Best Kept Secrets of the OR #6- there is a code button in the OR

I train all the new nurses on how to do call. It’s been my thing for years and years and years. I was doing that way before I became the night call nurse.

I have a set spiel that I go through.

I help them optimize the electronic health record for ease in charting. Since I was one of the original subject matter experts (SMEs) that helped with deciding what the corporation’s Epic was going to look like I know my way around the EHR.

I definitely help them discover ways of where the heck the patient is in the hospital.

I set up their flowsheets to help capture hysteroscopy fluids and deficits.

I set up their flowsheets to help them do the appropriate charting for a miscarriage.

I show them how to perform and chart a pregnancy test because we test everyone who still has a uterus, age 10-55.

I show them how to use transport and how to find out how many patients are ahead of the requested transport.

I show them how to create a case and schedule the case that I just helped them create.

I show them how to put in blocks for requests that have to be blessed by day shift.

I show them how to find the ER patients. There is only ONE place to see the ER list. Even that took me about three years to figure out where it was.

The point is that there are a lot of things that I brain-dump on all the new nurses.

I made a call preserver book with frequently asked questions to use as a reference key.

But the very last thing we do, and I mean the very last thing, is talk through an emergency, such as a code blue.

Codes terrify the OR.

A friend of mine who is on the call team at the secondary trauma center said “Yeah, the OR is terrible at codes.”

But codes happen.

Sobering as that is.

I review where the crash carts with defibrillators are (PACU, ENDO, outside of Room 2, in the Cysto hallway, and ACU). I review the Broslow cart for those cases where the patient is a ped. I review where the MH cart is and the MH hotline number. I go through the silver anesthesia emergency binder that is in all the ORs (after we find it). I review where the critical care cart is in the OR core.

Frank talk of codes freak people out. But I am of the mind that familiarity brings comfort.

The last two things I show nurses are 1) where to chart the code in real-time in the EHR and 2) where the code button is in each and every OR.

I talk about what is the expectation after the code button is pulled about mass of people who will descend on the OR. Anesthesiologist, security, house supervision, ER, ICU, pharmacy.

The point is, they are not alone for long in the event of a code.

They just need to know how to activate one.

Because codes do happen in the OR.

In fact, one of my recent bootcamp attendees just had a code during a call shift. They did excellent. The patient survived. We had a debrief the next time I was at the hospital and they said they knew just what to do BECAUSE codes are the last topic in the bootcamp.

I think I will keep codes as the last topic of the bootcamp.

Because knowing there is a code button is half the battle.