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

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

Advanced Nursing 2021

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.

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Nursing Facts: 8 Things You Should Know About the Nursing Profession

                Nursing Facts: 8 Things You Should Know About the Nursing Profession

Advanced Nursing 2021

Did you know that nursing students account for over half of all health care students? Nursing is not only an important job, but also a booming profession. And those who earn a degree from a nursing program are not only learning valuable skills that can help them make a difference in the lives of others, but they are also entering an evolving and expanding profession with the necessary tools to succeed. Discover more about the profession with these nine interesting nursing facts.

Intriguing and Useful Nursing Facts

If you are interested in studying to become a nurse, these eight nursing facts cover not only the current state of nursing in the U.S., but also its projected future in years to come.

The Beginnings of the Nursing Profession

The history of professional nursing traditionally begins with Florence Nightingale, the well-educated daughter of wealthy British parents who defied social convention by deciding to become a nurse, then considered a low-status profession. She tended to injured soldiers in the Crimean War in the 1850s and played a significant role in changing the nature of the nursing profession in the 19th century. She opened the first professional nursing school in 1855 at St. Thomas Hospital in London.

Candidates Can Choose from More Than One Hundred Nursing Professions

An article in Medical News Today notes more than one hundred nursing professions. Specialties include ambulatory, geriatrics, hospice, nephrology, neuroscience, pediatrics, radiology, rheumatology, telemetry, transplant, and trauma. According to an article on Gap Medics, the following are some of the most popular specialties or professions within the nursing field: nurse midwife, ICU, nurse practitioner, neonatal intensive care unit (NICU), medical surgery, and oncology.

By 2020, More Than 800,000 RN Positions Are Expected to Go Unfilled Nationwide

According to the American Nurses Association, there will be “far more registered nurse jobs available than any other profession, at more than 100,000 per year.” Yet, many of those jobs are set to remain unfilled due to a combination of open positions and nurse retirement. More than 200,000 nursing positions are expected to remain unfilled by 2026.

Nearly 3 Million Nurses Are Employed in the United States

Registered nurse positions are opening up as demand for health care services expands along with the aging U.S. population. In fact, according to the U.S. Bureau of Labor Statistics (BLS), registered nurses held just under 3 million jobs in 2016 — 2,955,200 positions. The BLS projects 3,393,200 open positions by 2026, an increase of 15% in a 10-year period. In fact, an American Nurse Today (ANT) article notes 3.1 million to 3.6 million registered nurses already work in the U.S. today, meaning the projection has almost or already been met. These nursing facts bode well for future job hunters in the nursing profession.

Nurses Deliver Most of the Nation’s Long-Term Care

An ANT article notes that nurses handle the majority of our nation’s long-term medical care — care provided over a long period of time for people with chronic illness or disability, delivered at home or in health care spaces. According to LongTermCare.gov, a division of the U.S. Department of Health and Human Services, people turning 65 have a 70% chance of needing a long-term care service, with 20% needing care for more than five years. With hundreds of thousands of elderly people needing long-term care, nurses play a critical role in enabling more people to receive it.

Up to 62.2% of all Employed RNs Work in Hospitals

Hospitals are always a hive of activity. Nurses, physicians, technicians, therapists, medical assistants, patients, and their loved ones all have someplace to be or someone to talk to. That means many people may not realize just how strong the presence of nurses really is in an active hospital. For instance, according to an article in ANT, nurses are the largest group of hospital staff. Throughout a hospital, most health-care-related tasks are carried out by dedicated nurses. In fact, according to the same ANT article, 62.2% of all registered nurses work in hospitals.

Demand Is High for Home Health Care Nurses

As many hospitals shift focus to acute and specific care, many private health care options — such as home health care, outpatient centers, and neighborhood clinics — are expanding, opening up job opportunities for registered nurses. According to a 2014 report from the Centers for Disease Control and Prevention, 12,400 home health agencies served up to 4.9 million patients who received care at home. With so many people already using home health care, as well as more people aging into care in the future, nurses capable of working in home health care may find that there is no shortage of job opportunities.

General Nursing Practices Are Typically the Same the World Over

No matter where you go in the world, general nursing practices are typically pretty similar. According to an article published in the Online Journal of Issues in Nursing (OJIN), common universal themes include the different education levels for nurses moving up into more complex roles, credentialing standards to create a level of safety, nursing positions being held mostly by women, nursing occurring within a medical structure, and the existence of nurse shortages.

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What Is Nursing?

What Is Nursing?

Advanced Nursing 2021, Tokyo, Japan

21st Century nursing is the glue that holds a patient’s health care journey together. Across the entire patient experience, and wherever there is someone in need of care, nurses work tirelessly to identify and protect the needs of the individual. 

Beyond the time-honored reputation for compassion and dedication lies a highly specialized profession, which is constantly evolving to address the needs of society. From ensuring the most accurate diagnoses to the ongoing education of the public about critical health issues; nurses are indispensable in safeguarding public health.

Nursing can be described as both an art and a science; a heart and a mind. At its heart, lies a fundamental respect for human dignity and an intuition for a patient’s needs. This is supported by the mind, in the form of rigorous core learning. Due to the vast range of specialisms and complex skills in the nursing profession, each nurse will have specific strengths, passions, and expertise.

However, nursing has a unifying ethos:  In assessing a patient, nurses do not just consider test results. Through the critical thinking exemplified in the nursing process (see below), nurses use their judgment to integrate objective data with subjective experience of a patient’s biological, physical and behavioral needs. This ensures that every patient, from city hospital to community health center; state prison to summer camp, receives the best possible care regardless of who they are, or where they may be.

What exactly do nurses do?

In a field as varied as nursing, there is no typical answer. Responsibilities can range from making acute treatment decisions to providing inoculations in schools. The key unifying characteristic in every role is the skill and drive that it takes to be a nurse. Through long-term monitoring of patients’ behavior and knowledge-based expertise, nurses are best placed to take an all-encompassing view of a patient’s wellbeing.

What types of nurses are there?

All nurses complete a rigorous program of extensive education and study, and work directly with patients, families, and communities using the core values of the nursing process. In the United States today, nursing roles can be divided into three categories by the specific responsibilities they undertake.

Registered Nurses

Registered nurses (RN) form the backbone of health care provision in the United States. RNs provide critical health care to the public wherever it is needed.

Key Responsibilities

·         Perform physical exams and health histories before making critical decisions

·         Provide health promotion, counseling and education

·         Administer medications and other personalized interventions

·         Coordinate care, in collaboration with a wide array of health care professionals

·         Advanced Practice Registered Nurses

Advance Practice Registered Nurses (APRN) hold at least a Master’s degree, in addition to the initial nursing education and licensing required for all RNs. The responsibilities of an APRN include, but are not limited to, providing invaluable primary and preventative health care to the public. APRNs treat and diagnose illnesses, advise the public on health issues, manage chronic disease and engage in continuous education to remain at the very forefront of any technological, methodological, or other developments in the field.

APRNs Practice Specialist Roles

·         Nurse Practitioners prescribe medication, diagnose and treat minor illnesses and injuries

·         Certified Nurse-Midwives provide gynecological and low-risk obstetrical care

·         Clinical Nurse Specialists handle a wide range of physical and mental health problems

·         Certified Registered Nurse Anesthetists administer more than 65 percent of all anesthetics

Licensed Practical Nurses

Licensed Practical Nurses (LPN), also known as Licensed Vocational Nurses (LVNs), support the core health care team and work under the supervision of an RN, APRN or MD. By providing basic and routine care, they ensure the wellbeing of patients throughout the whole of the health care journey

Key Responsibilities

·         Check vital signs and look for signs that health is deteriorating or improving

·         Perform basic nursing functions such as changing bandages and wound dressings

·         Ensure patients are comfortable, well-fed and hydrated

·         May administer medications in some settings

What is the nursing process?

No matter what their field or specialty, all nurses utilize the same nursing process; a scientific method designed to deliver the very best in patient care, through five simple steps.

Assessment – Nurses assess patients on an in-depth physiological, economic, social and lifestyle basis.

Diagnosis – Through careful consideration of both physical symptoms and patient behavior, the nurse forms a diagnosis.

Outcomes / Planning – The nurse uses their expertise to set realistic goals for the patient’s recovery. These objectives are then closely monitored.

Implementation – By accurately implementing the care plan, nurses guarantee consistency of care for the patient whilst meticulously documenting their progress.

Evaluation – By closely analyzing the effectiveness of the care plan and studying patient response, the nurse hones the plan to achieve the very best patient outcomes.

Nurses are Key to the Health of the Nation

There are over 4 million registered nurses in the United States today. That means that one in every 100 people is a registered nurse. Nurses are in every community – large and small – providing expert care from birth to the end of life.

According to the January 2012 “United States Registered Nurse Workforce Report Card and Shortage Forecast” in the American Journal of Medical Quality, a shortage of registered nurses is projected to spread across the country between 2009 and 2030. In this state-by-state analysis, the authors forecast the RN shortage to be most intense in the South and the West

Nurses' roles range from direct patient care and case management to establishing nursing practice standards, developing quality assurance procedures, and directing complex nursing care systems.

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