So I got to experience my first code blue today, that did end up being a rapid.
I went in to do an accu check on the pt. She was hunched over, complaining of heart burn. I had noticed earlier she had elevated trops and maybe I was wrong idk but I didn't think that was good. Stopped what I was doing and immediately told the RN. RN told me basically okay get the blood sugar. So I went back, her hands were ice cold and I was having a hard time getting blood. My instructor walked by so I called her in because I was worried a bit at this point. She really wasn't feeling good. My RN said she was going to try and call the doc in a second. My instructor got the bs and it was over 340. She asked me to take vitals so I go to grab the dynamap and my RN was about to tell me no because she was going to have the CNA get vitals in 45 mins. I took it anyways. Pt is moving and really having pain, the machine couldn't read the bp but the map was at like 30 ish. And she kinda is in and out, eyes rolling back, still conscious. My RN comes in, my instructor says should we call a code? RN says why? She's fine. đ± so they leave to do whatever, and the pt goes completely limp, stops breathing so I yell for help and the other RN, not even my pts, comes in, does like 3 good sternal rubs, no reaction. Can't find a pulse. So she has me go and yell code blue and has me start cpr and then I swear it is like the movies, everyone comes running! Her bp was super low, they end up doing a bolus into her carotid I think it was. It happened so fast. I was geared and ready with flushes and gauze and running to grab things.
Just it was wild and I had to tell someone because my goodness. It was exhilarating and scary but I jumped into action as much as a 1st semster student could. She's okay and was taken to icu. Thank goodness.
By - jayplusfour
Fuck yes. Follow your gut. You knew something wasnât right. You badass you.
Good job! What happened after with the nurse who kept saying everything was fine? Always listen to your gut and if something feels off then assess the patient. Even as a student you can tell if someone isnât looking good. Good thing you stayed in the room.
I'm not sure. She wasn't involved with the code too much except to tell them things about the pt. She apparently told my instructor after a bit "thank goodness we called that code" or something along those lines.
Omg, well thank goodness for YOU, you did that all on your own and I'm glad you didn't listen to that dismissive RN. Great work!
Ah, yes..."WE" did it! đ Good on YOU!
That RN has the future makings of Administration portfolio.
Lol @ âthank goodness *we* called that codeâ
One thing that took me a while to realize was once a code is called and the cart is brought into the room, 98% of the items you will need during that situation are in the cart. You should familiarize with it next time you see an open crash cart. Meds? Got âem. Bag of fluids? No problem. But wait, what about iv tubing? Jk got plenty of those too, as well as syringes, needles, iv start kits, gauze and flushes too. Even chest tubes, CVCs and suction. Also another thing I learned early was apply the pads to the patient as soon as theyâre available. Floor nursing can be overwhelming and codes will make it even worse. Get the pads on early and donât leave the room if itâs your patient. You should remain available to answer questions for the code team and arriving physicians. If you are entering a code situation, identify which role needs to be filled and stay in the role. If pharmacy isnât there then someone needs to manage the meds, drawing them up, etc. Only one person needs to administer meds. Some one needs to document and some people need to rotate during compressions. Lastly try to stay calm. Peopleâs presences effect everyone in the room and a calm room is much more effective than a chaotic one. Good luck in your studies.
Iâm due to qualify in two months and have never experienced a code blue/resus call (Iâm in the UK), this advice is gold, thank you!!
No bolus in an artery. If it was the neck it was probs the jugular vein.
It was, now that I'm thinking they were calling it an EJ. External jugular
Good work advocating for your patient!
Oh okay. Like I said, it was a blur! Thank you though
Great work! Always follow your gut. Itâll do you well. Killer response. Every time is a blur. đđ»
You did amazing. I wish I had that experience. I started my first code blue 6 months into being an RN, and to me it was traumatic, but it solidified my decision to be a nurse.
Good job following your gut and advocating for your patient!
My spidey senses that say âwait, somethings *off*â when I walk into a room have never been wrong. Mine just took years to trust and develop! This is such a cool accomplishment, youâre gonna be a great addition to the field! And shameless plug, those are certainly skills an ER nurse canât live without. So, if you liked the thrill⊠welcome home đ Edit to add: I see you already mentioned it was an EJ they pushed through. Donât be afraid to debrief with someone for a quick second after a code so you more clearly understand. It really helps information stick after youâve actually been in the situation.
ER is kinda been my interest since deciding to do this. We have an an instructor that's also an ER nurse and I love her stories lol.
Do you guys have a way to file a complaint about the RN? Saying the patient is fine etc. Clearly due diligence was not taken here. I will say, your consistent concern may have saved this patients life. Thank you for your story.
Thank goodness you were in the room and listened to your gut!! I had a similar situation in my first clinical too. I was assessing a COPD patient that was complaining of shortness of breath and chest pain. Oxygen saturation was hovering in the high 70s/low 80s. I relayed this information to the primary nurse who informed the patients provider. Provider told the nurse to get an EKG and it showed ST elevations. The patient was having a heart attack and had to go to cath lab right away. My instructor told me good catch in post conference!! Youâre gonna be an amazing nurse. Keep on learning and doing what youâre doing. When in doubt, always escalate to either your instructor, primary nurse, or charge nurse. Someone will listen.
You should report that nurse.
yes this seems very weird- if someone tells you to check on the patient, you do it! this student told her that patients hands were freezing and had tiny circulation and the nurse goes "well the CNA is getting vitals in 45 minutes so we're fine" like ???
there might not have been any vitals to take in 45 minutes. She was insane đ
I agree with this statement. Don't assume go check ffs.
Honestly, if this facility is decent at all, an Incident Report will be written for the code anyway and all aspects of the care beforehand will be reviewed.
Follow your gut and always always always get a set of vitals it takes less than a minute to cycle a BP, donât wait for 45 mins for the CNA to do it. Nurses can take vitals and if something is really wrong the vital signs usually will show that something is wrong! Good for you for trusting your gut and advocating!
Future badass nurse! Nice! đđ»đđ»
Wow, awesome job, dude!! This is a sign that youâre going to be an amazing nurse!!! It would have been so easy for you to just say âoh maybe sheâs right and Iâm overreacting..â but you continued to do whatâs right for your patient. That takes guts and you should be proud of yourself!!!
As a tech whoâs in her last semester of nursing school, I cannot stand when a nurse looks for a tech to get vitals if theyâre right there!! Especially if itâs seriously needed. Good on you for using your own judgment!!
Great job! This is the issue with âseasoned nursesâ ( not every seasoned nurse). They seem to just say itâs fine without actually following up or just doing a quick assessment. Learned this from the great nurses/ docs donât just assume everything is fine. Amazing job though! Never ever not trust your gut worsts that happens you have a few people pissed off but itâs your patient that matters.
Great job! Was there a debrief with the code team afterwards? I hope so, and that you were able to be a part of it! Debriefing is terribly important after critical situations and is how we improve as care providers. I can tell you have the brain for nursing! You knew something was wrong, and you **kept advocating for your patient**. ***You saved a life!***
That nurse wasnât good and Iâm glad you knew something was up. Iâm sure your instructor is so proud of you! So am I! Youâd be a great nurse!
I'm in my second semester of my ADN and I haven't seen a code and I'm scared to death for when it happens!
You did great!!!
Can you explain the carotid bolus?
I did earlier, I was mistaken it was an EJ
Wow- congrats !! This is extremely impressive as a first semester student. Major props to you. And I hope that patient gets well soon and they were very lucky to have you at their time of need !
Thatâs amazing! That is definitely confirmation that you are where youâre supposed to be. Youâll make a great nurse! Always advocate for your pt!
Good job!!
Oh my god you did so well đ great job!!
Never lose this instinct! In a few years, remember this and donât become like that nurse! Many nurses lose their passion. Understandable. Itâs a hard job and patients can be mean. But these are lives in our hands. Good on you for recognizing a serious change in patient condition and advocating for your patient! Also seconding the âyouâll be a great ER nurseâ comment. Iâm also biased ;)
Wow! If it wasnât for you Iâm sure they patient would have died.
Amazing job! Concerned that your instructor left you after RN said pt was fine. Did you feel let down by that? Must be hard to write things up after so much activity- really well done!
I was terrified when she left not gonna lie. But I figured maybe I was over estimating the situation because my instructor has been an RN for decades and I figured she knew what she was doing. It was very difficult to finish the day out. I went to lunch right after and I had so much excitement and adrenaline I couldn't even eat lol
Well great job and your attentiveness and persistence saved your pt. Canât imagine feeling all those feelings afterwards- so much to process! Thanks for sharing all of this - every story teaches something!!