From the time I was in nursing school up until now (as a new graduate RN), I had never seen a code. Today for the very first time, I did not just see one code, I saw two and they happened to be right next door to each other! I know that I should have felt awful for the patients, but I was just so excited to finally see a code that I kept going back and forth to look to see what was going on for each one.
Do you think it's wrong to get excited when a patient is doing poorly? Of course I care about people or I wouldn't have become a nurse, but it felt a little strange afterwards.
I was just wondering how other nurses (you) reacted the first time you saw a patient code (go into cardiac arrest or respiratory distress).
My first code was a huge event. I was still on orientation and another nurse happened to glance at this one cardiac baby and noticed she looked awfully white and grunty. Took a temp and she was cold, pulse ox wasn't picking up and couldn't get a BP so we made some phone calls thinking we might need to intubate her...Turned into a 2 hour full blown code with 30-40 people in the room....pedi surgery, pedi cardiology, several neos, managers, many experienced nurses, and a bunch of curious onlookers. I was the recorder and I sure got a rush of adrenaline...I was shaking the whole time! And almost paralyzed with fear. We pushed epi 22 times, gave several atropines and bicarbs...chest compressions the whole time...We ended up losing her. I didn't cry until I put my car into Park in the driveway at home when I could finally just decompress on my own time. This code was talked about for over a month after it happened.
I was a bit more composed in my 2nd code..it was at night and much more contained. I did chest compressions and ended up getting him back for a little while until the parents could arrive. That made me feel really good, as we were about to call it. He ended up passing in mom's arms about an hour later...
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i was a brand new nurse when i saw my first code. i was out walking with my med/surg patient and saw a visitor go down! i went and rolled over the visitor, did the "shake and shout" and started cpr (we did mouth-to-mouth in those days without even thinking twice!) while the patient ran to get the charge nurse. she told me later that the patient was worried about me because he knew i was brand new! i was scared spitless until i started cpr, then training kicked in and i was fine. the visitor survived, went to icu and was transferred out several days later to be in the same double room with his wife whom he had been visiting.
my second code was a real cluster frack -- patient admitted for "work-up fatigue." she was in her 40s, so heavy she had to be weighed on the livestock scale at the vet school and so dirty that the admission orders read "shower before doctor sees."
she wouldn't fit in the shower, but we had an enormous tub, and the two student nurses who were caring for her that day asked if they could give her a bath instead of a shower. neither the intern nor i saw a problem with that, so into the tub she went. things went fine until the sns tried to get her out of the tub and found that she couldn't get herself out. moreover, she "turned grey and started gasping for air."
she was in full arrest when they came to get me. i ran to the tub room, slipped on some of the water on the floor and went skidding into the wall . . . patient is feebly flopping around. we got eight people in to try to lift her out of the tub, but no one could get a good grip on her. turns out that the patient had told the students that she was "stuck in here" and between the 3 of them they'd decided that a little keri oil would lubricate things up enough she'd just "pop out' of the tub. so they poured in the whole 18 ounce bottle! she was so slippery, no one could get a grip on her and we couldn't pull her out. someone let the water out of the tub, we called every available person from the whole house and slipped a bath blanket under her to drag her out. the tub room was too small, so we dragged her out into the hall to run the code.
so here we are, in the short arm of an "h" shaped unit, doing cpr on a >400 pound greased, grey patient with no one left on the unit to do traffic control. visitors were stopping by for the show. the cardiology attending was kneeling next to her in a puddle of keri oil and ruined his 3 piece suit. when we defibrillated her, the electricty arced and knocked out both the cardiologist and the intern kneeling on her other side. the er nurses (who had responded to the call for "all available help" were nudging each other and snickering. (the cardiologist wasn't real popular.) the student nurses (8 of them by then) were standing around watching the fiasco and wringing their hands. and this poor woman had the least dignified death i've ever seen!
i still laugh when i think back on that code and no, i don't feel like an utter failure as a human being. the only way to survive in this field is to laugh!
Yes it is unbelievable, but true. You can call my MOM!
My very first clinical patient I had in Nursing School died. I swear.
I was only on the floor to do ADL's, and as I was shaving my patient he became unresponsive. I thought he fell asleep (I was 18 and never even saw a member). His lips started to turn blue so I got my instructor. She called a code, he didn't make it, and I considered becoming a long-haul truck driver.
I then had the reputation of being the harbinger of death. Nice for a sheltered, small-town girl!
I was strangely very calm, the doctors had just completed rounding, and this pt, lung transplant sat up eyes bugged out, red faced, sob, his room was right next to nurse's station-I went and told the doctor, ran and got an abg kit, while they were doing that, went and got the crash cart into the room my charge nurse at that time was in the room by then- the spouse was at the bedside when all this started- so I got her to step out of the room, tried to calm her. Then had to go back in the room pt in next bed was confused trying to get to the bedside commode yelling his head off, on lactulose-you can guess what happened, crap every where but in the commode-on the curtian, on the floor,on everybody's shoes yuk! Then back at the bedside to get yelled at by doc to increase fluids,pt being intubated now-then it was over pt got transferred. I was shaking after, but I just kept telling myself deep breaths and that this was their code -the pt not mine, I'll just keep trying to have my freak outs afterwards.
The first code that I participated in I ended up giving chest compressions. It was the first time that I had ever performed CPR on a real person. At first I found it hard to get into the groove right at the start. Luckily I had an very nice and experienced RT working right next to me, and he corrected my pace and depth calmly and quietly. I was thankful with the correction I was able to settle down and focus on the situation more fully. It was intimidating for sure. Before this I had been present at another code and stood in the wings and even this was intimidating, but educational.
i was a brand new nurse when i saw my first code. i was out walking with my med/surg patient and saw a visitor go down! i went and rolled over the visitor, did the "shake and shout" and started cpr (we did mouth-to-mouth in those days without even thinking twice!) while the patient ran to get the charge nurse. she told me later that the patient was worried about me because he knew i was brand new! i was scared spitless until i started cpr, then training kicked in and i was fine. the visitor survived, went to icu and was transferred out several days later to be in the same double room with his wife whom he had been visiting.
my second code was a real cluster frack -- patient admitted for "work-up fatigue." she was in her 40s, so heavy she had to be weighed on the livestock scale at the vet school and so dirty that the admission orders read "shower before doctor sees."
she wouldn't fit in the shower, but we had an enormous tub, and the two student nurses who were caring for her that day asked if they could give her a bath instead of a shower. neither the intern nor i saw a problem with that, so into the tub she went. things went fine until the sns tried to get her out of the tub and found that she couldn't get herself out. moreover, she "turned grey and started gasping for air."
she was in full arrest when they came to get me. i ran to the tub room, slipped on some of the water on the floor and went skidding into the wall . . . patient is feebly flopping around. we got eight people in to try to lift her out of the tub, but no one could get a good grip on her. turns out that the patient had told the students that she was "stuck in here" and between the 3 of them they'd decided that a little keri oil would lubricate things up enough she'd just "pop out' of the tub. so they poured in the whole 18 ounce bottle! she was so slippery, no one could get a grip on her and we couldn't pull her out. someone let the water out of the tub, we called every available person from the whole house and slipped a bath blanket under her to drag her out. the tub room was too small, so we dragged her out into the hall to run the code.
so here we are, in the short arm of an "h" shaped unit, doing cpr on a >400 pound greased, grey patient with no one left on the unit to do traffic control. visitors were stopping by for the show. the cardiology attending was kneeling next to her in a puddle of keri oil and ruined his 3 piece suit. when we defibrillated her, the electricty arced and knocked out both the cardiologist and the intern kneeling on her other side. the er nurses (who had responded to the call for "all available help" were nudging each other and snickering. (the cardiologist wasn't real popular.) the student nurses (8 of them by then) were standing around watching the fiasco and wringing their hands. and this poor woman had the least dignified death i've ever seen!
i still laugh when i think back on that code and no, i don't feel like an utter failure as a human being. the only way to survive in this field is to laugh!
OK, I will probably sound like an idiot for this question, but here go's anyway. I am an LPN and have been for a bit over 2 years now. Have worked in LTC, and now am on psych. I have not witnessed any codes. I am in RN school and have 2 semesters left. I always imagine myself working in a critical care unit, not sure why. I do love adrenaline rushes, maybe that is why. But I also love to bond w/ my pts. My biggest fear is a code. What exactaly is the nurses responsibility in a code situation? I know you obviously maitain the ABC's, but what do you do after the team arrives? When someone is "recording", what does that mean? I'm assuming it means documenting everything that is said and done, but how could you possibly "record" all that chaos? Any insight into the nurses dutys in a code siutation would be greatly appreciated. I feel my assessment skills are good for a fairly new nurse, but I am terrified of the "code" situation.
My first code...I really don't remember my thoughts. It was a flight or fight response...i got in there and started do compressions....and continued for about 45 minutes with another nurse and I switching out
I am going to be a third year student and have not yet seen a code. The only thing that has come close for me was when my aunt was in the hospital a few years ago, a woman coded in the room diagonally across from her in the ED. Although I couldn't see what was happening/wanted to protect pt. privacy, I could hear everything and I saw docs and nurses in and out of the woman's room for about 20 minutes trying everything. Unfortunately, the woman died. I was a little sad because I thought about her being here one minute and gone the next. This was a weird feeling for me because I hadn't even seen her face, just all the commotion in and out of her room. I hope this year in my med/surg rotation I will get to see a code of some sort , although I'm nervous I won't know what to do. In the last LTC facility I worked in as an aide, I don't think the nurses had any idea what to do in a code. This scared me because a lot of the patients were full code (maybe shouldn't have been but were) with complicated health problems. On my orientation to the floor, I asked the aides were the emergency equipment was and no one knew. Then I asked the RN and she pointed to a cart in the med room covered by a sheet but didn't really seem to know the contents of that cart. There was only one nurse there who had regularly dealt with codes because her previous job was at an acute rehab hospital. Thank God no codes happened on my shift because the aides weren't even required to be trained in CPR (I'm assuming basic CNA courses do not teach you CPR. It is usually a seperate course) at that facility!!!!! I prob would have been the only having some idea of what to do and I have no experience whatsoever with codes ! Ruby Vee, that woman in the tub sounds like a nightmare!! It must have been so frustrating trying to get her out of there and to someplace you could perform lifesaving measures knowing trying to get her out of the tub was wasting valuable minutes. God, I think if something to that degree happened to me, I'd have a nervous breakdown!
In the mid '60s, CPR began, and I was Inservice Education Coordinator at an acute care hospital in San Francisco. Walking obliviously down a hallway the first week of my job, I was accosted by a usrgeon to whom I';d been introduced at a meeting. He said, "There's a "code" in room 359, and they don't know what they're doing! Well, I'd never heard of a "code" (not that I'd tell him that when folks died in my experience, the top sheet was usually drawn over their faces, and a doctor was called to "pronounce" them.
I rushed to see what wasn't being done right in room 359, and couldn't believe my eyes when I saw what looked like someone pummeling a patient, and many nurses looking stricken. So I went back to my office, as it certainly didn't seem prudent to remain there, and called the American Heart Association (as the pummeling seemed to be done near the patient's heart.
They roared with laughter and enrolled me in a "Cardiac Nurses' course. During it, as I saw the possible benefits of CPR, I suggested that families of known cardiac patients still living, should be taught that. The doctor who was the instructor said, "Oh no, my dear they'd feel much too guilty when it didn't work. And the rest is history.
Let me tell you, I taught every nurse, intern, resident, engineer housekeeper, dietary department staff, and pharmacist how to do CPR. Things were going quite well, no one compressed the top of the sternum any longer I thought, until a cardiologist saw a code on one of his patients, and pulled the electric plug of the defibrillator from the wall. I was there to monitor and critique the goings on and was appalled. He directed his acerbic comment to me, saying, "for God's sake this guy has advanced metastatic cancer!" Start of the "No code". It's always something.......
I remember my first code. It was when I was a CNA. I had just started a week prior and had never had any experience with patients before. One patient was getting ready to be discharged home. I took her telemetry box off, gave her a lunch tray and stepped out of the room. One of the nurses walking by noticed that she was slumped over and went to assess her and called the code. It was my first code. I cried. My manager looked at me like I was stupid.
I've had other codes as a nurse. I'm very bossy/vocal and get irritated with the doctors about barking out orders when there should be one code captain and not five code captains. The last code I was involved in, I ran the cart and amazingly I wasn't jittery nervous. The code that I was involved in before that code, the patient came in with r/o MI, he walked from the stretcher to the bathroom, then to the bed, asked for a vernors, hooked up the bedside monitor to him, left the room for a few minutes to go to the desk to check orders, looked at the central monitor, patient was in V-fib, ran back to the room, called the code, coded patient for 22 minutes with code team and then we called it. He was purple.
Ruby Vee, that woman in the tub sounds like a nightmare!! It must have been so frustrating trying to get her out of there and to someplace you could perform lifesaving measures knowing trying to get her out of the tub was wasting valuable minutes. God, I think if something to that degree happened to me, I'd have a nervous breakdown!
texas2007, BSN, RN
281 Posts
My first code was a huge event. I was still on orientation and another nurse happened to glance at this one cardiac baby and noticed she looked awfully white and grunty. Took a temp and she was cold, pulse ox wasn't picking up and couldn't get a BP so we made some phone calls thinking we might need to intubate her...Turned into a 2 hour full blown code with 30-40 people in the room....pedi surgery, pedi cardiology, several neos, managers, many experienced nurses, and a bunch of curious onlookers. I was the recorder and I sure got a rush of adrenaline...I was shaking the whole time! And almost paralyzed with fear. We pushed epi 22 times, gave several atropines and bicarbs...chest compressions the whole time...We ended up losing her. I didn't cry until I put my car into Park in the driveway at home when I could finally just decompress on my own time. This code was talked about for over a month after it happened.
I was a bit more composed in my 2nd code..it was at night and much more contained. I did chest compressions and ended up getting him back for a little while until the parents could arrive. That made me feel really good, as we were about to call it. He ended up passing in mom's arms about an hour later...