questions about your first code.. from a student nurse

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Hi all.. I'm a second year SN seeking my BSN. Today on peds I had a toddler who was going into respiratory distress with stridor. Luckily the code team was able to revive him. I assisted a little bit-and helped calm the mother down. The is the 1st time I've seen this happen to a child-I managed to keep it together during clinical today but I keep feeling so sad for him-and his mother. It was a difficult and scary thing to see, especially for someone so young. I know as a nurse I will see this often-but my question is: do you get used to it? Is it normal to feel teary, especially for a child? I'm not sure how I am supposed to react. I did go into the break room and pray for a minute-Is it normal to have something like this linger in your head post-shift?

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Yes, everything that you are experiencing is normal. I will never forget seeing my first code in the PICU. I was standing at the nurse's station and there were so many people in the room the mother was pushed to the hallway. She was there with this look on her face that I will never forget in my life and I felt for her, not as a student nurse but as a mom myself. They didn't revive the child and I saw her leave later that day with the soft blankets and the child's clothing.

There is a wonderful book that I think would help you tremendously called Trauma Stewardship. It was recommended to me by a social worker and it's about taking care of ourselves while at the same time taking care of our patients. It helps to teach us not to get wrapped up in people's lives but not to make ourselves so distant that we become cold. It's about attaining that balance we need to have as healthcare workers. It's one of the best books I've read. Good luck in your career!

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Specializes in Hospice.

I work in hospice, and have for 2 years. I see people, including children, die every day. Today, one of my patients, a 5 year old die. And I still went to my car and bawled after I pronounced the death. And I do this with many of my adult patients to. I hope I never get to the point where seeing this does not make me upset.

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Specializes in ER/ICU/Flight.

after reading your post, it sounds like you're a very empathetic person...which is a wonderful emotion that lots of people don't really have. I think you do "get used to it" in a way, not that it doesn't bother you but you can come to expect and anticipate death when you see a patient in extremis. we do everything possible to prevent it but sometimes it's inevitable.

it's normal to get teary, regardless of the age. I personally don't cry much (maybe once every 8-9 years) but there are many times when I feel like it and wish I could. as far as the lingering thoughts in your head after experiencing something like that...definitely. In fact I'd almost say if you didn't review and critique those patients after the shift then you may be in the wrong line of work. I've coded a lot of kids, most did not make it (almost all of them were traumatic injuries) and I remember things about them. Not their faces so much as the feeling of their lifeless bodies. it's beyond tragic and I replay images like snapshots in my mind sometimes, I can't help it...even though 5-10 years have gone by since some of them died. I believe that in some way, each time we remember those people we are honoring their life and keeping their memory alive.

Good luck in school and remember you have a big community of people who you can turn to when you need them. Take care.

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I know that I could never work in NICU or PICU because I would get too emotional seeing a child die. I am still sad when an adult patient dies but I am able to rationalize it . . . a 90 year old, the natural end of his life. But, a baby or young child . . . has not lived . . . get teary just thinking about it.

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My mother is going through chemo for breast cancer... and at each treatment she is paired up with a different patient and they recieve chemo together. So far she has been paired up with two people that were terminally ill and they are still chosing to fight. This has changed my total outlook on nursing- fearing death. I was so afraid of my emotions and how I would react to dealing with death. These oncology patients have the most courage that I have ever seen. I'm not afraid anymore, and honestly with what we have been through- to see a nurse who got teary eyed would not offend my family. My advice, is to try not to supress your feelings, deal with them as they come. Prayer is probably the best medicine, like you said- you took a little break to pray for your patient. Maybe, make a habbit of that to help yourself get through these situations. I also try to think about it this way: the people we have met and come to know- that if one of them passed away, all of their pain and fear would be healed.

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Specializes in Infusion Nursing, Home Health Infusion.

Oh yes if you are not used to seeing these things it can be quite traumatic. I have had co-workers that can not and some that do not want to start IVS on infants and children b/c they can not get their emotions under control. For me I have trained myself to focus focus and focus. I am a very determined person and when I have a job to do I am on a mission......I will get that IV in and push the meds as ordered or get those fluids going. All hell could be breaking loose and it does not phase me at all b/c I know I am needed and have a job to do. As you get confident in your skills and role you will grow into your role as an RN and for most it gets easier.

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Specializes in CNA, Psych tech, ED tech, Basic EMT.

I was lucky enough to participate in a code in the ER, where the person was revived, albeit placed on a vent and sent to ICU. The code itself was exhilarating, but it was an older lady. Not sure how I would feel about a kiddo.

Before I was a student nurse, I was a 911 Police, Fire, EMS dispatcher for several years. Whenever we had a tramatic call, and there were plenty, we had the opportunity to participate in a CISD, or Critical Incident Stress Debriefing. The same thing applies to nursing. Its not shameful in any way to be bothered by a code. If you find yourself distracted, bothered, or even upset over a traumatic event like that, please go talk to a supervisor or a nursing instructer.

Those kinds of calls or codes can be extremely stressful, and have a way of affecting a person days, weeks, even months afterwards.

Don't be afraid or ashamed to seek that debriefing.

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Specializes in PACU, OR.

Stridor is one of those things that I regularly have to deal with in PACU, so I'm a bit blase about it, but it is very scary when it's one of the little ones, they desaturate so quickly.

Yes, it will linger, like any traumatic experience, and you probably will never forget it; it was, after all, your first potentially life-threatening situation. Emotional reactions after any code are common, because you are functioning on adrenaline during the crisis, and nurses frequently break out in tears or need to sit down rapidly-before they fall down!-once the emergency has passed.

Kudos to your team for saving the kiddie, and to you for caring.

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IMHO, if you're not touched by every code you're involved in, there's something the matter. (and before I get yelled at, I don't mean you have to be really upset, I just mean you should feel something beyond 'well, that's one less bed bath').

your first code will almost always be awful, and the fact that you managed to make a useful contribution to it is more of an achievement than I think you realise. well done for not freezing in the corner.

bless you for caring enough to feel for the child and their mother. some days having empathy can leave you drained and you'll wish there was an off switch, but really, would you want to be any other way?

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It's very normal to feel normal human emotions in reaction to a sad, scary event.

You sound like you were able to function properly during the code, which is wonderful. Be glad, be reassured.

After it was over, you reacted normally - you were sad and scared. you comforted yourself, you expressed your feelings properly, you took a few moments to "let it out", and you are here asking other nurses and students if you did ok. I assure you, you did beautifully. You are not made of stone, my friend. You have senses and sensibilities, just like all humans do.

God bless you.

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IMHO, if you're not touched by every code you're involved in, there's something the matter. (and before I get yelled at, I don't mean you have to be really upset, I just mean you should feel something beyond 'well, that's one less bed bath').

your first code will almost always be awful, and the fact that you managed to make a useful contribution to it is more of an achievement than I think you realise. well done for not freezing in the corner.

bless you for caring enough to feel for the child and their mother. some days having empathy can leave you drained and you'll wish there was an off switch, but really, would you want to be any other way?

I have to say that it is normal, imho, to feel something akin to "that's one less bedbath" after you've been through the experience many times and also have been worked nearly to death and are at your limit of empathy, especially if the patient has suffered a lot and you believe death is a blessing, a release from suffering for pt and family. Or maybe a nurse or other staff going through these situations often just gets sort of depressed from too much sadness and stress?

Feelings are just that - feelings. There's no real right or wrong, is there? We don't act upon all our feelings, but we do have a range of them. They're a safety valve, like tears, like trying to keep a stiff upper lip in the face of pain and adversity, like joking around, like practicing intubation on corpses because that's the only opportunity you're going to get. It's cold, maybe, but it happens every day.

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