes

[guest769224]

I work in the ER so no code blues but it was maybe my second day (as a tech, I'm not a nurse) and we had a heroin overdose come in where I got to do chest compressions.

A code blue and a code are the exact same thing. If you're doing compressions the patient is coding. Code blue is more of a floor nursing term. In ICU and ER we tend to use the terms "code, coding", but it's the exact same thing. So the ER does get code blues by technical means.

[mindofmidwifery, ADN]

A code blue and a code are the exact same thing. If you're doing compressions the patient is coding. Code blue is more of a floor nursing term. In ICU and ER we tend to use the terms "code, coding", but it's the exact same thing. So the ER does get code blues by technical means.

I understand that but I'm saying they aren't called code blues [emoji29] I think I'd be questioning what the heck I'm doing if I didn't already know everything you just said

[wanderlust99]

Mine was in nursing school, in the ED. I did compressions. It was my first time looking into a dead man's eyes and it was quite unreal.