3 Code Blue Tips for New Nurses (how to survive your first code)

first code blue nurse nursing student

Can I make a confession?

As a brand new nurse (straight out of school) in a 34 bed Neuro ICU, I was about to pee my pants the first time I heard “Code Blue Neuro ICU” sounding over the intercom.

While these transient episodes of adrenalin rushes where one of the reasons I wanted to work in the ICU I was terrified to actually respond to the code.

  • Would I know what to do?
  • What if the other staff discovered that I was a new nurse?
  • What if I make a mistake?

These fears raced through my head as my preceptor and I arrived to the room, I was devastated to find that the patient who was coding was a young mother who had experienced severe complications during the birth of her baby and had spent the last month on our floor unresponsive.

By the time we arrived the room was already swelling with medical staff (nurses, physicians, respiratory therapists, and residents) and family.  My preceptor nudged me into the room and forcefully advised the other staff that I was going to jump in on compressions.

3 Code Blue Tips for New Nurses

Fast forward a couple years and I am now on the Code Team and Rapid Response Team responding to all codes and RRTs within my large Level I Trauma hospital.

After responding to countless codes in almost every department of the hospital I want to share with you a few tips that will allow you to learn and provide the best possible outcome for your patients.

If You Aren’t Doing Anything GET OUT!

I know, I know, this sounds harsh, but codes are no place for gawkers.  There will be 5-15 people in the room already each with a task and each working in unison to save the patient . . . even one extra body can greatly reduce the chances of a positive outcome.

If you are unsure what to do and do not have a task . . . step aside and take in all that you can or check on the other patients on the floor while the other nurses are busy in the code.

Do Something

Yes, this might sound like it contradicts my first tip but let me expound.  The best way to learn is by doing.  Getting in on the code and being a part of the team is the fastest and best way to learn.

Everyone can do compressions.  Start with compressions.

You may need to walk right up to whoever is currently doing compressions and tap them out in order to do them and that is exactly what you should do.  Hard and Fast!

As you confidence begins to grow you can start pushing drugs, recording, or manning the cart or defibrillator.  But only do those things as you feel competent and comfortable.


Communication is essential in everything we do in medicine and even more so during a code.  Codes can be CRAZY (to say the least) and with so many people running around and doing things it is important that you communicate everything that you do.

ACLS is based on algorithms and whoever is running the code needs to know what has been done.  This is no time to be timid or shy.  When you do something SHOUT it out and make eye contact with the leader if possible.


While this is not a complete discussion on codes or ACLS practices I wanted to provide you with a simple set of practices that you can incorporate to be less intimidated and learn when you respond to the next code or your first code blue.

Overall, I simply want you to have confidence and trust what you know

What other tips do you have for codes? Share your thoughts below.

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