Some adrenaline junkies may like the rush, but most nurses dread the coding patient. Patients die when they code, or they get sick enough to need a transfer to higher levels of care. Codes mean that patients are dying, and this can be frightening for the nurse. Of course, nurses are professionals. You go into that room, follow the ACLS protocols, and do your job. Regardless of the outcome, you do your job.

But how do codes affect nurses? How do you recover from something so stressful, so emotional, and so potentially devastating? It isn’t easy, and some nurses never fully recover, leading to compassion fatigue if the emotions are not dealt with properly. For this reason, it is important to follow these 7 strategies to recover after you experience a code.

1. Deal with the details.

When asked how they deal with codes, most nurses respond that they do the paperwork. It seems that patients don’t even die unless it is charted! Seriously, the amount of charting and responsibilities after a code are enormous. From cleaning the room to calling the family, a code can take a long time to recover from when approached from a purely pragmatic level. No matter how the code turned out, you will have to do something by way of documentation, and that can help to delay the real recovery that comes later.

2. Take some time for emotions.

Yes, you need to take time for emotions. Nurses don’t have time for lunch. Nurses don’t have time to urinate, and nurses don’t have time to go cry. It’s not okay, but you may need to delay your emotions while you continue to care for the rest of your assignment. You can’t shut down on your shift because you had a code, but at some point, you are going to need to face your emotions. Something traumatic just happened to you. If you don’t address those feelings of loss, anger, fear, or guilt, it will eat away at you. Allow yourself to cry. Allow yourself to scream. Get those emotions out, because they can be toxic when denied.

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3. Debrief.

After the paperwork is handled, the next step is to debrief. Your manager will probably want to know what happened, and you may find yourself talking to your fellow nurses about the code. Only a nurse knows what it is like to stand next to a person, a patient that is quickly losing their life. No one else can understand that feeling, and the best people to share that feeling with are other nurses. Don’t be afraid to talk about it. You don’t have to break down, but be sure that you go through what happened. You may need to look at what you did right or wrong, but the important part is to get your story heard by the people who are most likely to understand what you are going through.

4. Rely on beliefs.

For many nurses, their personal beliefs come into play when dealing with the aftermath of a code. When you feel like you have nowhere else to turn, you can turn to your faith for support. Some nurses feel that the outcome is out of their hands. Maybe you aren’t religious, though, and that’s just as valid a stance as any other. You can still examine this from a perspective of your beliefs. You can focus on the track that person’s life had taken, how their lives had affected the people they touched, and how special it is to be there for a person as they take their last breaths.

5. Listen to music.

Music has a way of touching emotions that other methods cannot. It can draw forth sorrow or pump you up. When you are dealing with the aftermath of a code, you can listen to music and let the words or melody take you away. Perhaps you need the softer, happier tones of Michael Bublé, or the hard crushing, angry strains of Nine Inch Nails. It helps to match your mood to your music. If you are feeling wistful that the person has died, you may try more inspirational music. Let it pull your emotions from you and aid you in expressing them, even if it is only to your steering wheel.

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6. Quietly reflect.

Reflection is important. Yes, it has something to do with releasing your emotions, but reflection is really about becoming quiet. Sometimes, you need to let your feelings swirl in your head, and you can’t do that with all of the noise of your workaday world. Meditation is probably the best form of quiet reflection, but it is only a formal way of reflection. You could just as easily have a cup of tea after work and think about what you experienced. If you suppress it, the emotion will come out in other ways, such as hatred for your job. Take the time to look at the situation in a calm manner, exploring it and confronting the parts of the code that are salient to you. You could even write in a journal to get to the root of how you are feeling. Codes can awaken a great deal of emotions in you, and quiet reflection is a great way of soothing those feelings.

7. Share.

Sharing is therapeutic, but you have to be careful about who you share with since HIPPA is a concern—and you don’t want to violate a patient’s privacy. However, the code happened to you, it is a traumatic event, and it is part of your narrative. Therefore, it is something that needs to be shared and discussed. Again, holding it in will only lead to compensatory feelings, such as anger, sorrow, or apathy. Who do you share with? You can share with your loved ones, but sometimes they don’t quite understand. The best way to share is to have a chat session with a nurse mentor or friend, someone you can trust. Sit down with them and review the code, and then review how it is making you feel. You may feel like you are making a big deal out of something common, but every code has the ability to knock you off your game. You are not weak or a “bad nurse” for needing to deal with the aftermath of a code. You are human, and that means you deserve the same compassion and understanding as you give to your patients.

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Lynda Lampert
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