In-hospital cardiac arrests can happen suddenly and without warning. As a floor nurse, your response can be the difference between life and death. While critical care and emergency teams lead advanced interventions, bedside nurses are often the first to recognize patient deterioration and initiate life-saving actions. Here’s how to stay ready.
1. Know the Warning Signs
Early recognition of a deteriorating patient is key. Look out for:
- Changes in vital signs (BP, heart rate, oxygen saturation)
- Altered mental status
- Chest pain or shortness of breath
- Decreased urine output or skin perfusion
Trust your clinical instincts—if something feels off, escalate immediately.
2. Keep ACLS Skills Fresh
While ACLS-certified, nurses may not practice code situations daily. Review key skills regularly:
- Chest compression quality (depth and rate)
- Use of the defibrillator and AED
- Knowing your hospital’s code blue algorithm
- Drug administration protocols
Consider joining mock code drills or running through algorithms with your team.
3. Know Your Role in a Code
When a code is called, chaos can erupt. Having defined roles streamlines response. As a floor nurse, you may:
- Begin CPR until the code team arrives
- Retrieve or apply the AED
- Provide vital patient history and recent vitals
- Assist with IV access or medication prep
Clear communication and situational awareness help the entire team respond effectively.
4. Stay Familiar With the Crash Cart
Do you know where the nearest crash cart is—and what’s inside? Take time to:
- Learn its layout
- Practice opening drawers quickly
- Know where to find emergency drugs and intubation tools
The more familiar you are with the cart, the faster you can help.
5. Debrief and Reflect
After a code, participate in the debrief. These sessions provide insight into what went well and where improvements are needed. They’re also essential for emotional processing and team learning.
Final Thoughts
Floor nurses are the eyes and ears of the hospital, often detecting problems before they become critical. Your preparation, training, and confidence can save lives. Stay sharp, stay calm, and know that your actions truly matter when seconds count.
