Amidst Nursing’s Daily Challenges, a Longing for Enduring Meaning

Early ideals, current reality.

I recently co-facilitated a breakout session at a national nursing conference in which we had the participants reflect upon life experiences that sparked their initial desire to go into nursing.

Some knew from a very early age that they were drawn to providing care for others. Others, like myself, were second-career nurses who had spent time in other professions before making our way into nursing.

We spent time talking about our early idealism about the profession and the various experiences or issues that have challenged our ideals over time. I was struck by the deep and broad range of emotions in the room: pride, frustration, hope, discouragement, cynicism, and longing.

‘An almost palpable ache.’

It is the longing that stood out to me the most.

The nurses I met in that room, and nurses I meet everywhere, certainly express longing for better staffing, improved systems that facilitate smoother workflow, and a supportive work environment. But these are all longings that tie into one deeper longing, which is a longing for enduring meaning in our day-to-day work—as hard as some days may be—and a broader sense of hope about our profession in the midst of 21st century politics and health care.

I heard hints of cynicism, as nurses spoke of feeling their humanity overtaken by their workload and tasks, feeling morally compromised by an increase in ethically challenging situations, and feeling detached because of grievous cases that they never had opportunities to really process.

I heard nurses speak of their struggles to be the nurse they once thought they would and could be, and the room filled with an almost palpable ache as one nurse after another articulated his or her struggles, while the rest of the room nodded in agreement.

What endures after Nurses Week has come and gone.

Nurses appreciate the intent behind gifts and celebratory activities from our places of employment during Nurses Week. But it is the on-the-ground ability to connect our own sense of meaning behind nursing with what we actually do when we come to work that sustains our own inner sense of celebration about our profession, long after Nurses Week has come and gone.

We want to advocate for our patients’ rights, not violate them. We want to connect, and not just function. We want to heal, even at our patients’ end of life, and not harm. This longing to find enduring reasons to love and celebrate our profession runs up against formidable challenges in 21st century health care, but it runs true and deep even still.

 

Code Blue in the Hospital: What to Do as a Nurse

Code Blue in the Hospital: What to Do as a Nurse

What is a Code Blue?

A code blue is called when a patient experiences unexpected cardiac or respiratory arrest that requires resuscitation and activation of a hospital-wide alert.

These cardiac or respiratory arrests are handled by the “code team” of the hospital. However, if a nurse is nearby, he or she will have to step in and begin immediately until the code team arrives.

There is Code Blue training for nurses so they can learn how to properly and quickly respond to these codes. If you haven’t taken one of these pieces of training, look for one near you.

When to Call Code Blue

The decision to call a code blue will happen in a matter of seconds, so you have to think fast. You will know to call a code blue when the patient isn’t pumping the oxygenated blood they need to survive due to cardiac or respiratory arrest. In other words, if their heart stops pumping or they stop breathing.

Before you call a code, make sure and do a quick assessment. Look for a pulse and signs of breathing. If either of these isn’t happening, that’s when you call a code blue.

When you call a code blue, the code team will respond. Keep attempting to resuscitate the patient until they arrive.

Role of Responders During a Code Blue

When someone calls a code blue, the following people will respond and begin the process of trying to revive the patient.

Here is what the first responders to a code blue will do:

1. Call for help.
2. Drop the head of the bead and remove the pillows so the patient is flat on the bed.
3. Check the carotid pulse.
4. Begin chest compressions.
5. Bring the e-cart and other emergency equipment to the site.
6. Put the backboard under the patient.
7. Clear and manage the patient’s airway with an ambu bag or a pocket mask with a one-way valve.
8. Turn on the AED/defibrillator and use it for pulseless patients.
9. Verify that IV fluids and emergency medications are ready.
10. Document everything.

Always check with your hospital and make sure you know their exact code blue procedures in case they are different from what is listed in this article.

Who is on the code team?

Your hospital might have different members on the code team. More often than not, these are the people that make up the code team.

• Physician – typically the leader
• Unit RN
• Critical Care/ICU RN – might serve as the code team leader until the doctor arrives
• Pharmacist
• Respiratory Therapist – manages airways and respiratory assessments
• Clinical Supervisor – the person in charge of communication between the physician and the patient’s family
• ED Techs

What to Do as a Nurse During a Code Blue

Now that you know what a Code Blue is and who is going to respond let’s look at what you should do as a nurse during a code blue.

The most important thing of all is to stay calm and think quick. Mistakes could be costly, so take a deep breath and make sure you are doing the right things.

1. Practice First

Seek out opportunities to walk through mock code blues. Every chance you have to practice will make it so that your body and mind know what to do even when you are under the stress of the real thing.

2. Help Out During Code Blue

The best way to learn is to help out during a code. Keep in mind that if you have no idea what to do, it might be best to stay out of the way. But if you went through training and you know the procedures, begin helping. It will give you priceless hands-on experience.

3. Let the Doctor Be in Charge

Respect their authority and follow their lead. Your job as a nurse is to support them and the team. This might mean giving chest compressions or running and grabbing essential toils and supplies. When a code is called the doctor might use a defibrillator to shock the heart and make it pump again. There are also medications that they can give.

A code blue is a terrifying experience as a nurse. It’s stressful for experienced nurses and those on the code team, but even more for inexperienced or new nurses. Let’s look at what code blue is and how to respond as a nurse so that you are prepared.

What Not to Do During Code Blue

Just like there are some things you should always do, you need to remember the things to avoid too.

1. Do Not Yell

Keep your voice level and calm. It’s a very tense and stressful situation already, using a loud or excitable voice will only increase the anxiety and noise level of the room.

2. Do Not Guess

If you don’t know what to do, let someone else step in. This is not the time to make a guess and hope it is right.

3. Don’t Leave When the Team Arrives

Just because the code team is in the room doesn’t mean you get to leave. This is your patient and you were the last medical professional with them. They might have questions for you or need your help. Stay in the room.

4. Don’t Switch Roles

Communication is extra important during this critical time. If you are completing a task or in charge of a part of the process, don’t switch unless you communicate clearly and have someone take over for you.

Code Blue on DNR Patients

If you have a DNR patient, you won’t call a code blue. Typically, these patients have legal papers that say they don’t want cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS).

How will you know if a patient is DNR? It should be noted in their charts. Some hospitals will also put this information on their wristband.

To leanr more please download the brochure World Nursing Congress 2020

 

54th World Congress on

Nursing and Health Care