I have been lurking for months, maybe close to a year now. I'm in the middle of a career change to nursing; I left the financial industry in October, got my CNA and a lower paying job than I left, and started on the pre-reqs for my 2nd degree bsn program.
Fast forward to Dec. 23rd. I start on the oncology floor at my local hospital as an aide. Needless to say, this is a small floor that only uses 1 aide for 11 beds, so we run our tails off most days. Tuesday, I literally did not sit down all day, except for a 10 minute lunch in the back while charting. Wednesday, my aide supposed to be training me no called no show, so I was on my own. At 3, they found someone to help me, and by 6 pm we were caught up and getting things organized to give report. 6:15 I go clean up and turn one of our compassionate care patients who is now unresponsive, etc etc. While walking out of that patients room, I hear a chime.
What is that? Call light? No. Bed Alarm? No. OH CRAP!!!!! Then came the words "Code Blue. 5th floor. Oncology"
Okay- who? Where? What now?
All I can think is "I'M STILL IN FREAKING ORIENTATION! WE DIDN'T GO OVER THIS!" The only death I saw in my training was a peaceful passing in the nursing home during clinicals. Nothing like this.
So of course, adrenaline kicks in. I have to figure out wth I'm supposed to be doing! I walk into the room where one of the nurses is trying to suction (the pt aspirated), the tech is grabbing the crash cart, and i start pulling crap out of the room. Within seconds it seems the room is full of doctors, RT, etc etc. So then I step back and just watch. I did a couple of sprints to the clean storage and linen, etc but mostly just observed.
I really wish I could describe my feelings a bit more, but it was so AMAZING to see that code team spring into action. WHAT TEAMWORK! I felt like I was in a tv show. My memories are so dazed now... It's all a blur. Someone start compressions. Nurse rattling off brief history. Charging. Everyone clear. Shocking. Nothing.
Continue compressions. Yelling for drugs, calling out times to the recorder. Charging. Clear. Shocking. Nothing.
Are we gonna call it?
Let's try one last time. Charging. Clear. Shocking. HE'S IN A FIB!
But then... there's no room in the ICU. REALLY?!? Someone call House Sup he is going to ICU.
I don't know how they found a place for him that quickly but within minutes they were on the elevator to ICU.
But now what? I'm left on the floor trying to sort out my emotions, my actions, what should I learn from this?
So I do the only thing I know to do to help: check on all my patients and proceed to clean up the room from the chaos. It seemed dumb at the time, just some mindless task to be done, but now I get it. It was my own form of closure on the events that just happened. I'm not capable of making life sustaining decisions yet, but I know that sometimes you just have to pick up the pieces and do the best you can.
Well, now this is the time for u to go for ACLS certification in which u will be trained how to handle the code situation.
The OP is an aide. Ask the nurses what they would like you to do next time. Tell them you want to be nearby to help and learn when possible. Learn the art of good chest compressions. When they say push hard, they mean hard. Keep your arms straight and put your back into it. If I come into a med-surg room and see someone doing good compressions I let them keep going if they want to stay. That's a good place to be to learn. Most often, they are not doing good compressions and if an ICU aide came with me, I have them take over. Your back, shoulders, and/or butt will ache a bit the next day if you're doing them right! Know where to grab the code cart if it's not there yet (remember to unplug it... adrenaline brain usually makes me forget that!) Know where to find an ambu bag if it's missing and those green O2 nozzles that always walk off, too!
Also remember that the most important thing you might do during a code is remove that chair from the room (thanks for doing it without asking) and comfort the room mate or nervous nellie across the hall. If you've gotten to know the pt's family, talk to them. Don't lie and don't say more than you know, but "they're doing everything they can" is reassuring. Just stand there and hold a hand while the chaplain talks them through it. If you don't really know them, don't be fake, just get them a glass of cool water, tissues, and a chair if they look faint.
I remember many images from my first code, some are still unsettling because of the circumstances. I have strong images and memories of my first EMS code... what an experience that was! I can remember bits and pieces of other random codes, too. It's normal.
Nice write-up. You done good. As stated above, ask an rn and/or other tech what you need to do during a code.
Memories are funny. My 1st code was 12 years ago as an emt. Got to the house same time as medics for the cp. While getting vitals & initial assessment, pt said "help me" & arrested. Did not survive. Not too many memories of my 1st code as an rn, even tho' it was only last year.
Be a sponge, soak up all you can. You'll be surprised what sticks. Especially if it's something you learn while getting your hands dirty even if you don't totally understand what's happening. The light bulb will click on down the road.
I'm rambling. Sleep deprivation after a nutty shift.
I remember when I was a new nurse, I DREADED my first code! I would think about it and was scared to death I wouldnt do the right things or do something wrong. But when it happened, it was like I was in autopilot. I just did it. The adrenaline kicked in and I was amazed afterward. I jumped on top of the patient and did chest compressions while RT did ambu and the doc was ordering meds, etc.
You did a great job and I loved how you worded your post! It sounds like you are a good worker. Ive seen some try to sneak out of the room and hide, but you didnt. You took that opportunity to learn. It sounds like you are going to make a great nurse. You especiallly did a great job considering you were still in orientation! Keep up the good work!
It sounds like this was a good learning experience. Good teamwork in a code is key and as others suggested, be available , observe, run for supplies, offer to do compressions, support the family, whatever seems needed. This is great learning and will help you in the future. Any level of health care provider can be extremely helpful. My current facility is quite small, so on a given night there may be only 5-8 staff in the building. As supervisor and one of a few ACLS certified RNs, I have to run the code (and give drugs), since I have no MD on site at night. The RT bags, the LPN is my compressor, the new RN is the recorder, the CNA is the runner and the person to let the ambulance in. Everyone is vital!
When I read your post, I was brought back to my first code as an RN. I was still in orientation and was working in the SICU. The patient had esophageal varices that ruptured. There was blood fountaining out of the patient's mouth. It was total horror. I went home and cried on my mother's shoulder, " I don't want to be a nurse!" It was terrible and I still remember it. But here I am 19 years later and still at it.
You mentioned the "mindless tasks" you did afterwards. I still do this, after many years. I do think it helps order the mind. And as you mentioned in a subsequent post about the "images", I too, have had this. Use it to help you in the future.
My first code, I had been a LPN for 2 months in a prison on midnights. An inmate hung himself. I had to iniate and perform one man CPR for several minutes before the only other nurse in the facility arrived, then 20 more minutes before EMS arrived (there is alot of red tape to bring visitors into a correctional facility). We never regained a pulse or a shockable rythm. It was a horrble first experience and the next day every muscle in my body was sore. I think the first code is always a shock, but a necessary evil.
XingtheBBB, BSN, RN
198 Posts
The OP is an aide. Ask the nurses what they would like you to do next time. Tell them you want to be nearby to help and learn when possible. Learn the art of good chest compressions. When they say push hard, they mean hard. Keep your arms straight and put your back into it. If I come into a med-surg room and see someone doing good compressions I let them keep going if they want to stay. That's a good place to be to learn. Most often, they are not doing good compressions and if an ICU aide came with me, I have them take over. Your back, shoulders, and/or butt will ache a bit the next day if you're doing them right! Know where to grab the code cart if it's not there yet (remember to unplug it... adrenaline brain usually makes me forget that!) Know where to find an ambu bag if it's missing and those green O2 nozzles that always walk off, too!
Also remember that the most important thing you might do during a code is remove that chair from the room (thanks for doing it without asking) and comfort the room mate or nervous nellie across the hall. If you've gotten to know the pt's family, talk to them. Don't lie and don't say more than you know, but "they're doing everything they can" is reassuring. Just stand there and hold a hand while the chaplain talks them through it. If you don't really know them, don't be fake, just get them a glass of cool water, tissues, and a chair if they look faint.
I remember many images from my first code, some are still unsettling because of the circumstances. I have strong images and memories of my first EMS code... what an experience that was! I can remember bits and pieces of other random codes, too. It's normal.