Rough day

SierraBravo · Mar 26, 2015

You have to give yourself a break. You are a newly minted nurse and even when you've been through multiple codes, it's still stressful. Experience is the key here. And you'll gain it with time. You could start running scenarios in your head and that might help you prepare. For example, pt. stops breathing, initiate CPR and call for help. Continue doing CPR until 2nd RN is able to bag the patient, etc...

Gooselady, BSN, RN · Mar 26, 2015

Aww, that sucks

When I was almost ready to graduate, one of my last shifts with my preceptor, I'd had a rough day with a patient who crumped and my preceptor was a bit on the 'militant' side. So I opened my mouth to report off to a room of fifteen or so nurses/staff and completely froze. Then, I cried. Well, I tried to HIDE that I was crying, which is impossible. My preceptor huffed and rolled her eyes, but another nurse beside me said "Relax, just start over." And I did, my chin quivering and tears dripping. My nose plugged up completely so I sounded like a rhino.

I still get a crampy feeling in my guts when I remember it :) It was hideous.

I still went on to be a completely functional nurse anyway So will you. These things are awful, horrid, and your confidence in your whole SELF takes a hit. You feel too stupid to walk and talk at the same time, and you are positive everyone else agrees.

This will be a memory someday that you'll share with a new nurse who admits the same thing happened to her. And you'll tell her about your own experience with compassion and encouragement :)

jadelpn, LPN, EMT-B · Mar 26, 2015

That stinks, and I am sorry it happened to you. I would say breathe and focus. The code director will give you a job to do. If you need clarification, a simulated code debriefing is where to ask those questions.

If you are put in the position of recorder, focus on what is being said, write it down, watch your times. That is a really good place for a new grad to be. Focus on listening to everything, make sure that you have compressors to spot current compressors, and overall, try not to emotionalize the proceedings.

If you are put in the position of access, you need to attempt an IV wherever you can--and if not, know how to use an IO, and practice when there is not a code. Your nurse educator can help you. If there is a paramedic on staff, ask for help getting IV access as an educational tool. Paramedics are learned in large bore IV access. Also, do as many foleys as you can. Again, it will assist you in the instance of a code, and that is what you are told to do.

Finally, familiarize yourself with where everything is, how to get it, and how to put it on. (Defib pads, for instance). Knowledge is power, and can help you overcome that frozen feeling.

Come back and let us know how it goes---My wish for you is for you to say "I've lost that frozen feeling....and it's gone, gone gone....."

You got this.

By the way, I would have much rather gotten that frozen thing out of the way on a simulated code.....and I would NOT want to be the nurse who starts yelling and running around like a chicken with no head.....which also happens...JUST sayin'.......

BSNRN2014 · May 22, 2015

Thank you everyone for you words of encouragement. I keep telling myself that the first 6 months is the hardest for new nurses. I am watching the the nurses on my unit, seeing how they respond in critical situations so that I can learn from them. I am still having moments when my confidence takes a hit but i'm trying to move past those moments and to learn from them.

suanna · May 22, 2015

I'm thinking this is why they have "code simulations". It takes some time to get over the deer-in-the- headlights response when a patient crashes. Is the problem persists- ask if you can "shadow" whoever trots off to codes for a shift or two. (that means no pay, but all you are doing is watching and learning). Once you watch 3-4 codes, you will get a better feeling for the rhythm and priorities. Heaven help your patients if coding ever becomes blasÃ©. Someone trying to go into the light without our permission should always get our dander up- but not a paralyzing fear- just get down to business and try to turn that train around. Remember, very few "codes" ever make it out of the hospital. If you do everything GREAT- 5%-10%. Survival for a year after-2%-5%. So learn what you can, help with what you know, and hope for the best. Just realize, when you are pumping on someone's chest, it's a Hail Mary at best, and even a boy scout has about as much chance as you do in getting a positive outcome.