How important is it for a Charge Nurse to be able to run a code?

[Anna Flaxis]

Another thread here today got me thinking. On a scale of 0 to 10, with 0 being totally unimportant and 10 being absolutely essential, how important is it for a charge nurse to be able to run a code? Are there other leadership qualities that are more important?

The reason I ask is that I was recently at my ACLS refresher. One of the charge nurses from a 40 bed inpatient telemetry unit was in my group. This nurse should not have passed the ACLS refresher, IMO. He or she struggled every step of the way, and had it been a real code, I would have feared for this patient.

Now, I'm not saying that *I* could run a code seamlessly. There is a huge difference between a classroom environment and the real deal. But, I am not a charge nurse.

What say you?

[wooh, BSN, RN]

It could be that he/she struggled because it was a class and not the real thing. I've gone through a class with a nurse who has been an lpn for over 30 years and the way she acted and responded to questions and during mock code would make you think it was time to retire. But in actual codes she is totally different. In fact, she will tell the doctor what they need to do. There is something about having to perform in front of people in those acls classes that some people cannot handle. I would think (and hope) that the charge nurse has made it this far for a reason.

This is me. Imagining all the parts of the scenario takes up brain space that in real life I'd be using to fix the patient. I'm a VERY visual person. And not at all auditory. The scenarios KILL me. I need to see the person, see the symptoms. Hearing them doesn't register for me at all, so renewal kills me. I rock on the floor. I rock the written exam. I suck at scenarios. I saw an RT struggle with a PALS recert that is one of the people I'd want in the room if a patient was actually crumping. And I've seen people that rock the scenarios that suck in the real life situation. So from experience, I don't judge based on how people do in scenarios.

That said, I think it all depends on facility. Previous facility, charge from each floor would respond to the code. We'd never be the ones running the code though, that would be the ER doc. I think being comfortable in the situation is all we really needed there.

Current facility, there's an entire code team, and only the primary nurse stays in the room. Here, I think being able to get things ready for the code team is what's needed, definitely don't need to run the code because most of the time won't be in the room.

It seems a lot of people are taking glee in how much better they are at coding patients than other nurses. Personally, I take pride in my ability to keep my patients from reaching the point where they are coding.

[K+MgSO4, BSN]

Just a curiosty aside.......... any trained monkey can do chest compressions. All staff in my hospital are refreshed on CPR every year. So I'd have a porter or CA doing compressions. I can do it...but they cannot insert IV's, hang fluids, insert an LMA. Having a nurse compressing is a waste. Get a CA or student to do it.