I start clinicals in a few weeks. I'm in my first semester of nursing school.
I'm so scared of my pts going into anaphylactic shock.
How do you know it's happening?
What do you do?
What do you tell the staff around you during this time?
What happens if you freak out and step away? Can you do that as a student since you don't know what exactly to do yet? (We weren't taught anything except that it's an emergency crisis reaction to whatever they're allergic to)
Also, what is "code"? My professors say it a lot saying either they never had a pt who codes or they had one who codes.
What does code mean and what is it?
What do you do in the event?
Please tell me all of the codes. Please tell me what type of emergency situations can happen and what you need to do (in details and explain why).
I'd like to know to be safe than sorry and make sure my pts lives are not at risk because of my lack of knowledge and me being so scared freezing up.
If you're having trouble controlling your anxiety, I would seek out a professional to help you manage it. It's going to be hard for you to focus on anything if you can't control your anxiety in school/work and consistently focus on the bad things.
Several, but like RNperdiem said not many considering I work in an ICU. I'm not sure that detailing the stories will help alleviate your anxiety, though.
I will say -- as I did -- as a student and as a floor RN, it will all come down to two things: initiate BLS and call for help.
Several, but like RNperdiem said not many considering I work in an ICU. I'm not sure that detailing the stories will help alleviate your anxiety, though.
I will say -- as I did in the anaphylaxis thread -- as a student and as a floor RN, it will all come down to two things: initiate BLS and call for help.
That's actually better advice than mine. Yes, initiate BLS, call for help, then get in the corner and observe once the pros get going.
I'm a frequent charge nurse in an ICU and a responder nurse for my hospital (if a patient codes anywhere above the first floor, I go and run the show along with the ICU doc/PA). Seen a bunch. And seen a lot of the kinds of mistakes newbies make. I'm assuming you're BLS certified. So here are a few tips.
- Try not to panic. Know how to call a code in your clinical setting. If you don't know, and someone goes down, call for help and call loudly. If you can't reach the code button, call for help loudly. If unsure of whether help is coming, call loudly.
- If you can't feel a pulse (carotid or femoral) quickly, call a code. If you don't think someone is breathing (or their breathing is agonal), call a code. Don't worry that maybe they have a weak pulse and you're missing it. Call the code. Calling a code incorrectly results in healthcare staff muttering under their breath... so what? Hesitating to call a code when it's needed results in death. If in doubt, call the code and let the pros sort it out.
- Start BLS. Don't worry about getting everything perfect. Worry about doing good compressions and assembling a team.
- Once you have one person compressing and another one bagging the patient, make sure that the defibrillator is hooked up to the patient and that the patient is on a backboard if possible. Incidentally, new BLS algorithms emphasize early rhythm detection and defibrillation. Waiting for a full cycle of compressions to finish once a defibrillator is available and hooked up is no longer advised. It's amazing how often I arrive at a code to find that no one has hooked it up.
- If you're confident in your compressions, rotating into that role is a good place for less experienced personnel to get experience in codes. Likewise, if you see only one person doing compressions with no one to back him up, line up behind him and offer to relieve him before he wears out. Minimize interruptions.
- If other staff is there and you don't have a well defined role, get out of the immediate area. Too many bodies standing around do not make for a smooth and efficient code. You might continue to help by standing outside the doorway and going to get any supplies the code team asks for that aren't in the cart/room.
- Actually giving medications, establishing IV access, etc, is out of the scope of your practice as a student. However, there's nothing wrong with studying ACLS algorithms if you want to know which medications are given when just for your own knowledge. Epinephrine every 3 minutes is the single most important drug for pulseless rhythms and asystole.
- Again, try not to panic. No one expects you to run a code yourself. Call for help, start the basics, and don't waste much time second guessing yourself.
First - take a nice, deep breath. Anaphylaxis or Anaphylactic Shock - is a bad allergic reaction in which the throat of the patient closes up. Trust me; you will know something isn't good with a patient that is experiencing it.
"Code," in this context means cardiac arrest.
These are both very scary experiences. If ANYTHING appears to be that off with a patient you are assigned to, your responsibility is to get your instructor and/or staff to help you. Stay with the patient and use the in - room alert system (call bell or code button - depending) to summon help if something serious like what you're describing happens.
Clinicals and just starting them can be very scary. But don't worry - you are certainly not expected to know everything. This is why you are a student. Trust your instructor.
Code Pink = a nurse is being maltreated by a doctor and the other nurses gather around and make sure the maltreating person is aware he or she is being observed by all of them; a show of solidarity for one's beleaguered colleague.
This is way better than a code pink in my hospital, where it means that a pediatric patient has gone missing.
Horseshoe, BSN, RN
5,879 Posts
You will NEVER have to handle a code as a nursing student. If it ever happens, get in the corner and watch everyone like a hawk.