So I was just finishing up my last day of clinicals for my first term of nursing school this past week. As we were sitting in the break room of the hospital talking with our instructor about the day's events this guy walks in and announces they have a code coming in and invited the students to come along. I thought cool - we will get to watch what happens on a code! Another student and I say we'll go and off we walk to the emergency dept.
As we are walking this guy (can't even remember what his title is) starts quizing us on our CPR knowledge and it becomes apparent that we have just volunteered to do the chest compressions! Suddenly I find my anxiety level has gone through the roof and I am thinking oh my gosh what I have just agreed to? Can I really do this? What if I do it wrong? What if I see the patient and can't do it!
BREATHE I tell myself....remain calm...BREATHE...you can do this!
We get to the emergency room, get quick instructions on where to stand, then we gown up. After a few tense minutes the patient arrives and my anxiety level seems to dissipate a little and is replaced by excitement. The moment has arrived. It is a controlled chaos as everyone takes their places around the patient. When the pt first arrived she had a chest compressor on - which is a device that does the compression's for you. For a brief moment I feel disappointment, perhaps we won't get to participate after all. But, the device apparently runs on batteries and quits working! So..before I know it my co-student is being told to start compressions. She jumps up on the stool and begins. Soon I hear her ask me if I am ready....ok here I go!
We change positions and I begin. With guidance from they guy who first came to tell us there was a code....my CPR training comes back to me and I get into a groove. WOW...I am tired....this is alot more work than I ever expected! But I keep going - and unlike what they teach in CPR class - we are not counting the compressions to breaths. I am told don't stop - just keep going while the person at the head of the bed manages to count my compressions and breathe for the patient. Once I get into a groove I glimpse down at the patient's face....mistake! I quickly looked away so emotions would not take over. "SWITCH"
After switching off several times between the two of us (students that is), I start to realize that doing CPR is nothing like it is in the class room. I am exhausted, out of breath and the plastic gown and gloves are sticking to me...yuk! They had us put on face shields as well - but we quickly took those off as our quick breathing had fogged the shield up anyway - making it impossible to see had we kept them on.
In the end, after working on the patient for what seemed only minutes (but was actually about 30 minutes) the Doctor called it. I knew from the beginning that the chances of this turning out good were slim, but I had hope anyway. I even prayed a few times as I was over the patient doing compressions "Please God let this turn out good, let us bring the patient back. Let me end clinicals on a good note."
Reflecting back on my first time doing CPR ~ I did crack a rib. I heard it pop but didn't feel anything. At first I thought what did I do wrong to make it pop? But it happens and I knew I couldn't pick myself apart over it. The whole time we were in the ER our instructor was standing behind us, giving us confidence and guiding us. The guy that grabbed us in the first place was also there guiding and instructing us as we were giving compressions.
As we took off our gowns and gloves we realized that we were covered in sweat - yew! Plastic doesn't breathe very well! The adrenaline rush lasted for about 2 hours afterwards and for the rest of the day I couldn't get the patient's face out of my mind. I wondered if my emotions were going to take over and I would break down but I never did...okay well maybe I cried just a little!
All in all - I did it. My first time doing CPR...wow....I did it! What a rush! I felt compassion for the patient and family - but I was also excited that I got to do CPR...and I almost feel like that excitement is just a little bit morbid! But then again.....don't all nursing students have that feeling when they get to do something new for their patients?
Oh and the next day I was so sore! My arms and upper back - heck even my wrists all hurt!
Thanks for listening! I knew this was a safe place to share my experience!!
And just a side note...according to ACLS protocol, once an advanced airway (ET tube/LMA) is placed, you no longer have to stop for breaths after 30 compressions. After the pt is intubated you can do continuous compressions while someone is giving 8-10 breaths/min. BUT you must do the 30:2 until the pt is intubated.quote]
:yeahthat:
I'll never forget my first code as an RN. My pt, a 90-yr-old male. We coded him twice, about an hour apart. I broke ribs during both codes. I don't think I will ever forget that feeling. But, I would not have been doing quality compressions if I hadn't. He didn't make it either.
It sounds like you did a great job. Be proud of yourself. That was a terrific clinical experience for you.
What an awesome experience for you!!! I would have loved to have participated in a code during clinicals! Not that I WANT anyone to code...but you get what I'm saying..haha...We had a patient code during clinicals this semester and actually had a nurse bring us along to help...when we arrived another nurse cussed us out and screamed for us to get away and physically pushed us out of the room...it wasn't a good experience!! haha!! But I'm so happy that a fellow student was able to realize their talents in a chaotic situation!! GOOD LUCK with future situations!!!
Participating in a code was the catalyst for my career change. I took the EMT-Basic course simply because I thought it was interesting, but had NO plans to do anything with it. Then, on one of my final clinicals in the ER, a code came in. Of course I was drafted to do compressions. That was when the light bulb came on for me...as long as I continued to circulate his blood and the respiratory therapist continued to breath for the patient, he still had a chance. He didn't make it either, but that experience was an epiphany for me. I went on to become a paramedic and eventually, a RN. Codes have become fairly routine over these past 11 years, but I will never forget that first one, and how it changed my life.
Great Job and welcome... I think that it is awesome that you chose to come and share your experience with us. This is an experience you will always remember. :) ~Ivanna
The only way to really asses the efficacy of chest compressions is to feel for the carotid pulse while administering compressions.
Correct and I am suggesting using a cardiac monitor is a good way to monitor your "pace and rhythm" while doing CPR and no watching a cardiac monitor is not a particularly good way to check a patient's corotid pulse. :)
I remember my first code as a student. Big guy, witnessed arrest while working with an outdoor contracting co. He was beyond blue and his eyes were someplace else. So much work compressing his huge upper body and in the end he was pronounced dead. The work was exhausting! I was soaked in sweat and my calfs hurt for two days. As disappointing as it ended the experience was priceless. I now work in the ER, many codes, many heart breaks, many ibuprofen and leg massages. In the end we look in the mirror and say we did our best.
Participating in a code was the catalyst for my career change. I took the EMT-Basic course simply because I thought it was interesting, but had NO plans to do anything with it. Then, on one of my final clinicals in the ER, a code came in. Of course I was drafted to do compressions. That was when the light bulb came on for me...as long as I continued to circulate his blood and the respiratory therapist continued to breath for the patient, he still had a chance. He didn't make it either, but that experience was an epiphany for me. I went on to become a paramedic and eventually, a RN. Codes have become fairly routine over these past 11 years, but I will never forget that first one, and how it changed my life.
You did great.
I was on med/surg and a Pt went unresponsive. The quick action/adrenaline rush changed my life.
Thanks to all for your posts and encouragement! I truly appreciate your feedback.
I do remember thinking that this patient was probably not going to make it because her coloring was very pale - not bluish though. I also remember the very distant and blank look in her eyes - that was my 2nd clue that I truly knew we weren't going to be bringing her back.
The chest compressor - yes - that thing looked evil! The compressions were so deep it literally looked like the patient was being squeezed in two! Ouch!!!
Again - thank you all for your feedback. Being able to write about this experience helped me a great deal!
Thanks to all for your posts and encouragement! I truly appreciate your feedback.
I do remember thinking that this patient was probably not going to make it because her coloring was very pale - not bluish though. I also remember the very distant and blank look in her eyes - that was my 2nd clue that I truly knew we weren't going to be bringing her back.
The chest compressor - yes - that thing looked evil! The compressions were so deep it literally looked like the patient was being squeezed in two! Ouch!!!
Again - thank you all for your feedback. Being able to write about this experience helped me a great deal!
:redpinkhe
I call it the thumper. However, they are an awesome machine, and in a smaller hospital where there isn't as much staff (or readily available students/residents), they can really help free up some hands. During a class, one of the ICU nurses said "I hated this thing and thought it was stupid until I saw it in a code where the patient had an arterial line. Before using it, the art line was reading 20's-30's(with compressions). While using it the arterial pressure jumped from 60-90". WOW!
You were very lucky to have the opportunity to do CPR while a student. Any patient that codes on you after you get your licence will have a better chance of a good outcome. You need to thank whoever saw this opportunity and made it available to you and your peers. It sounds like they have a real desire to ensure you are getting as much as you can out of your clinical rotation- that isn't always the case.
You did a great job! You'll never forget your first code.
It's cool you had the chance to do compressions while still in school. What a a wonderful opporunity you had, and you had someone to cheer you on as a bonus!
I worked as a CNA and then a nurse for years in several hospitals before I ever did compressions. Honestly, the first time was after several months in the ER. I remember doing the compressions and the Doc felt the femoral pulse and said "You're doing a great job, Rhia! I feel a very strong pulse." I was like "That's great, this is the first time I've done compressions!" He just looked at me and laughed.
Next thing you know- you'll find yourself doing compressions to the beat of whatever song you heard on the radio while driving to work
Suddenly I find my anxiety level has gone through the roof and I am thinking oh my gosh what I have just agreed to? Can I really do this? What if I do it wrong? What if I see the patient and can't do it! 
However, they are an awesome machine, and in a smaller hospital where there isn't as much staff (or readily available students/residents), they can really help free up some hands. During a class, one of the ICU nurses said "I hated this thing and thought it was stupid until I saw it in a code where the patient had an arterial line. Before using it, the art line was reading 20's-30's(with compressions). While using it the arterial pressure jumped from 60-90". WOW!
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