The Code

It's interesting when a Code is called here on my floor. It doesn't happen very often because I don't work on a cardiac floor, but occasionally- maybe once or twice a month something happens and a Code is called. Code Blue is the adult CPR code, and code white is a pediatric CPR code. Pink and Purple are for child abductions- I have never heard that one. Some codes have numbers, but I suspect those are for Housekeeping or Security Issues. For those of you who have seen that episode of Grey's Anatomy, I have never seen anything called a "Code Black" although there are codes for voilence and those types of emergencies. They are not paged to physicians and such. All codes are called over the loudspeaker.

First we here an announcement from the unit secretary, all available RN's to whatever wing. That is usually the first clue. At that point, about half of the nurses on the floor drop what they are doing and run to that area. Not walk, run. Usually the nurses on THAT wing are the first to respond, but since you never know, that is why they page the whole floor. Then usually within less than a minute from the first announcement the CODE is called overhead. "CODE BLUE Second Floor South". And then you see house managers, security and others come off the elevator or up the stairs fairly quickly. The crash cart shows up if it isn't already. There is usually somewhat of a crowd outside and inside of the patients room. The patient is assessed, sometimes bagged. CPR is started, sometimes meds are administered or they are quickly moved to another area or another unit.

Crying family members sometimes stand outside the patients room, politely ushered outside while the patients is being cared for.

Panic. Adrenaline. Sometimes it turns out ok. Sometimes a patient has been snowed by their meds and they just need something to kick them back in to response. Sometimes it's a heart attack. Sometime the outcome is good, sometimes it's not so good. Today was good.

It changes the mood here, though. It changes the whole feel of the floor, and it's nice to see people moving quickly for patients and the way that they feel energized and charged, and the dialog between the nurses that happens afterwards. It's usually always an opportunity for education through conversation.

And it's always better to call a code when it's not needed, than NOT to call a code when it is.