top takeaways from this conversation
- From monitoring mothers after delivery to helping newborn babies breathe, nurses in Labor & Delivery play a key role in resuscitative interventions.
- Compared to adults, there are important differences in neonatal resuscitation when it comes to scope, interventions performed, and when to start CPR.
- Newer nurses can remain calm in an emergency by focusing on what they can do now — and continuing to learn new skills outside of real events for the future.
Code Blue events bring a new meaning to the concept of “a team effort.” When a code is called, a patient’s life is — quite literally — in the hands of the clinicians who respond. And to make matters more complex, code teams are often composed of clinicians from a variety of backgrounds and disciplines who may not routinely work together — except to collaborate on infrequent, unplanned, and high-stakes emergency events.
That’s the inspiration behind our Resuscitation Perspectives series, where we interview different members of Code Blue teams to better understand their role and impact in resuscitation response. And while our interviewees preferred to remain anonymous for privacy, we know their insights will resonate and inform readers across all Code Blue roles — from nurses and physicians to patients and families.
Resuscitation role spotlight: Labor & Delivery Nurse
Recently, we spoke with a long-time nurse to learn how she draws on her years of experience to help stay calm amidst the chaos during Code Blue events. And while we left that conversation with a deeper understanding of the value that seasoned nurses bring to the table, it also made us eager to hear the perspective of newer nurses as well. What are the unique challenges new nurses face in responding to Code Blues? And without the benefit of years of experience behind them, how can they learn to stay calm and contribute during emergency response?
Fortunately, our most recent conversation with a new Labor & Delivery nurse delivered all that and more. Not only did she offer insight into how newer nurses can keep their cool in an emergency, but she also shared her thoughts on the unique role that Labor & Delivery nurses play in resuscitation for mothers and their newborn babies.
Keep reading for her take on the key differences between adult and infant resuscitation, how she thinks technology will shape resuscitation in the future, and what newer nurses can do to stay calm in an emergency.
What is your current role, and how are you involved with resuscitation/emergency response?
I’m a new Labor & Delivery (L&D) nurse, just off orientation, so I’m involved in maternal and baby codes. Before that, I was a Medical-Surgical and Intermediate Care nurse for 3 years and occasionally responded to localized Code Blue events on my unit.
How do the unique responsibilities of your role impact your perspective on emergency response?
I just got certified through the Neonatal Resuscitation Program® (NRP®). There are different levels of resuscitation for babies compared to adults, so NRP® has a greater scope than adult resuscitation and traditional pediatric Basic Life Support. We also use different resuscitation interventions for babies, like positive end-expiratory pressure and suctioning. I feel like I perform resuscitation every day now!
“Nurses are always doing some form of resuscitation intervention on babies, whether it is suctioning, warming, or something else to stimulate them to breathe and get the heart and lungs working.”
Impact on emergency response
What are two of the most important changes that you have driven, or been a part of, that improved resuscitation response?
When I was working as a medical-surgical nurse, we started using mechanical cardiopulmonary resuscitation (CPR), which was super helpful for compressions. Now in L&D, I’m learning the differences in practice for adult versus infant resuscitation. For instance, when you’re called to a Code Blue for an adult, you start CPR right away if they don’t have a pulse. But for babies, you focus on respiratory first and then chest compressions after. If a baby isn’t breathing, the first step is to think respiratory. That was a big practice change I had to wrap my head around.
Do you see your role as having an impact on improving patients’ survival?
Yes, especially in my current role in L&D. In Medical-Surgical/Intermediate Care, I was only involved in a few codes, but as nurses, we were the first line of code response: starting compressions, calling the code, using the defibrillator.
In L&D, nurses play such a large role. We are resuscitating the babies and the pediatrician may not even be there. The nurses are always doing some form of resuscitation intervention on babies, whether it is suctioning, warming, or something else to stimulate them to breathe and get the heart and lungs working. And with the mothers, we are assessing for hemorrhages and changes in their status as well; I would say that our resuscitation interventions there start with stopping a hemorrhage. My immediate actions have a huge impact on our patients’ outcomes.
Reflecting on the past — and looking to the future — of resuscitation response
What is some advice you would give your younger self that you didn’t know then, but know now?
Don’t panic. Even if you don’t know exactly what to do, someone is coming who does. Just do compressions — or whatever you feel confident with — and don’t focus on other things that you don’t know how to do well. Focus on what you know well, and learn other skills outside of a real event, so that you can eventually take on that role.
How do you see resuscitation response changing in the future?
With advances in technology, resuscitation response is only going to improve. Although I haven’t seen much with artificial intelligence yet where I work, I would love to see it help us with everything we need to document codes quickly. Even if you are experienced and know what to do, there is so much chaos, confusion, and scrambling during codes. As the documenter, you might not hear everything, or you might miss documenting something that happened. And if you don’t know what you’re doing when grabbing something from the crash cart, you might make a mistake by accident. Errors during codes are never on purpose; they happen so fast and are unexpected during an already busy and stressful day.
If you enjoyed this conversation, check out our interview with a long-time nurse and seasoned Code Blue responder for more insights on the crucial ways nurses impact resuscitation outcomes.