First Hospital Clinical....Code Blue

[Kschuppan]

Hello all,

So about a week ago i had my first 12 hour clinical in a hospital (i'am a EMT-B student). It was fairly slow then it all hit at once...

Had a massive head trauma come in due to a moped accident, i held direct pressure, felt pretty cool.

Then had druggie come in all tweaked and i watched the nurses work on him, pretty cool.

Helped with vitals on most patients.

But then it came, a siren went off and a code blue up in the hospital happened, they wanted the students to run up there and do chest compressions for CPR. Immediately i was excited, but mostly scared $hit-Le$$ and kind of wanted to run away. We got up there and they had stabilized him with drugs and his vitals were normal, he was a vegetable, but still "alive" none the less. I was kinda of re leaved because, i am admitting this too you all so don't give me too much crap, i was scared to be around and touch a dead person. I know this job includes this a lot, im not naive, i was just scared, my adrenaline was going but i was scared, we sat in the room for a while, while the nurses worked on him (they were all joking with each other, laughing, talking about their plans for the weekend) which i felt was odd, THERE WAS A DEAD MAN IN FRONT OF THEM?!?!.

So what i am asking is, has any one else had these feelings before? Another EMT-B student was pissed because "he wanted to break ribs and get dirty". I was more stand off ish, interested, but also very nervous.

Just curious, and i am kind of worried that i should not be in this field now, but i will never quit i will keep pressing on.

Thank you

Kyle

[medicgirl05]

I have had that scared/nervous feeling...at some point it stops being a problem and just becomes normal. At least it did for me.

I remember thinking how cold the people involved in my first code were too, but after a while you learn that the joking and laughing is just how many people learn to deal with such things. Now that should NEVER be done with family around...

I have had a few students tell me they couldn't wait to see someone die, or couldnt wait to feel the ribs break. Those students concern me far more than a student who is nervous/scared.

The dead body issue is something that hopefully will pass with time. You realize that it is just a body, there is no person in there anymore. It is just their earthly core.

If you are really concerned find an instuctor or preceptor that you trust and talk to them about it.

Edited October 13, 2011 by medicgirl05

[scollins1191]

I havent started my class yet so im not sure how much help i can be but this is something that i have gone over in my head a million times, I would think that everyone is going to handle death differently and the people like the nurses are more accustom to death then the students. I`m sure as time goes you`ll get more accustom to it as well. (not sure if accustom is the right word). And im sure i will have that same scared S***less feeling as well. As im sure a lot or most everyone else had too. Don`t second guess yourself too much, it sounds like you did everything you could and were supposed to, you cant save everyone, no one can. Take it in stride my friend and best of luck i hope it gets better.

[HERBIE1]

Being apprehensive is fine. It's pretty damn intimidating- especially when you are brand new. All I can say is just get in there- there's only one way to get over this fear. The good thing about compressions is that is ALL you need to worry about. Everyone else besides the doctor in charge is running around, doing multiple tasks. You have only one chore, and it's an important one. Just listen to what everyone is saying, because at some point they will tell you to stop CPR to do a pulse check, to intubate the patient, or to check the rhythm on the monitor. Just be ready to resume as soon as they tell you to.

You will become so focused on the task at hand, you will quickly forget your initial fear. Think about proper rate and compression depth as you are doing it. Focus on doing the best damned job you can. Think about how many resprations should be given. If you are just observing, look around at what everyone is doing during the code, See if you can figure out the various jobs people have. You might not understand everything that is happening- what the medications are, what the energy levels for defibrillation are, or what you are seeing on the monitor- that's OK. Make a mental note to ask your preceptor about all the things you don't understand. The more you learn about what is happening around you in a code, the more comfortable you will become.

Hang in there- you'll be fine.

[DFIB]

Being nervous is a good thing the first time out. It is a mixture of feelings. fear that "i might forget something and look like a fool", understanding the seriousness of the situation, uncertainty in an new and unfamiliar environment. I shows you respect the patient and his condition. The guy who wanted to "crack ribs and get dirty" understands none of these things and will probably finish his EMS days as a hose monkey. I try to stay clear of those guys because their ignorant bravado irritates me.

You have the right feelings for someone who has the potential to be a caring provider. Care for the patient, his condition, family. Remember that they are a human being and not a practice dummy to "crack ribs and get dirty" on.

My first solo CPR was a gunshot victim that bled out while we were working on him. I was so scared and nervous I had to jump out of the ambulance and puke.

Once you get a couple of minutes of chest compressions under your belt you will ignore the horror of the situation and be thinking about your interventions and the effect they are having on the patient.

anxiety from the incident don't hesitate to talk to your instructor about your feelings. They will understand because anyone worth their salt has been there before.

I think your feelings are appropriate and it sounds like you have the right heart to be a good provider. Stay the course..

Edited October 13, 2011 by DFIB

[Asysin2leads]

I find your fellow student's desire to induce fractures in the thoracic area of patients to not be in keeping with the principle of primum non nocere. Please do me a favor and tell him I said that he should find alternate means of entertainment and leave medical care to the professionals, which he is not now, nor ever will be. Seriously. Tell him I said that and get back to me.

[Kaisu]

I told a trusted preceptor once that I was scared when the tones went off. She had been working in hospital based EMS for approximately 20 years. This teacher told me that the day she stops being scared is the day she finds something else to do. I am apprehensive before each call. I mentally go through treatment strategies and "worse case" scenarios, plan what we need to take in, review drug dosages, etc. Once I get in there, training and experience take over and its not an issue.

This is a tough job. People that aren't strong emotionally cover up the fear and insecurity with bullshit bravado. It takes a lot of strength to remain open, to empathize with patients and deal with the uncertainty; to remain realistic (humble) in the face of the fact that you never have all the information, you will never have enough medical knowledge and you can be sandbagged on a regular basis with your weaknesses. The people that keep feeling and deal with those emotions become good providers with longevity in the field. The "I wanna crack ribs and get dirty" types remain whackers and/or wash out.

Good luck to you.

[DwayneEMTP]

You did fine. This is in no way an indication of your suitability, or not, for this profession.

Your' "break ribs and get bloody" buddy? He's a douche and needs to go back to flipping burgers.

I find scenes to be strangely relaxing most times. I get really calm and focused. The world gets really clear...But it's not always been that way. I've had trouble starting an IV because the nervous sweat was running into my eyes and my hands were shaking...but that's experience. Experience teaches some that they do their best work ramped up and driving hard, it's taught me to slow down. And it will teach you what you need to know too.

You are good at NOTHING significant without experience. To expect yourself to be prepared for something that you've never had the opportunity to prepare for is just being to hard on yourself.

You showed up, I'm willing to bet you would have participated if necessary, good on you.

Dwayne

[hatelilpeepees]

Agree with all of the above, the Nurses behavior should not happen but it does all the time, it is a coping mechanism. I would not complain about them though, as it would be a sure way to make sure students are not invited back in the future, and it is getting harder and harder to find clinical sites. As you do your clinicals you will probably see alot of things that you would never do, or atleast believe now that you will never do. Their actions were unprofessional, but of no harm to the patient.

[speedygodzilla]

Calls from time to time bother many of us. For me it is the sick or dead kids or babies. For me I may never get use to those. It helps me to know I did what I could and a lot about death is really out of our hands. With most adult codes I just think I have gotten use to it. I don't lose any sleep over it and remember to keep my personal and work life as separate as possible. Your feelings are normal, especially early on. You will either learn to cope with them, they will change to not negativly effect you, or they will control you and run you out of this buisness. If you continue to have problems coping than talk to experienced providers and ask them how they cope.