Notable Nursing - Cleveland Clinic

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Mock Code 10 Notable Nursing clevelandclinic.org/notable Residents, nurses and a respiratory therapist gather around a “patient” in the nursing education simulation lab. the multidisciplinary team is being briefed on the details of a mock code they are about to run. A resident and respiratory therapist take over during the mock code. Everything that happens during the mock code is recorded for a debriefing session later. A replicated “crash cart” is used to allow nurses to become familiar with its contents outside of an actual code setting. Residents, nurses and respiratory therapists gather for a debriefing in a classroom across from the simulation lab to talk about the mock code in which they just participated, review the recordings, and learn from what went well and what didn’t. the “patient,” also known as “Sim Man,” is a mannequin whose simulated blood pressure, breathing and pulse, among other lifelike characteristics, are controlled by a computer. A computer program is used during the code to change the patient’s vitals and give the participants scenarios on which to act. Here, nurses perform chest compressions and provide oxygen in an effort to “save” the patient. the mock codes are held once a month and open to any health professionals who may be involved in a code.
216.448.1039 Spring 2009 During an interdisciplinary mock code, nurses and residents who may or may not know each other must work together as a team — just as would happen in a real-life setting. Every person must know their own and each other’s roles and interact accordingly. tRANSLAtINg It to ReAL LIFe three new nurses bring hands-on learning experience to the bedside Fresh out of nursing school and four months into their new careers as nurses on the bone marrow transplant unit, Anna Zenczak (above left), Kelly Reiter (center), and Brittany Kelley (right) had all gone through simulation lab training for codes as part of their orientation process at Cleveland Clinic. They were as prepared as they possibly could be having learned and practiced on a high-tech mannequin. “I always have thought it would be helpful having gone through the actions in a mock code,” says Brittany. “The one thing I hadn’t experienced, though, was the emotion — the fear.” One night in the fall of 2008, Brittany stopped in to check on one of her patients whose temperature had been dropping. Her other vitals were stable. When Brittany returned about 20 minutes later with a PCNA, she found the patient was not breathing, had no pulse and was unresponsive. “I screamed,” she says. “I immediately called in a more experienced nurse and called the emergency response number (for a code team).” Doctors and other health professionals arrived for the code — the first any of the three new nurses had been part of. It ran smoothly and was organized. Brittany did the recording, Anna took over the floor and Kelly rounded up equipment. Although she said she felt overwhelmed being part of a real-life code for the first time, Anna says the training she got in the simulation lab did help. “Every time you have one it reinforces what you’ve learned,” she says. “Each experience you have builds up your confidence so you don’t have as much anxiety.” Although this situation is something you learn to prepare for as a possibilty on the bone marrow transplant unit, it was difficult for Anna, Brittany and Kelly. Patti Akins, RN, BSN, OCN, Nurse Manager for the unit, is proud of them. “It is intimidating to go through this as a new nurse. But they showed a great example of teamwork. I think they are developing into strong clinicians.” 11
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