What Every Nurse Needs To Know During A CODE BLUE
CODE BLUE! CODE BLUE! These two words are dreaded by EVERY nurse no matter how experienced they are!
Your first time WILL be an experience of pure terror and you will feel as if you have just forgotten everything you have ever learned.
THIS IS NORMAL! Do not feel like you are a terrible nurse when this happens…it has happened to every nurse at some point and if anyone says it hasn’t, well…they are lying. Most of you will experience a code blue at some point in your career. I will never forget my first code blue.
I went back to check on my patient when I heard her continuous pulse ox start beeping like crazy. It said 60% and she had become unresponsive. A code blue was called, but before the code team arrived we needed to put a board under the patient, remove the head of the bed and immediately start compressions and start bagging her.
I was white as a sheet and thankfully had another nurse on with me that kept things calm. I remember the first set of compressions I did and felt the patient’s ribs crack. The team arrived, which is about 10 people.
I alternated with a male nursing assistant doing chest compressions…it is like an insane workout. I have watched multiple nurses have to literally straddle the patient to get enough force. We intubated the patient, but we never could get a heart rhythm or get her oxygen levels to come up.
About this time we reached her family and they said to make her a DNR. She unfortunately had thrown a massive pulmonary embolism and she died.
Each time got a bit easier and eventually I became the “calmer” of the other newer nurses, but I was still as terrified as anyone. You, as well, will become that person as your career progresses. So here is my advice when this happens on your shift:
1. Take about 10 seconds to compose yourself. You are no help if you are a complete basket case. Call a code blue following your facility’s protocol. If there is family in the room tell them they need to leave.
2. Remember the patient needs to be flat. The headboard easily should lift straight off. Slide the flat board under the patient (each unit should have this).
3. Start compressions if there is no pulse. Have a nursing assistant or another nurse go and grab the crash cart. Have another nurse or assistant grab the ambu bag and start breaths. Hook up the defibrillator and put on the pads so you can assess the heart rhythm. If you need to deliver a shock you are ready.
4. Make sure the patient has IV access and if they only have one in attempt to put in a second…not the easiest task while there are compressions going on!!
4. Hopefully, by this time the code team will have arrived and will take over but you will still be in the middle of it.
This will get easier each time, but no matter how many times you experience it you will feel terrified…you ARE potentially saving someone’s life.
Always make sure at the beginning of your shift you always make note of your full code patients vs. your DNR patients so that you aren’t scrambling if something happens.
Finally…NEVER hesitate to ask for help and understand that you will have the biggest adrenaline rush of your life for about an hour after the code happens. Oh…and it’s okay to have a little cry when everything is done. It is a very emotional and overwhelming experience.
You all will be great!! Keep up the great work and remember you ARE a LIFE SAVER!!
- Daphne Neuhaus RN
Originally published at blog.nclexmastery.com on July 2, 2015.
