NursingLink

Last time I participated in a code was the last shift I worked, last Wed night.  OF course, I work in a pediatric ICU, so it is somewhat commonplace.  Usually about 1-2 a week.  Just coincidence whether or not you are working on that shift when it happens.  I drew up drugs and did compressions.  Where I am currently working, I am a travel RN, we are only an 8 bed unit, so there were only 3 nurses on at the time.  There were 4 of us there, however, because it was just after shift change and one nurse from dayshift was still there.  I have been in codes where there were only 2 of us there.  We also always have the MD and an RT.  The patient did survive that night, however, they withdrew support and he passed 2 days ago.  He was 18 months old and drowned in a hot tub on his back deck.

I worked a code in a car wreck about 4 years ago.  Very sad.  The driver was dead, but as a recent EMT, I tried anyway.  It was amazing to see him regain his color although he was dead.  Getting oxygen throughout his body was very interesting to see it's immediate effects on his coloring.  I was sad that I couldn't save him though.

My first and last code was last Sat. I'm in a weekend Nursing program that takes you from CNA to LPN to ADN to BSN. You attend weekend classes and clinicals are on Saturday. I will finish the LPN portion of this program in Dec. So the last weekend I had my very first ER rotation. Everyone had told me that the ER would be dead until about 11am but it would be a good place to practice some skills like IV's, Caths and EKG's. WRONG! 15 min after I arrived the paramedics brought in a man that coded while wheeling him in the door. I relieved the tired medic of compressions until the crash cart arrived then began bagging. It felt like we were there working frantically for hours until the MD called time of death and I realized it had not been that long at all. Before my ER rotation I was convinced I wanted neonates or L&D.... but that surge of adrenaline (even thought the gentleman did not make it) was absolutely amazing! I may be changing my mind. We shall see.

Adrian

Codes are very common place for me.  I work in the ER and everytime I am Charge Nurse there is at least one full arrest, a trauma, and it seems like 20 thousand patients.  Then of course if I am taking an assignment- Whatever the pt complaint or age I always seem to have one that crashes on me.  I had a 17 year old girl come in and she was sick with a temp and felt like she was going to pass out.  So I am working on getting her in the bed and an iv in and labs drawn when out she goes and then it was all downhill  after that.  It turns out she had toxic shock syndrome.  I don't know why but I have a black cloud over me.  Although one of my patients thanked me for my black cloud.  He had a hr of 200 and we gave him atropine and dropped it immediately to 60.  It stayed there so a couple hours later the doc said he could go home.  He got dressed I took out the iv and I let him go to the bathroom.   He came back sat down and I started to give him his discharge instructions.  He said "My heart feels a little fast.  I hooked him up and he was again 217.  I said well get back into bed and lets get started again.  He said "Why me?"  One of the other nurses started teasing him that it wasn't him just his bad luck to have me as the nurse.  He was laughing.  We never did get his hr back down they had to take him up to the cath lab and do ablation.  But before he went up he said he was thankful for my black cloud because he probably would have gotten home and had it happen again.

I know I am not an RN yet... but I felt like adding my $0.02 anyways. This was the first code I witnessed that had a massively profound effect on me.

A few years ago, I started working in an ER as a Patient Registration Rep. It was our job to get in the ER and do bedside registration. It was December 26th and the ER was fairly busy. I was working that shift in Triage - as Pt Reg in Triage we were there to accept patients as they came through the door, with the help of a RN assign a Priority number, assist in any way possible in the Triage... and do a TON of "checking on how long" for the grumbling pts in the waiting room. It was a fairly busy night, so I was also helping with registration inside the ER - this one man came in with chest pain. He had been admitted a week prior for the same thing, was released and now came back with the same symptoms. I went into his room, registered him and talked for a bit... he appeared to be stable. I stood outside his room and got his chart together when all of a sudden he coded - it was unsettling to me because like I said, he had been ok up until that point.

The man was lost despite the valiant efforts of the ER staff. They had moved him across the hall to bed 1, which had a solid door instead of a curtain. His family was notified, and they began arriving. This man was of Hispanic origin, and it was the day after Christmas, so as you can imagine a lot of family was in the area and man did he have a ton of family. I believe he had 10 or 11 children (the youngest being in her teens). The nurses were quite busy handling the influx of patients. I was alone at the front Triage window when a small group, including one daughter in her 20s showed up. I walked into the ER and spoke with the charge nurse and explained who was at the window. The charge nurse instructed me to bring them back and let them into the room he was in. So... I did. I walked them down the hall, and just as I was opening the door to the room the daughter says - Is he alright?? I turned to look at her and said have you spoken with your family... and the door was opened enough at this point for her to see that the lights were dimmed and the family inside was sobbing. She totally lost it in the ER hallway and after she went inside I completely lost my cool.

I went directly to the charge nurse and said that I was no longer bringing family members back because a doctor or nurse needed to bring incoming family members to the Family Room just like they had done with the other mermbers and explain what had happened because I just had to do something completely screwed up to someone's daughter and it was not my position to inform her of her fathers death as a Registration Rep. I was furious and felt completly awful for the daughter.

I lost my father a few years prior to that, and just felt incredible sorrow for the way everything was handled. It hit home personally for me, and that was truly the first time anything in medicine ever hit me so hard. I even went outside for a break because I was just so upset about hurting her like that. The charge nurse apologized to me (which knocked my socks off because as Pt Reg we were never treated with much respect despite any background in medicine). But it still hit me hard.

I'm sure in the future if I were to actively participate in a code, I would be able to put everything aside during the code and do what was needed - I have always worked very well under pressure. But... afterwards... if it was a particularly hard case, I hope I will feel compassion, but be able to seperate my own personal experiences from those who pass on or lose a loved one. I can cry at home or in the car after shift. I don't ever want to lose my cool like that on shift.

You would think it would be common sense to ask a RN or MD before bringing family members back into a cramped ER, but many Reg people think nothing of it. I dont know how many times I've seen them bring family members back and there is something bizarre with another patient happening, and they walk right into the middle of it. It's amazing.

Last code was two days ago and no  the patient did not survive. I did  chest compressions and when I was relieved I passed some epi, and atropine to the med nurse. It was well orchestrated. Oh yes , and my pants fell down around my knees. It lighten up the moment with a laugh.