October 23, 2009

Code

In psych nursing, most of the codes called are not code "blues" (i.e., the patient physiologically crashing).  Most of the codes are for out-of-control patients.  Which means that my ACLS and soon-to-be PALS certifications don't get much of a workout, but my "standing there looking incredibly tough and ready to take to you the floor if I have to" skills do.

Codes aren't all too common as a whole.  All of us are well-trained in heading off patient problems before they happen, so I can work for a week and not hear a single code called while I'm there.  Then again, I can also hear four codes called in one day. 

Most of the out-0f-control codes are called for the kids' unit.  The peak time is right after school vacations, just before or on the same day that school starts.  The rest are on the intensive care unit.

Generally, when you hear a code, available staff from whatever unit comes running.  If it's a medical code, then you'll see more nurses than anything else.  For out-of-control codes, you'll see everyone from administration to medical staff to maintenance...and yes, that includes those big burly guys that were there backing me up when I had to give those court-ordered IMs to the uncooperative patient a while ago.

The last time I was at work (a few days ago), they didn't have me on my usual unit.  I had been there for the past week, and I think some of the other PRNs whose home unit is there complained about being floated elsewhere, so they floated me to stepdown...whichwhile it is in an intensive unit, compared to all the work I have to do if I'm on detox, going was like giving me the day off with pay:  a lot less paperwork, a lot less meds, and less needy patients.  Though I felt bad for the two nurses who ended up on detox:  when I went to the floor on an errand, I saw the two nurses swamped off their feet with no supporting staff.

Floating was also a nice change of pace, both in patient population and coworkers.  They asked me if I'd like to transfer my home down to stepdown, but they've hired so many nurses for that unit I'm not sure how easy it would be for me to get hours if I was in that pool with them.  Plus, even though it's a hell of a lot of work, I'm learning a lot about the detox process and I'm really starting to find my groove there. 

Though in the end, it really doesn't matter where my home unit is because I'm hired to float--I can get sent off anywhere.  Which is fine by me because I do appreciate the change from time to time.

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