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On a scale of 1 to 10 how would you rate your response to your first code blue?

But please, be honest. And by first, I mean the very first of your career. Today I had my first one (I've been working for just a month). One of the aides found the pt dead. She was still warm, but she looked completely dead. I rate my response at 3/10. I forgot about all the rules/right sequence of CPR even though I took my CPR class just a month ago. Luckily the old lady turned out to be DNR, so I did no harm but I did learn a very valuable lesson... on how to do it properly (hours after incident when I remembered every single detail of what I did wrong). I learned I'm able to remain calm and the next time I will be prepared and won't make the same mistakes, hopefully. Tomorrow I'll ask my RCM to maybe implement drill codes. I think we need them.

You're not alone. I am also a relatively new nurse (October, 2009). I have been lucky enough to have only one patient of mine who needed rapid response so far. No codes for my patients yet but last week I ran into a room of another nurse's patient when a family member was screaming for help and the pt. was pulseless and blue. I helped initiate the code call with the button on the wall and I grabbed the cart and suction, etc. but I wish I would have hopped right up there on the bed and started compressions (someone else did) but you can see how some folks are "good" at it and how I was a step behind. I figure we'll get better with time in regard to moving fast and doing what we need to do quickly. I think I'm already getting better at it just from experiencing the rapid response and this code.

Don't beat yourself up, just continue learning! You are smart to ask about running drills. If it isn't a DNR pt. then you don't want to waste any time thinking about responding next time. I'm sure you did fine and it's totally normal to be a bit slower during your initial codes. It's a difficult thing to experience. I can still see the blue dude and think about the intubation, compressions, suction, vomit, etc.

So far I have participated in 2 codes as a patient tech, and one almost code as a student RN during my med surg clinicals.

First code I went in to take vitals on my patient and in the middle of that their O2 sats dopped to the 70's followed by visible respiratory distress. I panicked. I got the nurse in there who actually called the code when the patient went into complete resp failure. As a tech my job in a code was simple, clear the room of obstructions and go get anything the code team needed. So I push out all the bedside tables and stoodby as the code team arrived...then came my real panic moment. The cart had no pads for the leads. So I was sent off on a supply hunt thinking this poor patient was going to pass due to the fact That I couldnt navigate the supply room quick enough. Fortunately I found em, the pt was stabilized and transfered to ICU. The only sad note was the pt's family came up on the unit just as they were were rushing to transfer her out :(. I don't think I'll ever forget the looks on their faces when they realized what was going on.

2nd code was a little better, I was helping to discharge a 37 yr old man who had suffered a TIA. He was happy, going home, good to go. While helping him pack he grabbed my arm and spun me around pretty hard and stated he didnt feel okay. I saw the facial droop on the left side start and heard his speech slurring. Again..I panicked. I knew this wasn't a true code, and i don't even think my hospital had a RRT at that time but I called the code. I just stayed with pt holding him until the team arrived and they took him. I Heard he survived and that yes he did have a massive stroke. Last one was a drug overdose (That had been treated before coming to the unit but pt was almost blue when she arrived) that went into respiratory distress and seizures. RRT was called and again..I panicked. I did what I was told, was finally pulled from the room by my instructor who realized one of her students was helping with a possible code. So in reviewing my experiences I have decided panic is my friend..i dont panic as in I freeze or turn into an idiot...I panic and it seems to sharpen my mind to task at hand, gives me a sense of urgency, and allows me to get through the more unpleasant visual, audible, and olfactory elements that can accompany a code. So all in all I would rate my response at 5/10 as I am still learning and easily see I have very much more to learn and improve on.

RN Grad come Sept 2010

Edited by CareteamRN70
Forgot to add something

JulieCVICURN, BSN, RN

Specializes in CVICU.

It gets much better the more you do it. My unit is responsible for running the codes until the ER doc or another doc takes over, and usually the ER doc lets us just run it as long as we're doing what he thinks is ok (usually we're more prepared than they are). But when I was new and went to my first code, I just stood back and listened and watched, handed people stuff when they called for it, and did CPR. I guess I'd say I scored maybe a 7/10 on my first code, but that's mostly because the people I was with were so darned seasoned at it that there was really very little for me to do but observe and help when asked.

I still get nervous when it's my own patient who looks like they're circling the drain because I'm not quite sure when the turning point is that a code needs to be called, but because my patients are monitored it's easier to see the trend happening, so less of a judgement call/more obvious when action needs to be taken. I'm so glad I'm not on an unmonitored floor and have the risk of just walking in on someone who's been down, maybe for an hour or more!

Chisca, RN

Has 36 years experience. Specializes in Dialysis.

Post code reviews where everyone is allowed to critique the code are also helpful. Takes no more than 5 minutes.

Ruby Vee, BSN

Has 40 years experience. Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

my first code was an utter disaster. the patient was ambulating in the hall and then just went down. and i had no clue what to do. except scream for help. fortunately, the charge nurse was quite competent and sent me off for the crash cart and then to call the doctor and then to run blood to the lab . . . . and by the next code, i had a little bit more on the ball.

Dalzac, LPN, LVN, RN

Specializes in CCU,ICU,ER retired.

My first code was on my very first day as a tech. I hadn't even had an orientation. It was 2 hours in to the shift. I hadn't even taken my CPR course. Talk about green green green. Near the end of the code my charge nurse taught me cpr and how to use an ambu bag. She did tell me later that she knew I would do well in the future because I was so calm and listened to every word she said.

I wasn't scared mostly just curious So I would rate myself at about a 4or5

CapeCodMermaid, RN

Has 30 years experience. Specializes in Gerontology, Med surg, Home Health.

Not to be the voice of doom and gloom, but performing CPR on someone who is a DNR can be considered assault and in many states is reason to sue. Always check code status before starting CPR.

Ruby Vee, BSN

Has 40 years experience. Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

not to be the voice of doom and gloom, but performing cpr on someone who is a dnr can be considered assault and in many states is reason to sue. always check code status before starting cpr.

when your patient requires cpr, it's too late to check code status. know your patient's code status before he codes.

Many moons ago at my very first hospital job, I worked on a med surg floor. The hospital wasn't too big but had about five floors.

There wasn't a "code team" and when a code was called each floor sent someone to the code. There was a code called in the ER and they sent me. I had only been a nurse about three months and I was terrified!

When I got to the ER they told me to do compressions so I did what I was told. I didn't find out till later, the pt was already stone cold dead when I got there and they had me do compressions "for practice". I didn't think much of it then but looking back on it I don't think that was a very professional thing to do to a person.

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