new nurses who are recently off orientation...

Lynn4875, RN · Mar 12, 2007

Hi, I got off orientation in early January, and I'm still feeling lost when in comes to certain things, and like you, the nurses on my floor seem like the can't be bothered with my problems. For example, last week, RIGHT after I got out of report, I go to check on all my pts, and one of my elderly female pts is gasping for breath. The night shift nurse had told me that the pt had vomited a small amount of bile, and had notified the doctor. When I go in, the pt. is definitely in respiratory distress, and I run and get a Pulse Ox on her, and it was in the 40s and dropping fast, and had apparently aspirated on the contents of her stomach. I paged the doctor, who ran up. The pt's pulseOx dropped to the 30s, then 20s, then 10s, 5...then nothing! This is the first time I'd actually ever been in this type of situation. The doctor said to call the code, and I ran out of the room like a madwoman screaming "call a code, call a code!" There were 3 other nurses there, and one of them was the one who had precepted me. They didn't even bat an eyelash while I was running like a maniac. I grabbed the crash cart, got the pads on her, and helped put the board underneath the pt, and the doctor started doing compressions. The code team arrived a couple minutes later, and once they arrived, I felt in the way so I moved back. Finally a nurse came in, and she told me to start recording, so she handed me the code sheet. I was completely lost as to how to record on the sheet, but I did my best. Thankfully, the pt. survived, was intubated and transferred to the ICU. So anyway, I was told that in a code situation, one of the nurses' roles is to fill out the code sheet, especially if you're a new nurse, because that way you get to see how a code works, and also learn how to document. Hope this helps. :)

Lynn

Hoozdo, ADN · Mar 12, 2007

How can I prepare myself for when I have a pt that codes or has a dire situation...i.e. i need to know what my role is...am i preparing the meds for the doc etc...please give me some advice...

Well, call the code. Get the code cart or have someone else get it. If CPR is going to be done then get a backboard under that patient. You can start compressions until the code team gets there. If this patient has no IV access then get one stat.

Be prepared to give pt hx leading up to the code. Offer to be the code recorder (note-taker). The code team nurse will be in charge of the medications drawn up and given. Respiratory usually handles bagging during CPR, whoever is tall enough and strong enough does compressions. Doing compressions is tiring....so offer to swap out doing compressions.

OK, if you just happen to be bystanding and not recording there are things you can do. Draw up some 10 CC saline flushes. Get a doppler to check for femoral pulses. Towels are always needed and good to have on hand for getting a messy airway.

Nothing like a code to get the old adrenaline running! :uhoh3:

incublissRN, BSN, RN · Mar 12, 2007

At my hospital the primary nurse who is running the code pushes meds. Is there someone on your floor that you trust, such as your preceptor or unit educator, and could ask questions about what to do in certain situations, what paperwork to fill out, etc?

oualie20 · Mar 13, 2007

thanks for the advice it's all very useful. my preceptor was in the nurse;s pod as this was happening and did or said nothing to help me or the situation. so i certainly won't ask her anything. i just don't understand why the experienced nurses won't offer their help when they see that you need it. one good thing about this is...i'll know what to do for the next time thank goodness for this forum

**canoehead, BSN, RN** · Mar 13, 2007

If someone is off orientation and doing OK so far I might let them handle the situation, and wait for them to ask for help rather than swooping in and rescuing them.

RNLisa · Mar 13, 2007

If someone is off orientation and doing OK so far I might let them handle the situation, and wait for them to ask for help rather than swooping in and rescuing them.

If no one else will say this, then I will.....please swoop in and rescue me. I am new, even if I wasn't new, I'd want help. Why wouldn't I? or anyone else for that matter. I am not too proud to accept help from anyone especially during a code situation.

mimmy · Mar 14, 2007

I would come in and help you out, as I would hope that most other nurses would. I know some things are better learned on your own, but not in a code situation. I hope that all nurses would try to remember what it is like to be a new grad. Nurses should work together and help each other out. Keep up the good work, it does get better!!!!

oualie20 · Mar 14, 2007

I agree RNLisa...