I have been a GN for about 2 1/2 months. Today, I experienced my first code blue. It happened so fast, we barely saw it coming! I work in a telemetry floor, and my preceptor and I happened to be sitting down in front of the tele monitor. I was looking up the number of one of my pt's doctors, when my preceptor asked the monitoring nurse if a certain pt's baseline HR was in the 40's, which was what this pt was running. Now, I know it sounds silly to ask that question because NO ONE'S baseline HR should be that low, but I have seen that low on this floor. So, I was on alert, but I thought that maybe that pt was running at her usual sinus rhythm. Well, my preceptor decided to check it out, and I followed her. We looked for that pt's nurse, and my preceptor went inside the pt's room, and asked her if she was okay. The pt never responded. She went into asystole and we first called the Rapid Response team, but when I tried to find a pulse ANYWHERE, her skin was cold to touch and her cap refill was greater than 4 seconds, and her fingertips and toes were blue. Then, all hell broke loose.
Within minutes, about 20 people showed up in her room and began compressions, I put up the ambu bag, but to be honest, I froze on the spot! I started shaking, my adrenaline was pumping, and I could not believe it was really happening! Afterward, I felt like a failure because I don't think I contributed to anything.
So, my questions are these: When was your first code blue?
Was it your pt?
Did you lead the code?
How did you react?
How did you feel while you were working on the pt?
How did you feel afterward?
I'd really like to know anyone's responses because I want to know if I could have done something else aside from what I actually did. Is it normal to just FREEZE??
It is normal for anyone new in this position to freeze!
My first code was when I was in critical care in nursing school. Wasn't my patient; in fact, it wasn't anyone's patient. Patient coded 3 times in the ER and was brought upstairs to the MICU. All of us were going about our business when we heard the overhead page "Code Blue - MICU" and all of us went flying to the scene lol. Since we were students at that time, we weren't allowed to "lead" the code - we were only allowed to stand by and watch, administer chest compressions or administer breaths via ambu bag.
I was scared, tbh. All of us rotated through doing chest compressions and then someone asked if I had done them yet and I said no...I must have had that look of fear on my face lol. Someone sort of pushed me in so the RN who was doing them could switch with me lol. Everyone in the code was so calm and relaxed and it eased my fears. I could feel the patient's bones cracking and breaking underneath my hands. I then went a little compression crazy and really started to get into it lol...the MD established IV access via the femoral artery and then he said calmly, "stop compressions" but I didn't hear him, so blood squirted across the room No one got mad at me, he just said it again in the same tone of voice and then I stopped.
It was an adrenaline rush, that's for sure. I enjoyed it, though. I think I will freak out whenever one of my own patients decides to code. Afterwards, though, I felt bad - especially for the family, who were downstairs during this incident. The patient expired.
And for the record, some patients normally have HR's in the 40's-low 50's. I've seen that a lot in well-conditioned patients - they just normally have a slower HR at rest than the rest of us do. As long as they are asymptomatic, A&Ox3, warm and pink and putting out good urine, that's a good sign. You may want to keep some pacer pads and atropine at the bedside, though.
I have yet to see my first code; I've been working for 3 months now. That's the one thing that absolutely terrifies me. I just pray that if one of my patients codes that it will not be because of something I missed or failed to do.
turnforthenurse, MSN, NP
3,364 Posts
It is normal for anyone new in this position to freeze!
My first code was when I was in critical care in nursing school. Wasn't my patient; in fact, it wasn't anyone's patient. Patient coded 3 times in the ER and was brought upstairs to the MICU. All of us were going about our business when we heard the overhead page "Code Blue - MICU" and all of us went flying to the scene lol. Since we were students at that time, we weren't allowed to "lead" the code - we were only allowed to stand by and watch, administer chest compressions or administer breaths via ambu bag.
I was scared, tbh. All of us rotated through doing chest compressions and then someone asked if I had done them yet and I said no...I must have had that look of fear on my face lol. Someone sort of pushed me in so the RN who was doing them could switch with me lol. Everyone in the code was so calm and relaxed and it eased my fears. I could feel the patient's bones cracking and breaking underneath my hands. I then went a little compression crazy and really started to get into it lol...the MD established IV access via the femoral artery and then he said calmly, "stop compressions" but I didn't hear him, so blood squirted across the room
No one got mad at me, he just said it again in the same tone of voice and then I stopped.
It was an adrenaline rush, that's for sure. I enjoyed it, though. I think I will freak out whenever one of my own patients decides to code. Afterwards, though, I felt bad - especially for the family, who were downstairs during this incident. The patient expired.
And for the record, some patients normally have HR's in the 40's-low 50's. I've seen that a lot in well-conditioned patients - they just normally have a slower HR at rest than the rest of us do. As long as they are asymptomatic, A&Ox3, warm and pink and putting out good urine, that's a good sign. You may want to keep some pacer pads and atropine at the bedside, though.