Stephanie066

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 &not 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) Maintain or establish appropriate IV access Hope its helpful!

If you really truly mean that you 'hate nursing' when you're say 'this crap is not for me' then I strongly suggest you find another means to use your degree..and I don't mean that in a rude or condescending way, but bedside nursing isn't for everyone...I was working with med-surg/rehab/post op patients who were outrageously demanding and very unappreciative for the first few years of my nursing career. I went home every day and felt abused and defeated and most aspects of my life suffered. Then I got a job working in oncology...a lot of people asked me why I would ever take a job with that patient population, but the cancer patients I work with are some of the strongest, most determined and appreiciative souls I have ever had the privilege to care for. Maybe you just need to find another facility or specialty? You obviously didn't chose nursing for the money (let's be real) you've only been in the field for a short time, don't give up on nursing all together...weather you make a difference at the bedside or in case management or in administration you chose nursing for a reason, never lose sight of that

I started my nursing career working night shift on a LTC unit..so although I am a relatively new nurse I have a pretty good amount of experience in caring for dying patients. To answer your question..It is mainly for comfort. O2 at 2L is not going to really prolong their life or the dying process, it is really just to make sure that the patient is not struggling to breath. For example- I had a patient who was actively dying and the patients family refused to allow me to place the O2 on their mother because they thought it was going to keep her alive longer and 'drag out the process' (their words not mine). They weren't very well educated medically speaking and they had genuinely good intentions-they didn't want their mom to suffer for any longer they necessary-and that sort of thing. Even after explaining that the O2 wouldnt keep her alive any longer they still refused. As the night progressed the patient continued to become more and more restless despite ATC roxanol and ativan. I finally convinced them to let me put the O2 on because they finally realized that she was restless/agitated because she was not getting enough oxygen. Within 20 mins after putting the O2 on the patient was resting comfortably-no more restlessness and she died peacefully 2 hours later. So, in short and in my opinion at least giving O2 to actively dying patients is really just to make sure that their last minutes/hours/days are not spent struggling to breath. Hope that helped!

Where to start...I just graduated from nursing school this past May. I worked as a CNA at a SNIF during my last year of school and they offered me a per diem RN position when I passed my boards. However, just days into my orientation they begged me to fill a full time position that had unexpectedly become available...So, here I am fresh out of school and 3rd shift supervisor. I don't know about other facilities policies but mine requires that there be at least 1 RN in the building on 3rd shift, and because most of the third shift staff are LPNs I will be fulfilling the requirement. So not only will I be responsible for my 60 bed long term care unit but also in part for the 50 bed rehab/subacute care unit. A whole lot of responsibility for my first RN job..although usually a very confident person I find myself feeling somewhat overwhelmed. My main concern is earning the respect of the other nurses as well as the aides and others I will supervise. I often feel that the nurses second guess me on a lot of things or discredit my concerns/assessments etc, which is not only discouraging but also frustrating especially since they have told our DON that my skills are far better than they would have expected being that I am a new grad. Now I understand they have the right to challenge my judgment and I am ok with that but they do it in a way that is very belittling. For example a resident developed a boil so I cleaned with NS and applied a warm compress for 15 minutes (just a facecloth moistened with water from the sink in the patient's room inside of a bag) so when reporting this to the unit manager in the morning she stopped and yelled at me right at the nurses station because unbeknownst to me and all of the other nurses on shift nurses are never allowed to apply heat...EVER. My next biggest concern is being an effective leader on my unit...since I was a CNA at the facility before I became an RN I have found it hard to transition into a role that requires me to supervise the people who were previously my piers. In addition I am far younger than all of the aides and I can sense that a lot of them feel that my requests and expectations are somehow less credible because they are coming from a 21year old new grad nurse. Ok I know that was a lot to take in...but I would appreciate and any advice that anyone is willing to offer!