I am a new nurse. I just graduated 5 months ago, and I am so proud and excited about my career. One thing I feel new nurses are not really exposed to is the "code experience." I was NOT prepared for the first code blue I witnessed, and feel it is necessary to share my story.
Towards the last few days of my comprehensive practicum, I experienced my first code blue. The very busy acute care unit I was working on had about 30 patients, with a 5 to 1 nurse, sometimes 6 to 1 patient ratio. We were running off our feet!
In the middle of an evening shift, we heard a loud crash come from an isolation room. A man with MRSA fell to the ground with a loud thud. All nurses on unit rushed to his room, some gowned up, others didn't. We just needed to get in there!
My nursing preceptor (who was also a CPR instructor) initiated chest compressions while I got a chem strip machine upon the charge nurse's request. It all happened so fast. The code was called and the crash cart and code team were in the room within seconds. I was amazed at their speed and skill!
I took this man's blood sugar, and assisted with what I could while my preceptor at the rest of the team went about saving this man's life.I mostly watched. In hindsight, it is good to watch your first code, see what goes on. Very interesting and scary stuff!
A doctor is soon on the scene, intubating the patient. Is that blood coming out of the patient's mouth? Nope.... Its only red fruit punch he had been drinking moments earlier.
Atropine is pushed via IV several times. External defibrillations are given.
Rhythms strips taken and assessed. My preceptor continues to give chest compressions. She has been giving chest compressions for 10 minutes straight. Someone offers to take her place and give her a break. She quietly refuses, never stopping.
This patient's hands are gray - he's not looking good. He is now incontinent. Someone sitting beside me is taking notes of what happens each minute. Wow, we have done a LOT within 10 minutes!
You're kidding.... Can it be? Our machines indicate that this man has a normal heart rhythm.... He is ALIVE! His skin starts to pink up... I don't quite remember what happens after this. All I know is that this man is alive.
He is put on a stretcher and taken to the cardiac ICU. He is looking around, wide eyed, and afraid. But he's breathing... he's alive, much to my amazement.
I lean against a wall at the end of the hall, trying to take it all in.
It strikes me how fragile life is. I realize that this man could have died, but he didn't.
This has been traumatizing. I'm a new nurse - I question, is this really the profession I want to be in? Am I prepared for this?
I start to cry.
I need to talk to someone about what I've just seen.
Follow up to my first code story; notice an unhealthy imbalance and a craving for adrenaline in it? It takes a specific personality to be an adrenaline junkie (so to speak) and I speak honestly when I say this was NOT a healthy and balanced way of looking at things. It somehow turns you inside out looking for a bigger and bigger rush then one day you wake up after the 4th death that week and it hits you...people are dying all around and why are you trying to be next? Reckless "play hard work hard" outlook becoming more and more dangerous.
When the order said to "pull the plug" did you just murder someone? Repeated scenarios in a state that was very aggressive with "pulling the plug" wore on me down to my soul so i tried to drown it fast as I could soon as I got out of those scrubs.
I now know it was not healthy for me to remain in high acuity situations. I lacked the self awareness, maturity or professionalism to seek EAP and talk about it (like someone mentioned earlier). Although I was good at it (like a self destructive machine), kept up in my latest certifications, stayed current with all the toys and would take the worst patients by choice it was not good for me mentally, physically or spiritually. It lead to a serious downward spiral I didn't think i could recover from even with a reserve parachute! I'm just glad to be on this side of the dirt today!
Now if I could land that non high acuity job, I'll have a gratitude list the length of Florida!
Follow up to my first code story; notice an unhealthy imbalance and a craving for adrenaline in it? It takes a specific personality to be an adrenaline junkie (so to speak) and I speak honestly when I say this was NOT a healthy and balanced way of looking at things. It somehow turns you inside out looking for a bigger and bigger rush then one day you wake up after the 4th death that week and it hits you...people are dying all around and why are you trying to be next? Reckless "play hard work hard" outlook becoming more and more dangerous.
When the order said to "pull the plug" did you just murder someone? Repeated scenarios in a state that was very aggressive with "pulling the plug" wore on me down to my soul so i tried to drown it fast as I could soon as I got out of those scrubs.
I now know it was not healthy for me to remain in high acuity situations. I lacked the self awareness, maturity or professionalism to seek EAP and talk about it (like someone mentioned earlier). Although I was good at it (like a self destructive machine), kept up in my latest certifications, stayed current with all the toys and would take the worst patients by choice it was not good for me mentally, physically or spiritually. It lead to a serious downward spiral I didn't think i could recover from even with a reserve parachute! I'm just glad to be on this side of the dirt today!
Now if I could land that non high acuity job, I'll have a gratitude list the length of Florida!
Bless your heart. Great that you had the insight about adrenaline rush.
Thank you everyone for your replies. It is very cool that you took the time to talk about your experiences. I know I have so much to learn as a new nurse.
I was wondering if CASTLEGATES could better explain what you mean when you said:
"Follow up to my first code story; notice an unhealthy imbalance and a craving for adrenaline in it? It takes a specific personality to be an adrenaline junkie (so to speak) and I speak honestly when I say this was NOT a healthy and balanced way of looking at things."
Just want to clarify....
Do you mean that my outlook on my first code was unhealthy?
I was not seeking this experience out - it just happened, and I helped out where I could. I my reaction was scared bewilderment, and sadness.
I think every nurse needs to sort out their feelings towards seeing something so scary.
First code as a student occurred I think my second night of an externship in the ER, patient came in already a full code, I was made to watch(as expected) and I'm glad to have had to watch as it was a crazy experience to one see a code only on my second night, but also to see a death. This experience further solidified my want to continue nursing and my want to also get my emt, while in school. It went by really fast and I just remember walking out across the hall to one of my coworkers(not crying yet!) we talked and as I was walking out of the room, the stretcher with the pt rolled on my foot before I could react (I was fine I really didn't mind being rolled on) then about an hour later 2 more codes came in :/ again watched, but here I am now. Still loving the field and more educated as. A result of seeing codes.
Nursing student here! I The nurse was there too when the patient became unresponsive. I knew what she was doing when she did the sternal rub but my mind didn't register what it meant. Earlier we were able to watch an autopsy. Let me just say today was an eye opener.
As a nurse with some experience I will tell you that when you are a new grad there is little that you're totally prepared for especially Code Blues...My first ever code was my own patient and I had only been off of orientation & on my own for about a 5ish months. AND I had NEVER had the opportunity to observed/witnessed a Code Blue prior to this. I WAS TERRIFIED INSIDE.
He was a very ill pt with a lengthy history, but long story short I had a bed feeling in my gut, so I went down to his room and on my way I heart the TELE alarm for Vtach so I started to RUN to the room. I felt for a pulse-it was thready- and I could hear the TELE alarming for VFib and then I lost the pulse all together. I had that initial "OH ****?! THIS IS REALLY HAPPENING" moment. I stopped for a second, literally a second, took a huge deep breath and went to work. YELLED for help and for the code cart, started compressions...the rest is still mostly a blur even now a year+ later....
But I remember vividly thinking to myself..."Welp, he's dead...Literally, actually, clinically dead...So anything I do from here is an improvement from dead, Right?"
Eventually we intubated (which was very traumatic and actually bloody ¬ fruit punch bloody) we regained a regular pulse and transferred to the ICU. The man later died in the ICU after being coded a second time. But we kept him alive long enough for his wife and family to come and say their goodbyes.
You WILL NEVER be ready to watch another human being die, it will hurt and traumatize you a little bit every time-and if it doesn't then you shouldn't be a nurse.
My advice to you is to be thorough, be diligent in your care and assessment. If you need help ASK FOR HELP! Be on top of the things you can control. BUT also know that despite THE BEST nursing care there are things far beyond your control that may cause a patient to Code. ALWAYS trust your gut instinct. and ALWAYS remember, when your patient is legitimately Coding whatever you do is better than dead...
The MOST important actions(*not neccessarily in order since alot happens simulantously*):
Call for help and to activate whatever system your facility has for codes
Start compressions
Ventilate and protect their airway (ambu bag, Oxygen, suction, and eventually intubation once the appropriate provider arrives)
Place the monitors/defib pads (do this when you turn them to put the cpr board under them to save time)
CASTLEGATES
424 Posts
Follow up to my first code story; notice an unhealthy imbalance and a craving for adrenaline in it? It takes a specific personality to be an adrenaline junkie (so to speak) and I speak honestly when I say this was NOT a healthy and balanced way of looking at things. It somehow turns you inside out looking for a bigger and bigger rush then one day you wake up after the 4th death that week and it hits you...people are dying all around and why are you trying to be next? Reckless "play hard work hard" outlook becoming more and more dangerous.
When the order said to "pull the plug" did you just murder someone? Repeated scenarios in a state that was very aggressive with "pulling the plug" wore on me down to my soul so i tried to drown it fast as I could soon as I got out of those scrubs.
I now know it was not healthy for me to remain in high acuity situations. I lacked the self awareness, maturity or professionalism to seek EAP and talk about it (like someone mentioned earlier). Although I was good at it (like a self destructive machine), kept up in my latest certifications, stayed current with all the toys and would take the worst patients by choice it was not good for me mentally, physically or spiritually. It lead to a serious downward spiral I didn't think i could recover from even with a reserve parachute! I'm just glad to be on this side of the dirt today!
Now if I could land that non high acuity job, I'll have a gratitude list the length of Florida!