What to do when u find an unresponsive patient

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I am a new grad who just got off orientation. I never witnessed a code ever and in my nursing orientation my role in a code was never explained nor any policy given. That being said, a CNA came and motioned for me to follow her. I got to the room and she said she couldn't wake the patient. The patients nurse came in a few seconds later and we both tried to wake the patient and get a pulse. The patient was cool to the touch, somewhat stiff and had mottled skin. The patients nurse left to call a code. He is a very experienced nurse and left us there with no instruction. We believed the patient was dead and were not sure what to do. Within seconds more nurses arrived and nobody began CPR, the patients nurse didn't bring the crash cart with him after calling the code and so it wasn't there when the code team came. The patients nurse kept leaving the room so the doctor had a hard time getting information about the patient The whole thing was a disaster. I'm afraid I may be fired and lose my license . Is a nurse supposed to stay with his or her patient if they are unresponsive?

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Specializes in Clinical Research, Outpt Women's Health.

My 1st question would be were they a code or did they have no code status?

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Specializes in Critical Care.

Do you work in a hospital ? Was the patient a full code? As a CNA are you not required to know BLS?

Was CPR ever initiated?

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Specializes in Complex pedi to LTC/SA & now a manager.

Are you a nurse or cna? Are you not required to take BLS/CPR? Why did the cna get you and not the patients nurse? Did you not go over your role during orientation? If not why did you not ask after the fact? Do you work in LTC or an acute care facility? Was the patient a DNR?

Cold, stiff & pulseless is dead. No amount of CPR or advanced cardiac life support will bring the person back with a pulse. Dead is dead

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Specializes in ICU.

I agree with the person who said dead is dead. If the patient is a full code, they have to be coded anyway for appearance's sake, at least. No pulse and full code - start compressions. You can always do that if you don't do anything else.

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My first question would be to ask the nurse if they were dnr....then, if not...CPR. dead is not "dead" until the physician calls it. If they sue the hospital and they weren't a dnr...the first thing is going to be why did it take so long to initiate CPR.

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You should have begun chest compressions immediately when a pulse was not found.

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Specializes in Med-Surg.

I don't understand... Did this patient have a pulse? Respirations?

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Specializes in Complex pedi to LTC/SA & now a manager.
I don't understand... Did this patient have a pulse? Respirations?

Cold, mottled, pulseless. Likely apneic. Unless known DNR then start CPR

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If the patient isn't a DNR you begin compressions. We've done slow codes before but it was a code none the less. But that's a whole other topic which I'm sure has been discussed on here in the past.

So OP yes unless the patient is DNR, as the patient's nurse I pressed the code button, delegated someone to actually call the code, delegated someone to actually bring in the crash cart, delegated someone to hook the patient up to the monitor. I then switch CPR with someone because by this point I'm tired. I made sure an IV was established (I always made sure my patients had a working IV or documented as to why not) and check the rhythm on the monitor. I delegated someone to record the code also. Usually I'm the one pushing the drugs or shocking the patient if needed as directed by the physician. I've also delegated these tasks to another nurse if I need to quickly report the patient's background to the code physician.

So yeah I become quite bossy but I didn't like participating in unorganized codes.

Sent from my iPhone using allnurses

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Specializes in ICU, LTACH, Internal Medicine.

Dead is not dead unless 1) DNR and 2) properly and fully documented as being dead.

So, yes, check for code status and if anything but DNR, start CPR. And the patient's nurse is supposed to stay in that room until it all said and done.

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Specializes in Acute Care, Rehab, Palliative.

I have seen this happen where I work. However if the patient is clearly dead we don't call a code. Dead is dead. OP you did nothing wrong. Why on earth would you be fired or lose your license over this?

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