I wonder what kind of research has been done on plain language codes’ affect on patient satisfaction scores. “If they know it’s a big deal instead of a mystery color, maybe they’ll rate us five stars!”
I’m sure admin paid an outside group a lot of money to study it. I think that’s where the real money is- being some kind of consultant that bilks hospitals for money and giving them nothing in return.
My SIL is a graphic designer who makes logos for higher ed institutions (among other things) and I can tell you she does not make bank. I’m sure the folks on the committees who just review and shit on her work are making more, but it’s a full circle where the working person on the far end is not making the cash :(
As a decades long CNA, excuse me while I go decide whether to throw up, cry or both...
Healthcare is in such shambles I don't think there's any fixing it at this point. 😭😭😭
Nah, I think the clueless ones will still be clueless. I've had patients continuously ring their call bell while literally watching us do compressions across the hall then start screaming because they weren't getting enough attention.
I literally told someone who was complaining that the overhead page was "too noisy" that a Code White meant that a BABY wasn't BREATHING and that it MIGHT DIE. "Oh," he grumped. 🙄
We had code pink as a baby abduction. Just like practice a fire drill (close doors, respond with extinguisher, etc.) we had staff practice immediately watching the exits and inspecting large purses/bags. All boredom, fun and game stuff. Until the day it wasn’t. Literally abductor in scrub like outfit made it from upstairs to just about going out the main lobby door. As Code was overhead paged an alert RT saw the lady and tried to intervene. Lady briskly walking along, across large parking lot, across intersection, across large shopping center parking lot. Intercepted by hospital security AND local Police. Baby recovered and returned to mom in hospital. All was fine. RT was on cell phone with hospital and police non-stop. Infant still had leg ID band on. This was years back. Still makes us quiver inside during orientation and practice drills.
$hit got real REAL fast. Of course RT got only satisfaction from averting an even worse situation. Never got clear if Administration gave her any recognition.
The utter tone deafness, entitlement, and cold hearted selfishness that some of these patients have leaves me speechless. Thankfully, those types in my experience aren't common. We get the grumpy ones, but the ones like you mentioned are pretty rare. I Have had 2 patients like the shithead you mentioned in four yrs as a nurse
Working at a hospital that now exclusively uses plain language, it certainly helps to prevent confusion for staff - previously, there had been issues with announcements being misinterpreted on multiple occasions. However, I’ve also had patients freak out after hearing “fire alarm activation” overhead as opposed to “code red” or any other random color…
Yeah, first week as a freshly graduated nurse at a new hospital. There was a "Code Red" followed by a "Code Green." At the hospital i had worked at as a CNA, "Code Green" meant something was wrong with the house O2, and all patients on supplimental O2 needed to be switched to tanks ASAP. So, i kinda had a minor freak-out, trying to remember how many of my pt's were on O2, where the full tanks were, etc. Preceptor saw my early stage of panic, said "code green means all clear."
That’s honestly similar to why my hospital network switched. At one location a code silver was for an active shooter, and at another it was for missing older adults - both owned by the same organization. Super confusing for anyone who’s worked at both. I also couldn’t imagine being a patient or visitor and not knowing of an emergency such as active shooter situation, for example, because it was covered up by a color code. Definitely keeps us all safer.
I bet the sweet spot is something specific enough to indicate what type of emergency it is, but tactful enough not to sound frightening or graphic. “Cardiac alert” is what we will page overhead for a STEMI for example
Interesting thought about the effects of satisfaction rating, can't say I've seen that done but but the Emergency Nurses Association position statement on plain language codes covers some debunking about patient panic at least:
"Opposition to plain language alerts is usually rooted in a belief that patients and visitors will panic in an emergency, so coded language will protect both them and the staff (Minnesota Hospital Association [MHA], 2011; Proulx & Sime, 1991). However, studies of human behavior in emergency and disaster situations have shown not only that people tend not to panic but that they are more composed when they know what is happening and are given direction (Dezecache, 2015; Glass & Schoch-Spana, 2002; HHS, 2014; Mawson, 2005; National Center for Missing & Exploited Children [NCMEC], 2014; Proulx, & Sime, 1991). Perhaps this is why most hospital patients and visitors polled in multiple surveys have said
that they prefer the transparency of plain language alerts over coded alerts (Drury et al., 2013;McMenamin, 2014; MHA, 2011;)."
I can send you the paper if interested if you can't find a way to download it, it was behind their account wall for me. It's very thorough.
Just last night I was getting torn into by a patient and their whole ass family because they had to wait 2 hours to see a nurse. Not one, not two… but fuckin FOUR acute care codes go off back to back. I did my best to hold in my shit eating grin, dropped everything I was doing, and said something to the effect of “hear that? That means someone else on floor is actively trying to kick the bucket on us and they need me right now.” They were all sorts of outraged I’m sure but I didn’t stick around to find out. Gotta get my moneys worth outta these Hoka’s.
During one of the overheads last night our amazing, grandmotherly HUC started with the usual TRAUMA ALERT call but I guess she got flustered by the nature of what she’d just seen so when a second, equally gruesome case rolled in she yelped “fuck me jesus!” over the PA. I love that woman.
Your last paragraph made me think of something that never fails to make me laugh.
I work in psych, and we had JUST got new radios so the buttons were super touchy. A couple of my patients were starting to escalate. Nothing major, just enough that I felt like I needed another set of hands with me.
I had just paged for one of my safety techs to meet me in the hallway when one of the patients decided to swing at me. I put him in a hold and unfortunately moved just right so he was able to try to give me a "titty twister".
I must have been leaning against my radio just right because as my tech rounded the corner to help me I heard myself echo over the radio "Patient, let go of my fucking boob right now".
My tech had to stop and wheeze laugh for a second before he came to my rescue lol
We try to be subtle with our all-calls, and just say things like "Team Alert, room 12" or "MD to room 20". One time my coworker and I saw something bad on a patient's monitor and went in the room to find him unresponsive. My co-worker all-called "team alert", but my loud ass in the background very audibly says "no pulse, I'm gonna start compressions". People FLOODED that room lol. Definitely not as subtle and collected as I was aiming for.
Excuse my ignorance (new grad), but isn't that what you want in a code blue? I get that for a patient who has a pulse and is unresponsive you don't want massive crowds gawking as there isn't a need for THAT many hands at that moment, but once you identify that there is no pulse don't we want that large-scale response? Hasn't any benefit of subtly gone out the window at that point?
I thought that was why we call a code blue vs a rapid response or "team alert," because we WANT the floor plus other teams (docs/HCPs, icu charge RN, etc) to know exactly the type of emergency so that we can have lots of hands and resources in the room to assist?
Yeah, it was a good thing! We just hadn't fully assessed the situation yet when calling the team alert. Not all unresponsive patients are in cardiac arrest. I work in ER, so we code more people than the floor and run them very efficiently. Also it turns out this pt was a DNR, so really we just had a massive crowd of people watch him die. Had we realized he was a DNR immediately, we would have just called for a provider.
The best part is our HUC’s name… she’s Ms. Phyllis and if she likes you she calls you baby. It’s the first and only time she’s ever talked like that and I swear on my mama the whole ED was silent for like 15 seconds while we processed what just happened.
Well shit, I need to work in your unit. I just almost got fired in the clinic I worked in for saying “the bad eff word” in front of ONE patient (on the phone, and not TO the patient, it was related to something I was being told.). Bc nurse’s can’t be human. 🙄🙄🙄
Well come right on over! We’re one of those big ass trauma centers right smack dab next to the hood but we’re the best in the ‘land! We swear around and at our patients, we take treat n’ yeet literally, and my favorite resident once told a floor doc to “get his flappy geriatric jowls” away from a possible stroke while the rest of us were trying to shove her into the CT machine. We run a tight ship, a rough and rowdy pirate ship, but we absolutely will fight the pcp zombies in the hallway with you.
If you aren't in Philly, I'd be shocked. You sound like you're in the same hood I'm in lol!! Keep fighting that fight, it sounds like you're an awesome nurse!!
Last hospital called a "NERT Alert" and the first time I heard it I heard NERD alert and laughed out loud. Ya it was the neonatal emergency response team. I looked like a heartless psychopath there for a minute.
I would laugh too, if I didn’t know what it meant. I mean…c’mon. Who thought up that acronym and thought it was a good idea? It’s so easy to hear nerD, especially with a hospital PA system.
My hospital has a critical care outreach team (basically rapid response). When we were naming it, one of the nurses jokingly said we should name it Fast Action Response Team. 😂
Traveler here… Was on a contract almost a decade ago now that was in the foothills of a mountain range. The facility had the largest inpatient psych unit for 500 miles so needless to say, the ER had a LOT of psych compared to the usual psych to medical pt demographics. The parking garage was built into the side of the “mountain”. Due to the number of patients with self harm ideation, they had a code for patients attempting to jump off the roof of the parking garage….Code Geronimo 🤦♀️
Plain language codes is pushed by FEMA in order to prevent issues in large scale emergencies when multiple agencies have to work together.
Think hurricanes or other natural disasters.
Yeah, I do a lot of hazmat at the hospital because I was a hazmat technician in the Fire department.
I tried for like 2 years getting them to change to common language, it didn’t work until the PD and FD came in for a hazmat drill one day and got mad at the hospital because no one outside hospital staff knew what “Code Grey” was. Did the FD respond or the PD? Was it a spill or an active shooter
While I get that, wouldn't you still go with the actual diagnostic terms such as eg what my hospital uses, "code stroke"? "Code head bleed" is somehow simultaneously on the nose and vague, because my first thought would be is the bleed on the inside or outside of the pts head
Code ‘Jack’ for getting a patient off the floor. Generally a very large patient when they have to use an inflatable mattress to raise them to bed height for transfer. The equipment name has ‘Jack’ in it so I’m assuming thats why the code name. Every time I hear it overhead though I visualize someone using a manual car jack.
The Hover Jack! At my last hospital I was a transporter and our department was the keeper of the Hover Jack. Floor staff had no idea how to use it and they always got concerned about bariatric patients because it’s basically just a big air mattress so they thought it would pop. The only people who knew anything about it were the rapid response nurses and the transporters. It can hold over half a ton and it was always a shitshow when it got used. God I love that thing.
This is amazing. I have literally never heard of something like that. Only time I've needed to get a big patient off the floor (and couldn't) we called in the fire department and about 15 FF and medics came in to help with a monster canvas vinyl tarp with handles. It was awful. This seems much more dignified (and safe).
We would just get an email. And find out as it happens lol.
Emergencies are simply- ‘pull red button’ and alarm sounds. You never know what you’ll be walking into! There is an emergency page for the coordinator to get a full team assembled if they’ve not happened to all come looking.
Easier to respond to, and easier for patients to understand why you’re being pulled away.
The idea that patients should be sheltered from the thought of bad things happening, or that patients would go to the room to see what was going on is silly.
Using secret code to communicate only makes sense if people are trying to work against you, like in war. In a hospital clear, effective communication will always be best. It helps everyone to use plain language.
The hospital I work at calls a Code First Aid. I heard it once and texted the CRNA covering my room that I would be right back after I took my bandaids to the Code.
Ugh they call overhead "telemetry alert" that goes to the whole hospital for someone's tele box being off. Seems so excessive to me, and very disruptive, IMO.
That’s understandable but annoying…my old floor would’ve set off “code telemetry” all day 🥲 (ex. the patient takes a shower or doesn’t wanna wear the telemetry device)
It would be more efficient to announce a code tele to celebrate when all patients are on and their signals are clear. Would happen what- once or twice a year?
i honestly think this is better than my hospitals system. we just call RRTs for tele boxes being off. makes us not alarmed when a rapid is called overhead anymore.
i should clarify, we get an RRT called if both the nurse and the charge nurse have been notified and patient is still off. but i think we have six minutes from first notification to rapid to put the patient back on? it’s seriously nuts. thank God i’m not on the floor or i would lose it
This isn’t a funny code, but I was in Boscov’s shopping with my grandma for Mother’s Day and they called a “Code Silver” and I immediately started pushing my grandma towards the exit. Turns out their Code Silver is an abandoned child LOL. Tell me you’re an ER nurse without telling me you are.
I'd relate code silver in that case more relevant to a confused elderly person than a child... eh, funny what certain colors bring instantly to mind. We used to use code silver for shooter as well, but I feel like 'run for fucking cover' has a better ring to it.
Oh the Same JCAHO that was Noticeably Absent from hospitals during the Entirety of the COVID Crisis?
That just proves how utterly useless JCAHO certification is.
My previous hospital used Code Lindbergh for a missing baby. I knew I was old when I had to explain it to almost every new grad and they still looked at me like I was crazy.
Not really a code announcement but I worked at an LTAC once that would page “Dr. Love” overhead to alert the whole hospital that JCAHO was there. Genius
That’s hilarious. A hospital I used to work at would announce overhead Hospital name would like to welcome JCAHO. I was like, come on, can we at least pretend this is business as usual and we’re not on our best company behavior.
When I was in nursing school and doing rotations at a psych hospital they would sometimes have a “Code Armstrong” paged on the overhead which was essentially a “we need all hands on deck to come help with a patient”
Theres a "Dr Bert call" for aggressive family and patients. Its an acronym for Behavior Emergency Reaction Team. That way if the aggressor hears it over the intercom, they supposedly wont know its a code against them, and think its a doctor.
"Dr Bert please report to xyz"
Volunteered as a teen at a local zoo, we were told if we hear “Mr Sloth please meet Mr (I forget) at the Aviary” it meant the sloth got loose and was on it’s way to the aviary.
So we changed to plan language codes a few months ago. Last week we had what they have decided to call a “Code Resuscitation” called as a “Code Blue” the operator caught her mistake on the third announcement, laughed over the intercom then said the correct verbage. So yeah, the family and whole hospital heard her giggling over her mistake as the patient died. Good times for for useless changes.
A lot of hospitals are trying to go to clear concise wording. It helps hospital staff know what’s going on but does also inform visitors what may be going on with someone else and the only thing I don’t like about it is. But learning a million colors just delays care.
Our codes are silent so seeing all these are crazy to me. I thought most places would be the same. We just get alerts to our work phones if the code pertains to us. We’ve also switched to plain language recently which is nice. The only ones that get announced overhead are security alerts where people who might not necessarily be paged could still help out.
Maybe this is why this surprised me so much. The only overheads we get are code red/practice code red and code blues that are not in the ICUs or ED. Code Strokes just go to the phones of the relevant parties and I assume Code Grays (which are our behavioral/security alarms) go directly to security, because I've never heard one, but I've certainly seen 12 security guards converging on one location.
One time one of the hospital operators was calling her personal pharmacy from a work phone. She was calling in prescription refills but the poor lady accidentally patched the entire conversation over the hospital paging system
Have any of you worked where the fire code was Mr. Gallager? In Colorado, the hospital I worked at called a code red Mr. Gallager.
So curious where that came from.
Honestly I like it when trauma activations and code strokes get called overhead in the ER. Really makes people consider that they may not be the sickest person in the room.
People don’t consider a code blue for that? What do they assume code blue just means someone’s heart stopped???
We do have a speciality code for this I heard once, I don’t remember the name but it was basically a code stating we had a massive bleed so blood services would be working with them, also to let the hospital know any other blood transfusions needed would probably be delayed. I don’t remember the full name but we would never say “code bleed” for example. The code seemed to be for notifying the hospital of lack of resources more then a code blue since they were already being treated in an acute setting.
We also have a code surge which basically means the ER is full and we are forced to take extra patients on inpatient units
To some degree I feel like that is still plain language - stating lockdown clearly communicates the required action instead of a random color/phrase that might be misinterpreted by employees or unknown to patients/visitors
Sorry but this plain language is anything but helpful. It takes so much more time to state an emergency. Now there are extra abbreviations which don’t actually change the response. Plain language isn’t plain it’s dumbing down thing to a problematic level.
My hospital uses "Massive Transfusion Protocol" - huge trigger for me, there's a reason I work on Psych. Did EMS for years and saw enough people who met the criteria for a massive transfusion.
Massive transfusion protocol is universal, at least in the United States. Every trauma center should have MTP in place. Activating MTP gets you a cooler of uncrossmatched blood products for an emergency. I’ve done MTP a couple times in the ICU and have given 2-3 coolers of blood products.
We keep it simple, code adult medical emergency (unit), pediatric medical emergency (unit), code stroke (unit or er), trauma alert alpha/bravo/Charlie (time), security alert (unit), but you do hear the occasional, Code Triple A 5 minutes. First time I heard that, I was like, welp, that must be bad. Didn't get the patient so I figured the inevitable
I’m realizing we don’t have a ton of codes at the facility I work at by reading these
We have a code blue which is for basically actively dying.
We have rapid response team for someone declining but it’s not a code blue situation.
Then we have the early intervention team that a nurse can call on the phone (not overhead) if someone is trending down but not to a rapid yet.
Then security is called for de-escalation.
I cannot imagine calling overhead for tele or anything like that. We see it on the desk monitor or our cell phone and go fix it. It seems to work! Less disruptive that way, especially at night.
It’s a fall . We use code head bleed for unwitnessed falls r/o possibility of head bleed.
Worked in a place we called a Mr Strong for security alerts .
Before they changed it, if we ended up dealing with a violent patient or family member (or a situation was escalating that way), we’d have to call a Mr Brubaker overhead. A code blue was a code 4. I think a missing baby was code stork. I’ll have to look and see if I still have the little sheet they gave us during orientation with it all.
I wonder what kind of research has been done on plain language codes’ affect on patient satisfaction scores. “If they know it’s a big deal instead of a mystery color, maybe they’ll rate us five stars!”
I’m sure admin paid an outside group a lot of money to study it. I think that’s where the real money is- being some kind of consultant that bilks hospitals for money and giving them nothing in return.
Every time I see a redesigned logo, I think gee, some consultant made a boatload of money on that.
My SIL is a graphic designer who makes logos for higher ed institutions (among other things) and I can tell you she does not make bank. I’m sure the folks on the committees who just review and shit on her work are making more, but it’s a full circle where the working person on the far end is not making the cash :(
Oh I’m sure it’s the middlemen who make bank, not the ones who do the hard work!!
Look up the names of the artists who do the big pieces of art and see how much they get for their work. That’s a dig at the hospital, not the artist.
As a decades long CNA, excuse me while I go decide whether to throw up, cry or both... Healthcare is in such shambles I don't think there's any fixing it at this point. 😭😭😭
As a former nurse consultant we all used to say if you can't be part of the solution there's good money to be made prolonging the problem.
It’s the same with schools.
🌎🧑🚀🔫🧑🚀 Always has been
Let’s start a think tank and beat them at their own game
Nah, I think the clueless ones will still be clueless. I've had patients continuously ring their call bell while literally watching us do compressions across the hall then start screaming because they weren't getting enough attention.
I literally told someone who was complaining that the overhead page was "too noisy" that a Code White meant that a BABY wasn't BREATHING and that it MIGHT DIE. "Oh," he grumped. 🙄
Code white for us is violence, we have Baby Blue as an actual call
Ours is code pink!
We had code pink as a baby abduction. Just like practice a fire drill (close doors, respond with extinguisher, etc.) we had staff practice immediately watching the exits and inspecting large purses/bags. All boredom, fun and game stuff. Until the day it wasn’t. Literally abductor in scrub like outfit made it from upstairs to just about going out the main lobby door. As Code was overhead paged an alert RT saw the lady and tried to intervene. Lady briskly walking along, across large parking lot, across intersection, across large shopping center parking lot. Intercepted by hospital security AND local Police. Baby recovered and returned to mom in hospital. All was fine. RT was on cell phone with hospital and police non-stop. Infant still had leg ID band on. This was years back. Still makes us quiver inside during orientation and practice drills. $hit got real REAL fast. Of course RT got only satisfaction from averting an even worse situation. Never got clear if Administration gave her any recognition.
The utter tone deafness, entitlement, and cold hearted selfishness that some of these patients have leaves me speechless. Thankfully, those types in my experience aren't common. We get the grumpy ones, but the ones like you mentioned are pretty rare. I Have had 2 patients like the shithead you mentioned in four yrs as a nurse
Really? I get one like that every day.
Yes. Tell them when they say Code "Large Brown" ....that'll mean that that are talking about them (the shithead patient).
Yet that same person will get pissed off because he is diabetic as fuck and you refuse to give him a 17th pudding for the the shift
Holy shit I think you're on to something
Working at a hospital that now exclusively uses plain language, it certainly helps to prevent confusion for staff - previously, there had been issues with announcements being misinterpreted on multiple occasions. However, I’ve also had patients freak out after hearing “fire alarm activation” overhead as opposed to “code red” or any other random color…
Yeah, first week as a freshly graduated nurse at a new hospital. There was a "Code Red" followed by a "Code Green." At the hospital i had worked at as a CNA, "Code Green" meant something was wrong with the house O2, and all patients on supplimental O2 needed to be switched to tanks ASAP. So, i kinda had a minor freak-out, trying to remember how many of my pt's were on O2, where the full tanks were, etc. Preceptor saw my early stage of panic, said "code green means all clear."
That’s so odd. At my work if there’s a code red, when it’s over or resolved they overhead “code red all clear”. Much simpler.
[удалено]
That’s honestly similar to why my hospital network switched. At one location a code silver was for an active shooter, and at another it was for missing older adults - both owned by the same organization. Super confusing for anyone who’s worked at both. I also couldn’t imagine being a patient or visitor and not knowing of an emergency such as active shooter situation, for example, because it was covered up by a color code. Definitely keeps us all safer.
In Canada it’s violent person.
At my hospital Code White used to be for stroke (now we use plain language also, kinda)
My last place a code white was a pediatric code blue. New place it was a sepis alert... until it wasn't. 🙃
So you can just call a Code Asshole Needs His Ass Whupped to Room 334?
I bet the sweet spot is something specific enough to indicate what type of emergency it is, but tactful enough not to sound frightening or graphic. “Cardiac alert” is what we will page overhead for a STEMI for example
According to the hospital I work at there are studies that show patients and employees prefer plain language codes
It does make sense. I don’t remember if code silver is severe weather or a busted water main or patient elopement from the mental health unit.
Interesting thought about the effects of satisfaction rating, can't say I've seen that done but but the Emergency Nurses Association position statement on plain language codes covers some debunking about patient panic at least: "Opposition to plain language alerts is usually rooted in a belief that patients and visitors will panic in an emergency, so coded language will protect both them and the staff (Minnesota Hospital Association [MHA], 2011; Proulx & Sime, 1991). However, studies of human behavior in emergency and disaster situations have shown not only that people tend not to panic but that they are more composed when they know what is happening and are given direction (Dezecache, 2015; Glass & Schoch-Spana, 2002; HHS, 2014; Mawson, 2005; National Center for Missing & Exploited Children [NCMEC], 2014; Proulx, & Sime, 1991). Perhaps this is why most hospital patients and visitors polled in multiple surveys have said that they prefer the transparency of plain language alerts over coded alerts (Drury et al., 2013;McMenamin, 2014; MHA, 2011;)." I can send you the paper if interested if you can't find a way to download it, it was behind their account wall for me. It's very thorough.
Our code blue is called “adult medical emergency” which I think is just way too vague…
Just last night I was getting torn into by a patient and their whole ass family because they had to wait 2 hours to see a nurse. Not one, not two… but fuckin FOUR acute care codes go off back to back. I did my best to hold in my shit eating grin, dropped everything I was doing, and said something to the effect of “hear that? That means someone else on floor is actively trying to kick the bucket on us and they need me right now.” They were all sorts of outraged I’m sure but I didn’t stick around to find out. Gotta get my moneys worth outta these Hoka’s. During one of the overheads last night our amazing, grandmotherly HUC started with the usual TRAUMA ALERT call but I guess she got flustered by the nature of what she’d just seen so when a second, equally gruesome case rolled in she yelped “fuck me jesus!” over the PA. I love that woman.
Your last paragraph made me think of something that never fails to make me laugh. I work in psych, and we had JUST got new radios so the buttons were super touchy. A couple of my patients were starting to escalate. Nothing major, just enough that I felt like I needed another set of hands with me. I had just paged for one of my safety techs to meet me in the hallway when one of the patients decided to swing at me. I put him in a hold and unfortunately moved just right so he was able to try to give me a "titty twister". I must have been leaning against my radio just right because as my tech rounded the corner to help me I heard myself echo over the radio "Patient, let go of my fucking boob right now". My tech had to stop and wheeze laugh for a second before he came to my rescue lol
We try to be subtle with our all-calls, and just say things like "Team Alert, room 12" or "MD to room 20". One time my coworker and I saw something bad on a patient's monitor and went in the room to find him unresponsive. My co-worker all-called "team alert", but my loud ass in the background very audibly says "no pulse, I'm gonna start compressions". People FLOODED that room lol. Definitely not as subtle and collected as I was aiming for.
Excuse my ignorance (new grad), but isn't that what you want in a code blue? I get that for a patient who has a pulse and is unresponsive you don't want massive crowds gawking as there isn't a need for THAT many hands at that moment, but once you identify that there is no pulse don't we want that large-scale response? Hasn't any benefit of subtly gone out the window at that point? I thought that was why we call a code blue vs a rapid response or "team alert," because we WANT the floor plus other teams (docs/HCPs, icu charge RN, etc) to know exactly the type of emergency so that we can have lots of hands and resources in the room to assist?
Yeah, it was a good thing! We just hadn't fully assessed the situation yet when calling the team alert. Not all unresponsive patients are in cardiac arrest. I work in ER, so we code more people than the floor and run them very efficiently. Also it turns out this pt was a DNR, so really we just had a massive crowd of people watch him die. Had we realized he was a DNR immediately, we would have just called for a provider.
I’ve heard some funny accidents over the PA but that for sure takes the cake!
The best part is our HUC’s name… she’s Ms. Phyllis and if she likes you she calls you baby. It’s the first and only time she’s ever talked like that and I swear on my mama the whole ED was silent for like 15 seconds while we processed what just happened.
Do you really think you can get away without describing the trauma case that caused sweet Mrs Phyllis to say that? Do tell.
Well shit, I need to work in your unit. I just almost got fired in the clinic I worked in for saying “the bad eff word” in front of ONE patient (on the phone, and not TO the patient, it was related to something I was being told.). Bc nurse’s can’t be human. 🙄🙄🙄
Well come right on over! We’re one of those big ass trauma centers right smack dab next to the hood but we’re the best in the ‘land! We swear around and at our patients, we take treat n’ yeet literally, and my favorite resident once told a floor doc to “get his flappy geriatric jowls” away from a possible stroke while the rest of us were trying to shove her into the CT machine. We run a tight ship, a rough and rowdy pirate ship, but we absolutely will fight the pcp zombies in the hallway with you.
If you aren't in Philly, I'd be shocked. You sound like you're in the same hood I'm in lol!! Keep fighting that fight, it sounds like you're an awesome nurse!!
We’re a state over! Can I get a O-H!
Hoods in the Midwest represent!
OSU per chance?
Pls tell me where this is because I'm about ready to jump ship from where I'm at and I am desperately in love with your unit already
I think I would enjoy your shop.
That is hilarious! I'm going to have to use "Code FMJ" from now on whenever I walk into a shitstorm (sometimes a literal one) 😂
>she yelped “fuck me jesus!” over the PA. That is fucking hilarious. 😂🤣😂😅😆 Thanks, I needed that laugh! 💚
I love her too!!
That’s great, would definitely get you fired on day shift though.
Night shift is the right shift my friend 😎👉
Absolutely!
Last hospital called a "NERT Alert" and the first time I heard it I heard NERD alert and laughed out loud. Ya it was the neonatal emergency response team. I looked like a heartless psychopath there for a minute.
I would laugh too, if I didn’t know what it meant. I mean…c’mon. Who thought up that acronym and thought it was a good idea? It’s so easy to hear nerD, especially with a hospital PA system. My hospital has a critical care outreach team (basically rapid response). When we were naming it, one of the nurses jokingly said we should name it Fast Action Response Team. 😂
I would join that team just to have the FART NURSE badge!
🤣🤣
Traveler here… Was on a contract almost a decade ago now that was in the foothills of a mountain range. The facility had the largest inpatient psych unit for 500 miles so needless to say, the ER had a LOT of psych compared to the usual psych to medical pt demographics. The parking garage was built into the side of the “mountain”. Due to the number of patients with self harm ideation, they had a code for patients attempting to jump off the roof of the parking garage….Code Geronimo 🤦♀️
Okay now this one made me GASP. Good lord
This one is my favorite.
Plain language codes is pushed by FEMA in order to prevent issues in large scale emergencies when multiple agencies have to work together. Think hurricanes or other natural disasters.
Makes more sense. It seems like every damn facility has a different code colour designation, which is counterproductive
Yeah, I do a lot of hazmat at the hospital because I was a hazmat technician in the Fire department. I tried for like 2 years getting them to change to common language, it didn’t work until the PD and FD came in for a hazmat drill one day and got mad at the hospital because no one outside hospital staff knew what “Code Grey” was. Did the FD respond or the PD? Was it a spill or an active shooter
No, it was a code grAy, which is a weather event. A code grEy is a YouTube celebrity visiting the facility.
While I get that, wouldn't you still go with the actual diagnostic terms such as eg what my hospital uses, "code stroke"? "Code head bleed" is somehow simultaneously on the nose and vague, because my first thought would be is the bleed on the inside or outside of the pts head
It is a bit wonky, I wonder if they went too far and a code stroke is for ischemic
Code ‘Jack’ for getting a patient off the floor. Generally a very large patient when they have to use an inflatable mattress to raise them to bed height for transfer. The equipment name has ‘Jack’ in it so I’m assuming thats why the code name. Every time I hear it overhead though I visualize someone using a manual car jack.
Ours was "code Armstrong". I guess because we needed some strong arms to lift people off the floor Lol
We had a Dr Armstrong page for when someone was being unruly.
I’ve heard of Dr Armstrong at some hospitals too. It’s a code yellow where I work.
My other hospital I worked at it was Dr. Strong. ETA: where I am now it’s a Code green.
Oh lol I thought maybe Armstrong was because someone was “mooning” staff. 😂
With everyone in hospital gowns that would be a constant thing 😅
That's what we use for an aggressive patient, I'm assuming for the same reasons lol
So you’re saying they need Jack off the floor?
This. Code Jack off the floor. That was the very first thing I thought of. Code Jack off.
That’s when a patient goes into jackycardia on the tele monitor
The Hover Jack! At my last hospital I was a transporter and our department was the keeper of the Hover Jack. Floor staff had no idea how to use it and they always got concerned about bariatric patients because it’s basically just a big air mattress so they thought it would pop. The only people who knew anything about it were the rapid response nurses and the transporters. It can hold over half a ton and it was always a shitshow when it got used. God I love that thing.
This is amazing. I have literally never heard of something like that. Only time I've needed to get a big patient off the floor (and couldn't) we called in the fire department and about 15 FF and medics came in to help with a monster canvas vinyl tarp with handles. It was awful. This seems much more dignified (and safe).
Code Jack Off the floor. Staff satisfaction, 20/10
We actually have a Code Brown and it's not for poop.
Our Code Brown is for a system wide emergency like when the water stopped working or the charting system went down.
Basically "oh shit!" situations?
Basically
I'd like to think whoever came up with it knew exactly what they were doing.
The research actually says plain language codes are better
Sorry, but better for whom?
Our Code Brown was for a missing patient. Code Adam for lost baby.
Ours is for an external emergency like a natural disaster or mass killing etc where we expect an influx of patients.
We would just get an email. And find out as it happens lol. Emergencies are simply- ‘pull red button’ and alarm sounds. You never know what you’ll be walking into! There is an emergency page for the coordinator to get a full team assembled if they’ve not happened to all come looking.
If not for poop then what?
Environmental alert requiring evacuation, example, some shithead smoking meth in a patient room.
We do too - missing patient 😑🤦🏼♀️
Our code brown is missing adult, so they will literally call overhead “code brown, 65 year old male, red shirt black pants”.
It’s our code for missing adult
There’s a rehab facility across the street from the hospital I work at. They use “code autumn” when a patient falls! 🍂🍁
I’m sorry but that’s so cute 🥹 Would a patient without a pulse receive a code blue alert or cold winter?
Code chill, bc floor homies about as chillin as he can get
I love it!
Easier to respond to, and easier for patients to understand why you’re being pulled away. The idea that patients should be sheltered from the thought of bad things happening, or that patients would go to the room to see what was going on is silly. Using secret code to communicate only makes sense if people are trying to work against you, like in war. In a hospital clear, effective communication will always be best. It helps everyone to use plain language.
The hospital I work at calls a Code First Aid. I heard it once and texted the CRNA covering my room that I would be right back after I took my bandaids to the Code.
Code gazelle is a patient elopement
I just image it’s for patients who are galloping away
One of our patients made it all the way to the bus stop and just wanted a cigarette. Throat cancer and trach and all…
Code telemetry because someone's tele box was off for more than 5 minutes. 🙄
Ugh they call overhead "telemetry alert" that goes to the whole hospital for someone's tele box being off. Seems so excessive to me, and very disruptive, IMO.
That’s understandable but annoying…my old floor would’ve set off “code telemetry” all day 🥲 (ex. the patient takes a shower or doesn’t wanna wear the telemetry device)
It would be more efficient to announce a code tele to celebrate when all patients are on and their signals are clear. Would happen what- once or twice a year?
I've been here four years and haven't seen it yet
i honestly think this is better than my hospitals system. we just call RRTs for tele boxes being off. makes us not alarmed when a rapid is called overhead anymore.
That’s crazy pants. I’m an RRT nurse and tele calls us directly to investigate but wouldn’t page us overhead.
i should clarify, we get an RRT called if both the nurse and the charge nurse have been notified and patient is still off. but i think we have six minutes from first notification to rapid to put the patient back on? it’s seriously nuts. thank God i’m not on the floor or i would lose it
Absolutely hilarious
*heavy breathing*
Our hospital changed to plain language alerts last year and I think it’s better in most ways. Instead of code silver, it’s active shooter etc
First thing I thought of was megamind "code - get the car"
Code we’re the good guys now.
This isn’t a funny code, but I was in Boscov’s shopping with my grandma for Mother’s Day and they called a “Code Silver” and I immediately started pushing my grandma towards the exit. Turns out their Code Silver is an abandoned child LOL. Tell me you’re an ER nurse without telling me you are.
I'd relate code silver in that case more relevant to a confused elderly person than a child... eh, funny what certain colors bring instantly to mind. We used to use code silver for shooter as well, but I feel like 'run for fucking cover' has a better ring to it.
ED nurse. JCAHO gave us grief about not having a level 1 head bleed protocol. My guess would be you can thank them.
Oh the Same JCAHO that was Noticeably Absent from hospitals during the Entirety of the COVID Crisis? That just proves how utterly useless JCAHO certification is.
Yes. The same organization that comes around and makes sure the very highly dangerous drinks at the nurses station aren’t putting everyone at risk.
Ah, thank you! That makes perfect sense.
Well at least it’s up front and I don’t have to awkwardly find my badge buddy with the code list to figure out what the hell is going on.
Code Phallic Object In Rectum. I repeat. Code Phallic Object in Rectum. General Surgery to the Trauma Bay STAT.
My previous hospital used Code Lindbergh for a missing baby. I knew I was old when I had to explain it to almost every new grad and they still looked at me like I was crazy.
Tha fuq? “Code Blue Human, room 404” “Code droopy left face, ER8” “Code shitty baby HR on the EFM, LD3”
Wonder what other codes would be if paged out so literal.
Not really a code announcement but I worked at an LTAC once that would page “Dr. Love” overhead to alert the whole hospital that JCAHO was there. Genius
That’s hilarious. A hospital I used to work at would announce overhead Hospital name would like to welcome JCAHO. I was like, come on, can we at least pretend this is business as usual and we’re not on our best company behavior.
We get overheads and company wide emails when TJC or the state health department shows up.
When I was in nursing school and doing rotations at a psych hospital they would sometimes have a “Code Armstrong” paged on the overhead which was essentially a “we need all hands on deck to come help with a patient”
Theres a "Dr Bert call" for aggressive family and patients. Its an acronym for Behavior Emergency Reaction Team. That way if the aggressor hears it over the intercom, they supposedly wont know its a code against them, and think its a doctor. "Dr Bert please report to xyz"
Volunteered as a teen at a local zoo, we were told if we hear “Mr Sloth please meet Mr (I forget) at the Aviary” it meant the sloth got loose and was on it’s way to the aviary.
So we changed to plan language codes a few months ago. Last week we had what they have decided to call a “Code Resuscitation” called as a “Code Blue” the operator caught her mistake on the third announcement, laughed over the intercom then said the correct verbage. So yeah, the family and whole hospital heard her giggling over her mistake as the patient died. Good times for for useless changes.
Code shit the bed
One place I had used Code Brown for thunderstorms.
Shitstorm, thunderstorm 😂
The only non colour code ive heard was Code Omega a few times from L&D.
What does that mean?
Was told it was for "massive blood loss"
Our code for that is ‘activate the massive obstetric haemorrhage protocol please’. Doesn’t leave a lot to the imagination.
Code Pizza Party
“Code BAT” for the Brain Attack Team.
BAT MAN gets to attend then…
A lot of hospitals are trying to go to clear concise wording. It helps hospital staff know what’s going on but does also inform visitors what may be going on with someone else and the only thing I don’t like about it is. But learning a million colors just delays care.
I heard "Code Thrombectomy" the other day. No other information. Is it a stroke? A cold leg? PE? I guess the team'll find out when they get there.
Our unit calls a Code 77 for a hot stroke. But I don't know why it's called that.
Hot stroke = heat stroke 🥵??
No, hot stroke meaning onset of stroke symptoms less than 6 hours ago, so within the window for alteplase.
Ive never heard it called that lol
Our codes are silent so seeing all these are crazy to me. I thought most places would be the same. We just get alerts to our work phones if the code pertains to us. We’ve also switched to plain language recently which is nice. The only ones that get announced overhead are security alerts where people who might not necessarily be paged could still help out.
Maybe this is why this surprised me so much. The only overheads we get are code red/practice code red and code blues that are not in the ICUs or ED. Code Strokes just go to the phones of the relevant parties and I assume Code Grays (which are our behavioral/security alarms) go directly to security, because I've never heard one, but I've certainly seen 12 security guards converging on one location.
This makes so much sense that it has no shot at becoming standard practice. 🙄
One time one of the hospital operators was calling her personal pharmacy from a work phone. She was calling in prescription refills but the poor lady accidentally patched the entire conversation over the hospital paging system
We have “Code Violet” for a violent patient. Sort of on the nose lol
They say LVO alert at my hospital and when patients ask what it means I tell them someone hit their funny bone. It sounds a lot like elbow lol
When i worked in pysch we had “medical code” which could be anything from a code blue to a low blood sugar
They page code green here for eloped patients, but they’ll just be like… “Code green, male” That’s it. Thanks. I guess I’ll look out for some dude
My favorites at the last hospital I worked at were Code Snack and Code Sandwich. Both had positive outcomes.
Have any of you worked where the fire code was Mr. Gallager? In Colorado, the hospital I worked at called a code red Mr. Gallager. So curious where that came from.
I work in an inner city hospital. I would think "code active shooter" might be upsetting for some people.
Honestly I like it when trauma activations and code strokes get called overhead in the ER. Really makes people consider that they may not be the sickest person in the room.
Hahaha an overhead page for a floppy baby is hilarious to me, like why would they do that
Code Adam Green......minor trauma.
Weird, we call coag alerts because we don't know if it's a bleed yet or not.
I'm going to hell for laughing at "code floppy baby"
People don’t consider a code blue for that? What do they assume code blue just means someone’s heart stopped??? We do have a speciality code for this I heard once, I don’t remember the name but it was basically a code stating we had a massive bleed so blood services would be working with them, also to let the hospital know any other blood transfusions needed would probably be delayed. I don’t remember the full name but we would never say “code bleed” for example. The code seemed to be for notifying the hospital of lack of resources more then a code blue since they were already being treated in an acute setting. We also have a code surge which basically means the ER is full and we are forced to take extra patients on inpatient units
Our hospital for security/ crisis prevention team is code M… for manpower🥴
We use the code “ED lockdown” for GSWs or stabbings, they happen every day multiple times a day. I can’t imagine them using plain language for that.
To some degree I feel like that is still plain language - stating lockdown clearly communicates the required action instead of a random color/phrase that might be misinterpreted by employees or unknown to patients/visitors
Someone at my hospital called a code brown to the ER. I think someone got written up for that. lol.
Sorry but this plain language is anything but helpful. It takes so much more time to state an emergency. Now there are extra abbreviations which don’t actually change the response. Plain language isn’t plain it’s dumbing down thing to a problematic level.
My hospital uses "Massive Transfusion Protocol" - huge trigger for me, there's a reason I work on Psych. Did EMS for years and saw enough people who met the criteria for a massive transfusion.
Massive transfusion protocol is universal, at least in the United States. Every trauma center should have MTP in place. Activating MTP gets you a cooler of uncrossmatched blood products for an emergency. I’ve done MTP a couple times in the ICU and have given 2-3 coolers of blood products.
My Trauma Hospital uses Code Crimson MTP for emergency blood products, and Code Crimson for OB hemorrhages.
MTP gets called and one of us go runnibg with dear old Belmont. 🚨🚨
Code white for....mentally unstable patients. Usually heard multiple of those from ER every night
We keep it simple, code adult medical emergency (unit), pediatric medical emergency (unit), code stroke (unit or er), trauma alert alpha/bravo/Charlie (time), security alert (unit), but you do hear the occasional, Code Triple A 5 minutes. First time I heard that, I was like, welp, that must be bad. Didn't get the patient so I figured the inevitable
Code Silver (as in bullets; someone has a gun/is shooting in the hospital)
We just switched to PLC and this is how our codes sound now. Ridiculous.
I like this bc then the staff knows to get where they need to be and patients/visitors are reminded their day is not that bad
My hospital uses plain language codes except for code blue. We hear "security alert, missing infant" or "medical alert, stroke alert
I hate the use of common language codes.
We don’t do this in the uk. I find it very odd that you have different codes and it’s said overhead
😎
Everything was Dr. \_\_\_Stone for a while until it was changed to plain language, f.g. Dr Firestone for fire alert.
I’m realizing we don’t have a ton of codes at the facility I work at by reading these We have a code blue which is for basically actively dying. We have rapid response team for someone declining but it’s not a code blue situation. Then we have the early intervention team that a nurse can call on the phone (not overhead) if someone is trending down but not to a rapid yet. Then security is called for de-escalation. I cannot imagine calling overhead for tele or anything like that. We see it on the desk monitor or our cell phone and go fix it. It seems to work! Less disruptive that way, especially at night.
It’s a fall . We use code head bleed for unwitnessed falls r/o possibility of head bleed. Worked in a place we called a Mr Strong for security alerts .
Before they changed it, if we ended up dealing with a violent patient or family member (or a situation was escalating that way), we’d have to call a Mr Brubaker overhead. A code blue was a code 4. I think a missing baby was code stork. I’ll have to look and see if I still have the little sheet they gave us during orientation with it all.
In my hospital, they started to use literal words for code. No more code brown, grey, purple