Never been in a code?

Asystole RN · Dec 7, 2016

Weird.

When I worked in LTC/Rehab I participated in several a year. Cannot imagine escaping them in tele.

Don't worry, you can only do your best. Just BLS until the cavalry arrives to take over, then do whatever the loudest person yelling at you says.

Been there,done that, ASN, RN · Dec 7, 2016

That is a concern now that you are a traveler. If you were working within a same facility, you would @ least perform within a "mock" code for your yearly mandated education.

The traveler's extensive list of competencies.. includes code experience. So, what happened there?

maybug, ADN, BSN, RN · Dec 8, 2016

Of course there is a skill list I fill out as a traveler, so it's no secret that I have no experience with codes. but obviously I cannot help that I've never had one.

RainMom · Dec 8, 2016

Hey, you're not the only one! I literally was just involved in my first code yesterday after working 5+ yrs! It's one of the reasons I decided to move into a more critical area because I was starting to feel like it would never happen. I've had multiple rapid responses & "near" codes, but had never been involved in a full blown code, not even for another nurse's pt while I was working. I can finally mark that off my to do list :rolleyes:

VANurse2010 · Dec 8, 2016

Hi all!
I've been a nurse for 4.5 years now with my first year in hospice, 2 years med/surg tele and travel nursing for the past 9 months with PCU experience. I'm nervous that I'm considered an experienced nurse
yet have never experienced a code! I've assisted in a couple rapid responses but I've never witnessed or had a code blue. Is this normal? It makes me nervous about ever having one.

I worked 2 years of messy telemetry and almost 2 years of ICU before it happened to me - in a patient with a balloon pump and swan through the groin. Assisted in quasi codes before then, but never did much more than compressions in a true code blue until then. I've still only had 4 - less than 1 a year.

Lev, MSN, RN, NP · Dec 8, 2016

See if you can spend a shift in the ED - just to shadow perhaps.

amoLucia · Dec 8, 2016

Weird.
When I worked in LTC/Rehab I participated in several a year. Cannot imagine escaping them in tele.
Don't worry, you can only do your best. Just BLS until the cavalry arrives to take over, then do whatever the loudest person yelling at you says.

Now that's funny and made me LOL!!! TY

akulahawkRN, ADN, RN, EMT-P · Dec 8, 2016

Hi all!
I've been a nurse for 4.5 years now with my first year in hospice, 2 years med/surg tele and travel nursing for the past 9 months with PCU experience. I'm nervous that I'm considered an experienced nurse
yet have never experienced a code! I've assisted in a couple rapid responses but I've never witnessed or had a code blue. Is this normal? It makes me nervous about ever having one.

Your experience isn't all that unusual. I've been through around 2 dozen now, the last 5 or 6 were as an ED RN. Most of the codes I've worked over the past 16 years or so have almost all been as a Paramedic. You'll remember your first, a couple of memorable ones, and your more recent ones. If you come across one on your own, the first thing you need to do is breathe. Take a deep breath, trust your fingers (they're telling you "no pulse") and get things rolling. Worst case is that you call a code blue on someone that's not dead. Just be as sure as you can be about knowing that person's code status. If you don't know and there's nothing around to tell you otherwise (signs, wrist bands, etc) assume full-code, call for help and start working. Honestly, the hardest thing to wrap your mind around is starting compressions. Chances are good you'll break something (ribs, sternum, etc) and you'll feel that happen. Then things will usually start happening both fast and slow. You might feel like it's taking forever for the code team to arrive or suddenly they're all in the room before you could even blink. You might feel like you've been doing compressions forever while it's been maybe 2-3 minutes or perhaps it feels like you just got started. When it's all over, debrief. If it's your first or first few, you'll want that debrief to critique how you did and how you can learn from it, process it, and move on.

From my own perspective, it's a whole different ballgame when you're NOT the one running the code and you're having to fill a role and you have to remember what your role is when you're used to being the one running the code. Once I'm in a rhythm, I start scanning the room too, perhaps even watching the monitor for real-time feedback. Sometimes you can get a good pleth on the SpO2 with a decent reading with *good* compressions.

If you know a Paramedic or two and if they have time (and are willing) they may be willing to talk you through a code sim and get you into the mindset of doing a code. One final-ish thought: no matter what happens, do NOT make that person's emergency become YOUR emergency. You don't own it. It's not yours. When it's all done, leave it behind in the room and go about your day. Learn from your mistakes yes, but don't carry it with you.

maybug, ADN, BSN, RN · Dec 8, 2016

Thanks so much for this.

HouTx, BSN, MSN, EdD · Dec 14, 2016

Maybe OP's situation is due to the fact that she has fantastic assessment skills - identifies the deterioration & initiates pro-active measures to avoid having to call a code. Heck, I'd definitely go with that version

maybug, ADN, BSN, RN · Dec 14, 2016

Hahaha! Awesome point of view :up: