Unanticipated Codes

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN. She currently has an essay appearing in The Examined Life Journal.

Code cart/courtesy of author Code cart/courtesy of author

My mentor once told me that there are almost never unanticipated cardiac arrests in the ICU. I’ve found this to be true. Certain indicators, like laboratory abnormalities or particular cardiac rhythms, can foretell a Code, and sometimes subtle signs trigger an instinctual foreboding that I’ve learned never to ignore.

The conviction that a Code Blue can be anticipated provides a sense of security; if the arrest is anticipated, then it may be preventable. And when it’s inevitable, at least anticipation allows for preparation. I strongly believe this. And yet this weekend my patient coded and I was caught completely off guard.

I had just remarked to one of my colleagues that my petite, elderly Chinese patient (some identifying details have been changed) was looking so much better than she had when I’d admitted her earlier that day from the floor—she’d been in respiratory distress, in a hypertensive crisis, and in need of immediate dialysis. All of the various specialty consultants had seen her and collaborated and I’d had the thought that Ms. M’s day would end very well, that it would be one of those nursing shifts where I’d see a metamorphosis […]

February 20th, 2013|nursing perspective|5 Comments

A Role to Live Up To

By Kinsey Morgan, RN. Kinsey is a nurse who lives in Texas and currently works in the ICU in which she formerly spent three years as a CNA. Her previous posts on working as a new nurse can be found here.

Now in my sixth month as a new nurse, I find every day that there is something new to learn, figure out, or adjust to. The constant stimulation and challenge is part of what makes me love being an ICU nurse.

Recently I was exposed to the simple yet powerful fact that being a “unit nurse” carries more weight than I’d thought. During a code blue on the medical–surgical floor a few weeks ago, I was performing CPR when it became necessary to initiate a dopamine drip to support a failing blood pressure.

One of the medical–surgical nurses spiked the bag and connected the tubing and proceeded to tap me on the shoulder and ask me if he had correctly entered the dosage of dopamine into the IV pump. Time stood still for a split-second while I contemplated the weight of this question. Though my mind and body quickly returned to the task at hand, the implications of that question haven’t left me yet.

The nurse who asked has been an RN for several years and has a lot more experience than I have. In reflection, I am honored and humbled by his trust. Not having encountered vasoactive drugs very often in his practice, this nurse […]

February 28th, 2012|career, nursing perspective|1 Comment