Taking the Fear Out of Cardiac Codes with Susan Davis
Welcome back to Don't Eat Your Young, the podcast that delves into the inspiring stories and impactful work of individuals shaping the landscape of healthcare. In today's episode, get ready to be inspired by the incredible Susan B. Davis, better known as the Rescue RN! Susan is not just a healthcare professional; she's a force driving cardiac arrest awareness, CPR training, and AED preparedness in communities. But that's not all! Join us on this journey as we unravel Susan's story, from her innovative mock code training program, CodePRep, to her pivotal role as the Resuscitation Education Manager. Get ready for a friendly chat about making a difference in resuscitation preparedness and response, and how one person's dedication can set new standards in healthcare. This is a tale of heart, passion, and life-saving impact – don't miss it!
ABOUT SUSAN
Susan B. Davis stands at the forefront of cardiac arrest awareness, CPR training, and AED preparedness within communities. Known affectionately as the Rescue RN, Susan has dedicated her career to transforming public understanding and response to cardiac emergencies. In the hospital setting, Susan identified a critical gap in the preparedness of healthcare professionals to manage in-hospital cardiac arrests effectively. This insight led her to establish CodePRep, an innovative mock code training program designed to enhance the competency and readiness of hospital staff. Susan's impact extends into her role as the Resuscitation Education Manager for a prominent healthcare system in Southwest Florida. In this capacity, she oversees the development and implementation of all things related to resuscitation for healthcare professionals. Her leadership ensures that the system's staff are current with the latest cardiac care protocols and proficient in their application, ultimately enhancing patient survival rates and setting new standards in resuscitation education. Susan’s visionary approach and unwavering dedication have established her as a distinguished figure in resuscitation preparedness and response.
LINKS
Find the CodePRep Workshop here www.rescuern.com.
Book Rescue RN for speaking events here www.rescuern.com.
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Beth Quaas
Welcome to Don't Eat You're Young. I am your host, Beth Quaas. If you have ever felt nervous or scared about running a code coming to a code, wondering if you should call a code, this episode is for you to listen to. Susan Davis is the rescue. RN and she is. Teaching people how to prep for codes to recognize when they need to call it and what to do. The first steps. She really takes it down to the nitty gritty of how to respond. I'm so excited to have her here today, so please welcome Susan Davis. Welcome to the show, Susan. I'm so happy to have you today.
Susan Davis
Ohh, I'm thrilled to be here. Thank you so much for having me.
Beth Quaas
So tell us a little bit about your nursing career and how you've gotten to where we are today.
Susan Davis
Yeah, it's one of those journeys that you don't know you're on and all of a sudden, one day you wake up and your cardiac arrest education specialists. How did that happen? So I did start out in trauma. So emergency was my. Thing and I definitely work better in that type of environment. I loved trauma medicine from there, you know, responding from critical care, emergency room to the inpatient environment is where I first started seeing the difference in the mindset and the skill set of someone who works in critical care versus an inpatient environment. So from there I I I had a great interest in critical care and I ended up getting my medical license. While I was working trauma because I wanted to do flight, so I did a little bit of flight and not I didn't do that for very long because I didn't like being on call. I was a mom with three kids, and although my sons thought that was super cool, like high five, mom, you're out of here. My daughter, my mom were sure I was going to die. You know, every single time. I left and so that worry wasn't worth it, so I didn't do that for very long, about a year and a half. And then I did some cardiac stuff. I I I was indoctrinated into an ICU nurse, the CV ICU. So cardiovascular, holy smokes, you want to talk about some smart nurses?
Beth Quaas
Right.
Susan Davis
So I loved that was the probably the best education in in cardiac stuff for that advanced type of medicine that I had. And then I completely pivoted my career because again, I was, I was a single mom and I had three kids and they were they were not good children and they were very, very active in sports in life. And two of my sons were traumas during those days from their sporting issues or accidents. One was a motorcycle accident and the other one was, oh, I don't know, jumping. BMX or jumping off something high? I don't. So that led to me actually pivoting to. I became the director of a large corporate American Heart Association program. And during that time frame, the schedule far, far more suited, my life of being a mom with three kids. So it was wonderful. I worked for State College. I represented a local healthcare system, and I trained with my team. About 100 to 200 healthcare providers weekly in basic Advanced and pediatric life support. So over the over that time frame, which was close to a decade, you know we trained hundreds of 5060 thousand healthcare practitioners. And so here's where it starts coming together. I had my internal view of being a you know. An ICU nurse. And then I saw the others and and back then, by the way, you know, I only would arrive, I would think, gosh, this is just like kind of sort of a hot mess. What's going on here? But then and then I got the lens of watching all of these people come through our classroom and seeing their fear and their trepidation and how ill prepared they were. And even worse, how it. Made them feel. They were so uncomfortable in that educational setting, and that was it. See you again in two years and now go back to your unit and and that's supposed. We. That's it. So if if you go back in your organization or your immediate leadership doesn't prioritize some hands on practice that class where you were scared to death, embarrassed because you're nervous in front of your peers is the preparation you get for cardiac arrest.
Beth Quaas
Yeah, I have seen it. I've been a nurse a long time. I've taken a CLS and BLS many times. And every time you see somebody carrying an ACLS book, there's fear in their eyes that it don't want to go. They're worried. I'm like. It is a class that's going to be great and you're going to learn, but you're right, every two years. Are you kidding me? Especially for those that don't work in ICU's emergency room, where you're where you're having to use those skills if you're a bedside nurse. I totally understand that fear. And so. What you are doing is bringing a little bit more comfort, I think to people that are worried. Do you agree?
Susan Davis
Oh, for sure. And. And you know what I've I've discovered since I dove into this. Honestly. It's, you know, people who are critical care people. They have a skill set and a mindset that's very different than everybody else's. If you work in EMS, if you, you know, you have a skill set, a mindset that's very different. And so cardiac arrest is something that we're expecting to see and we're the kind of. People that run to it. But everybody else doesn't. Is not all warm and fuzzy about praise. It gives them a great deal of stress and so. If you if you break it down, what our education and training looks like, it's usually critical care driven as well. So you have your critical care team. Bringing in this education, even if it's American Heart, and so them being around them just being around them, much less being taught by them. We have a weird hierarchy, you know, fear right there. Just start without even we don't know what they're going to say. But surely they're going to judge us because we're not. You know, we don't do this all the time. We don't think that way. We are not running to it. We're afraid of it, and so there's so many layers of. Behavioral mindset behind being comfortable in a cardiac arrest situation. So for real, you have to not talk like you're a critical care person. You have to just talk meat and potatoes. So I break it all down to literally step one Step 2, Step 3, and it the relief. When they listen to what I how I teach this like critical care, people are not all that in a bag of chips. They they're scared too. They just channel it better because they're used to it. So there's so many ways to make this so much more approachable.
Beth Quaas
Ohh my gosh, I'm so glad you said. That I agree. There are different mindsets and that doesn't mean anyone is better. Smarter. You're right. It's how they channel it and what they're used to. So I so appreciate that you look at it from the lens of someone that isn't comfortable with it, that doesn't see it very often. And so. I remember taking a CLS for the first time and I was scared to death. I studied for weeks. I was only young 20 something and I had a drill Sergeant that taught that class and but I tell you what. I remember a lot. I learned a lot, but I was scared to. Taking it over and over, it's changed over the years, but tell me how you. Teach differently than a typical E CLS course.
Susan Davis
Well, here's the entire ACLS course if you're ready, this is what I say. OK, first of all, take a deep breath. You don't have to know the rhythms because the machine knows the rhythms so right it right there. People lose 20 lbs because nurses are scared to death of not knowing the rhythm. And I always say you're not going to know the rhythms. They don't look like they. Look in the book when it's a human, they just don't. So if you don't spend extra time and go take a special class and read more stuff we had what one chapter of cardiology and and and nursing adult, one O1 800 years ago. And that's supposed to be our baseline. So I teach. Don't worry about the rhythm. You the machine knows all you have to know how to push the button on the machine and it knows whether it's a shock whether or not so. First of all forget. That second of all, it goes like this. Are they sick or not sick? If they're sick. We're going to use electricity if they're not sick, we're going to pick a drug and then if it's too fast, we're going to slow it down. And if it's too slow, we're going to speed it up. I don't care what they're called. Deal. And they're like, deal like, OK, class is over. That's it. That's a CLS. Quit worrying about it.
Beth Quaas
That's fantastic. This stress, you're right, is. Probably most of the problem coming in to learn something is being so stressed out, so that's amazing that you can just break it down into something so simple, at least as a foundation.
Susan Davis
Yeah, I mean we we have to learn the drugs and we have to learn it and we have to know it and there will be foundational knowledge that we have to have. But but when it comes right down to. Right. We have two to six minutes to do compressions and electricity. If we are worried about that top drawer, which is what they're worried about the rhythms and they're worried about the drugs. But guess what we don't do when we're worried about that. We don't do recognize the problem, call for help, begin compressions and use electricity. That's it. The best science in the whole wide world. Supports only those two things.
Beth Quaas
Right.
Susan Davis
For survival, by the time we get to the top drawer, it's because we did not do those first things that were in the top drawer. So. I tried to tell him, you know, 2 to 6 minutes, master. Those first two to six minutes, which is the whole premise of code Prep. Of course. Level one. And then when our critical care teams are like, yeah, one, you're gonna get to our stuff. And I'm like, OK, show me you got this. And if you've got this at about a minute and a half, you'll be ready for your first drive. And then we can change your rhythms and we can make it as hard. It for you is you would like, but I'll tell you what again and again and again. They can't until we do it a few times and then they do it. So I think it's. I think it's about less is more instantly. How can you remember something so important in a fear state in your mind and body?
Beth Quaas
Right, absolutely. And so when? People come in, you know, the group that you're having in, if you're the instructor and you are tailoring it to that specific group.
Susan Davis
For sure. And and you know the beauty. Where I where we were teaching these courses and this was for a large healthcare system. So it was every, I mean every specialty would come in. So I would have groups that would be respiratory therapy. You might have a pediatric cardiologist, you might have a PT and you might have a transporter. Well, that's not true because transporters not have advanced, but they would, they might be all be in a basic life support. Class together, right? So the beauty of interprofessional classes like this is. I I always say you we don't. Get to choose. How we're going to do basic life support. It's the same for everybody. It's the same. So I don't care if you're a pediatric cardiologist. I don't care if you're transporter. We still have to recognize the problem. Called health. Being a presentation electricity, it doesn't change. So once we get that playing, playing field and. And it's like you have to slow your roll and literally make that. A major point. Because every goes right past basic life support and now we're into these algorithms. And that stuff is just, I mean, it's not cool.
Beth Quaas
It's an important point. You have to start with BLS before you can move to Acls. And I I was in a code situation they called a code and it was right outside the hospital doors and knowing everything that I know. We weren't allowed to do anything other than BL. And we had to wait for an ambulance to come, even though we were right outside of the hospital. But those were the policies. That's very hard, but. That patient collapsed and BLS was what was going to save that person's life in that first few minutes. Like you said.
Susan Davis
Yeah. And the research I and I just got back from the citizen CPR foundation, they have this amazing resuscitation conference every two years out in San Diego. And I just got back. And the research the top researchers in the world presenting their science on why hands only CPR right now is the gig. I mean, you know, giving breaths that, that that went out of Vogue Pre pandemic that went. Out of vogue. Vogue, you know, we have 6 minutes. We're compressed. Electricity is how the how the body responds. In a cardiac a sudden cardiac arrest. So it's it's the top science as well as I mean people feel so frustrated. You know we want to get IV, O2 monitor and all this stuff, but really in the majority of the world we only have our hands and if we're lucky and E. And there's people think you're in the hospital, so all that goes away. But it's not true. We're just people. We're nurses are people. Transporters are people. Cardiac, pediatric cardiologists are people. And and we get scared too. And we although we have equipment right there. If we don't do hands on practice with it all the time, then it's still going to be a A ruffle. And it needs to be broken down to just the basics. And when we do that, everybody is part of a basic life support, rapid response team. Everyone just like at home, you know, you're waiting at home, you call 911 and you wait for the team to arrive. Well, the same thing happens in the. We call for help and we're waiting for the team to arrive, but in the hospital the the average time in the United States for rapid response teams to arrive is 44.34.5 minutes. The time in hospital for the to 1st Shock in the United States right is 9 minutes. That's the average times. It is shocking. It's shocking. We're supposed to be compressions in one minute and and and shocking within two.
Beth Quaas
Talking to me.
Susan Davis
So this is a huge problem. It's it's a huge problem and and those cardiac arrest advanced cardiac algorithms aren't cutting it. So we could keep focusing on it, making sure these nurses know these rhythms know these drugs. But that's not where the outcomes aren't coming from those drugs and those algorithms outcomes are coming. From managing confidently, those first few minutes.
Beth Quaas
Yeah, and. The first people to typically respond to a code situation are the CLS nurses. Because the physicians are who knows how far away and the CLS nurses are ready, and they're ready to go. And those are some of the smartest people I've. Seen in a code.
Susan Davis
You're not even kidding. But even pre if you think about it, you know I talk about the hospital. I. Like I I equated to a burger a hamburger. I always talk about my hamburger, so the top one being the ICU and the bottom bun being the CR. ER pardon me, but the middle of the hospital being the BLS burger. So usually I mean the entire rest of the hospital is basic life support. I mean, there's some step down units and so forth, but usually there might be just one person on that unit that has a. E-mail us and everybody else's baseline support. So even before our critical care nurses get there. Who's there? I and they say I say so. You know, people have hospital systems, have code roles. And I say that my my program comes free code rules like what happens until those code rules start. Those are those first two to six minutes. So we can't. Talk about starting. It starts when it is a second. The person found the clock started so that you there are people who are there. They are rescued 1-2 and three regardless of job description, they're there. Rescue 1-2 and three and that's that's the core of level one of code Prep.
Beth Quaas
And I'm sure you. All of those people, not just nurses like you said, the transporters. Anyone that's had BLS, don't be afraid to start. Just go. Go start. Don't wait.
Susan Davis
And I I joke all the time. I was like, OK, and it's always a trick question. I say, OK, so how do we call for help in the hospital? And they all pause their eyes get big. And I know they're trying to find the right answer. Right. I think it's 444. Ohh. We pushed the button I. Was like, OK? Nope. You holler. I need help in here. And you don't leave the patient cause you're up. You are. Instantly life support you are life. Support your compressions and. Not just regular compressions people think about I gotta save this person. Their hearts not working. These are. Save the brains. Compressions like your compressions have to be good enough to get goody in and garbage out of the brain. And so they can't be too fast. But we're not getting goody and garbage out and they can't be too soft. They have to be, you know. And I just got to ask this question yesterday. I was. I was presenting at a A gated community yesterday and they said, well, how do we know? How? How we're, you know, how we're if we're going deep enough and fast enough. I was like, yeah, it's such a good question. You're not going to know. This is where you're a human and you have to use your instincts. You have to be thinking Turkey baster and keep that person alive. So if you don't get, you know, gravy and gravy out, you're not going to get any gravy. You have to be thinking Turkey baster. It could be a 300 LB person or a 90 LB. You know, the science says 2 to 2.4 inches and 100 to 120. The science. Come on. We're not going to be talking about numbers when someone's dying. So you just have to use. And I think that's the other thing is I think we're actually those algorithms teach us to maybe not use our instincts, our instincts. You watch nurses in a code. Your instincts are to go to it and start.
Beth Quaas
Right.
Susan Davis
It and then they actually. Should we that it drives me crazy that I should? I should not. I'm not sure what I should do. Well, we all know what to do. The fact that we're doing that should I? Shouldn't I? There's a problem. There's a. That's another. That's a mindset problem and A and. And from our leadership, it's a lack of support that we know what exactly what we should do. We own this moment and we're going to do it and we're doing it basic life. Support. So get out of my way.
Beth Quaas
I love that you take. You're right. You don't have to remember all that stuff. You don't have to remember how many inches. Just do and you break it down and you make it so anyone can understand it. I love that gravy and gravy out Turkey baster. Things that even in my head. I'm like, oh, that makes sense. Move the sludge. Move the sludge.
Susan Davis
Yeah, because we're, we're, we, we we I think it's a huge disservice critical care people often are like Can you imagine they're like Susan can you get them to at least do compressions by the time we get there. And I'm thinking like you know you're part of the problem we're part of the problem we you can't think that that class where they were scared to death and the land far far away from where the magic hits the fan right in some classroom was simulated equipment. Teams that are not their team, so it's not their team, it's not their equipment, they've got the drill Sergeant looking at them like, wow, you are not getting this, are you? And even if you knew it walking in the room, you instantly don't know anything because of the fear factor. And now we go back to our unit and we're supposed to respond and be rock stars. There's a huge gap. It's a ridiculous gap. It's been there forever and I keep saying I have not recreated anything you guys. I'm just calling everybody out standards, equal commitment. I just, I just talked about that today. I mean, if you're saying this is a standard. Then you have to be committed to it. Otherwise our our outcomes would match our our outcomes will match our commitment and put it to you that way and that's how you set a standard.
Beth Quaas
See, you saw the gap. And you have created what? Tell us what you are. Getting out to people that helps them in these situations.
Susan Davis
I did just that. I I broke it down. Like, what do I want? Where? Where is the problem and and how can I fix it? Because this seems just silly. This just seems silly. So I created a program called. In fact the name code Prep I I was studying in my graduate work early in my Masters. I was studying in hospital cardiac arrest. Response and mock codes all over the country all over the world, and I put together this amazing mock code program like a critical pure people do. And then I was walking in the door. I thought, you know what? This is just junk. I'm just repeating all the research I just read from all over the world and it's still not working. We don't need a code program. We need a code preparation program. They need to know what to do. Until we get there. So I started over. I said I'm going to start to the actual just from scratch. And I do like we literally we go to the crash cart. Do you? They don't know that the wheels are locked. They don't know that it's plugged in. I can't tell you how often I've seen, you know, drywall coming down the hallway and the wheels. And here it comes. And of course, now they're they're nervous and they're good. If you don't have to do the pads and undo the pads. I did this. They don't know how to turn the defibrillator on. They're afraid to touch it. They 90, some percent of them have never taken the backboard. Well, OK. So let's just talk about that and everyone wants to talk about the cardiac rhythms and the drugs that go. I'm thinking we're we're bit off track here like they need to be able to handle their equipment comfortably and confidently again and again and again and again if you add up the the wheels and the and the plug and not plugged in and get, can't get the backboard off their neck. Let's face it, they don't even get the backboard. So our compression, our compression quality is. In the in the trash. Without that backboard, if they're on the bed in the hospital. So, so code prep. Really. Truly. I I have 5 modules. They do they it's mindset. What are we talking about here? And then I do visual acuity. Which I trained. This is my early warning system I I created I I threw this in at the end because I would be remiss if I didn't do something upstream on on how how can I support nurses to catch the problem because the best cardiac arrest is the one we prevent something that's not more charting at, you know, early warning systems are great, but they're only as good as they're used. And that in timely information put into them and we know what nurses are doing. So mindset. The second one is visual acuity. I teach a green, yellow, red. I stole this from my emergency, my pre hospital knowledge of AM CIA mask casualty incident. Where the green are walking wounded, you know yellow. Have the one issue red. Have two. It's just a real intuitive. Like you're good. Thumbs up, thumbs down, yellow. I'm not sure. Gives them permission to get help and I go into all about that. And then red is. Yeah, we got a problem. It's time to cool. Prep the space. Bring the cart. Where's the stool? Clear the room. You know, we're we're thinking proactively. So that's just 10 minute module visual acuity and then I go to the emergency equipment and it's literally like step one, Step 2, Step 3, how everything on the outside of the car is what you need to save a life, quit worrying about that top drawer and then rescue 1-2 and three, who is rescue 1-2 and three and what are their duties? Everybody is the first answer. And the second answer is, you know. One you find the person you're up, you begin compressions 2, first one up to get there. Their immediate job is to support number one on their compression. First thing, you become a CPR coach. You tell them to take a deep breath. Slow down. What can I do to this space to make those compressions more optimal? Lower the bread, lower the rail, get the pillow out. Position the patient, open the airway. Whatever you can do for compressions first. Second is then room prep. Knowing that the world's on the way. And then the third is the cart. Grabber cart grabber. Everyone grabs the cart, they bring it in and then rest your 1-2 and three they do all the steps, they get the. Backboard, they place. The pads they turn on the defibrillator and they push the button, but I I train everybody to push the analyze function. No harm, no foul. Step One, Step 2, step step one. Turn it on. Just. Like an AED. 2 push analyze, not charge. These new defibrillators are the charge is already in there already anyway, but you don't have to know. The rhythm machine does push the analyze button in less than 10 seconds. The machine knows shock or not shock. Guess what happens if it says shock? We clear, we shock, we go back. And you know what we do that we do it again and we do it 3 * 3 times in the time frame. Often I wouldn't say often. Occasionally before help arrives. It's silly. It's brief. Hands on repetitive practice of those first Core 2 to 6 minutes and we are shocking three times before help arrives in the.
Beth Quaas
That makes me feel better, and I've been doing this a long time and. To break it down into such basic steps, and I guess what I see is basic, I mean truly turn the machine on. That's a big deal. And when you're stressed, you can hardly see. So just to know where that on button is is a really big deal.
Susan Davis
It's a big deal, you know, I if you I I usually have one sitting here, but you know, on the defibrillator, I I teach, you know, in the red because they're dead. You got your eye. Anything that's red on a defibrillator is going to be something to do with shocking because it's it's bad. So if you've never noticed but like the plug where the defibrillator goes in, that is red, where the pads connect, that is red. The steps right on on the defibrillator has literally it says 123 and it's in red. So I just. I'm like you don't need to worry about the rest of this machine. Just one 2-3. And we are, you know, like doing compressions, ordering pizza. When they arrived like, we got this, we got this. And then critical carotenes when they arrived, you know we have we build into Coke Prep as well. We there's a, you know, a formal handoff. And then a formal debrief. We do a quick down and dirty debrief. You know, honestly, what was the good? What? What did you see? What's the good? Being ugly and then later, because patients either probably going to a higher level of care or perhaps didn't make it one way or another, but if you skip that debrief, you're really skipping not only an opportunity for quality improvement, but a touch base on your heart and your soul with your teammates. I mean, you know, it is not cool. Everyone's not. Made out of lead and wrapped in cast iron like emergency room people you know and and we don't want our nurses going home bringing that home to their family. You know, if they if they if they didn't do what they think they should have done. If if if the outcome was bad and and or good or or they were unsure in any way shape or form and we let them leave. Not our bad once again so.
Beth Quaas
This is, I can't imagine anyone not wanting to take this course, whether you are a nurse or in the hospital outside of the hospital because to make it. Sound as simple as it is, and I know it's scary anyway, whether it's simple or not, you can save lives and I know you are very interested in outcomes as well. For what you are doing.
Susan Davis
I am and you know the weird part about it is I've been so focused on, well, the focus of my doctorate was. It's a long title, but it was code prep interprofessional drills for nurse and in a professional self efficacy. I mean it goes on and. On I was really. Outcomes weren't even on my list because I was so upset with how how it feels to not know what to do or to be unsure whether you should do it. I was that just it's that's why Pope Prep was created and and then I was like, oh, yeah. OK. So the patient outcomes, that's cool too. And and and it is true, it's very cool. And you know, if we master those first two to six minutes and we do get goody and garbage out from our brain then we will be our and and we get them to post resuscitative care. As soon as possible, and we do. Us and then we support them after, but we're going to have cerebral scores that are, you know, ones and twos is which we're after us. We want someone to go home and have the holidays with their family. We want them to be having a New Year's 2024. What's going on this year? What are my plans for the future? You know, a good getting into the ICU is cool, but getting them. Home is much cooler so.
Beth Quaas
What you said, you know how we feel about something really resonates with me and I'm sure it does a lot of other people feeling like you don't know, feeling like you're stupid. I think we've we've all felt that we've all been there. But to be able to take a course where. It's OK to feel that we understand that you you are human. You would feel that. And here's what we're going to do to make it so that maybe you can feel less. Uncomfortable in these situations, that's a big that's a big thing to me.
Susan Davis
Well, and you know, I give, I always say this like I am the permission like I do. I do speak the standard of care. I I'm not asking anyone to do anything other. That's not the standard of care. So get out of your head and realize that you have permission to do this. We have a duty to respond this way and I give permission to, you know, my critical care. Things cause they truly don't know either half the time right, but they think they're critical care and so they they maintain this hierarchy, you know, bravado. And they're scared to death too. Yeah, there's usually only one or two. In each unit that are the ones that are the real, I call them crackheads. You know lovingly, of course, but you know, they're the ones who run because I love this and they've got this, but everyone else is like, yeah, great. I'll. I'll watch all your patients. I'm good. Like, go for it. But. To say that I've been, let's say, a nurse for 20 years. And admit that I'm scared to death the cardiac arrest. That is another weird. You know, gig that nurses carry like I'm supposed to know. But I don't. And I I I would. I don't want to make myself much less my colleagues because I have seniority here. I've been here so long. Surely I I've seen this 100 times. But they haven't, you know. It's it's high risk, low frequency. Some nurses. I I spoke to a nurse. She was a nurse for I don't know again 20. Some 30 years had one. Code did compressions on one patient and she said she was, like, wrecked for a week. She. Remembers just being just. Wrecked, so people don't realize a nurse might see a code once or none in their career, and yet we're supposed to be ready. So, so a lot of it's about supporting their feelings and and you, we have to acknowledge that they're not going to see it. So these drills, by the way. Or two to six minutes. So it's a, it's a no complaint zone, and it's about once a month. So they have to each do rest year 1-2 and three once. So it's a 2 minute drill for each. And if you're and if you're good and you're getting pants on and you're pushing the button and a minute and a half, well then it's going to go quicker. So it's it's just brief hands on repetitive practice and then and then back to work, no charting, no just sign off that you did it. And then and then you're done. So we have the teams course that's for everybody and that's the only. Part. But then I do my workshops and I do the coaching classes because someone has to make sure that they're doing the drills correctly and there always has to be a driver, you know, like every other initiative in the world, especially in the healthcare, it'll fizzle out without drivers. So we need Co prep coaches. So that's part of my rescue tour is the. I'm so excited about some of these invitations I'm getting right now to to come in and we'll put together their core coach team. And they also get the teams course, but then I teach them how to put together the equipment for the drills, how to run the drills and then depending on how long they have me stay. I really like to stay a day and a half. I want to go with my newly trained coaches into their environment and run some drills with their team members in the units because that's, that's where, that's where the magic happens. You know, empowering them. And and getting the feelings out of the way and and letting every I let the first thing, that everything in the class is equalizer OK, we're all scared. Don't lie. Don't lie. We're all scared. And this is horrible. But I promise you, this is gonna be fine. And you know, they they relax and they get into it. But the first part of the, like, say, is a day and 1/2. We do the course. The second-half is hands on with equipment and then the the third half or quarter or half the next day is is hands on in the unit doing the drills. And then I like to pop into different areas and it's not a surprise attack. That's the thing. We don't like the. I don't like you can do mock codes after you've code prepped because now it's fair. They're not going to feel silly and put upon right and you don't move to the level 2 code prep, which is the ALS until you know they've got it. Now and then they'll actually be asking they'll ask for what's next. Now we we we know we feel comfortable in this. We know we can run the code until help arrives. We know we've given the patient and ourselves our best opportunity. OK, no challenges. Challenges change that rhythm. Let's see what the drug is and and then and then. It's fun and they're ready.
Beth Quaas
I'm in awe of what you're doing. This is. Incredible work. You are saving lives. Because you're helping people understand how to just get started, just start and that's what we need. And that is incredible. So next you're teaching nurses. Nursing students should have this information.
Susan Davis
My absolute favorite.
Beth Quaas
Yet take the fear out of them or some of the.
Susan Davis
I love working with nursing students. I I I hope that I get more invitations to work with more nursing students because they are also very hungry. They're scared to death, but they admit it. On day one. Yep, we're scared to death. Can you help us? I can do this class. You know, I've done this class. I can do it in 10 minutes. I can do my class in 10 minutes or three days. I you know, I can feel it. The science I can talk about. Failure to rescue. I can. You know what I can? Honestly, if I get 10 minutes, I'll take it. And we do it. And then I tell those nursing students I said no you right now are more prepared than any nurse in that hospital because they'll.
Speaker
Do it.
Susan Davis
If I say I give them permission. I'm the permission. This is the standard of care. These are the steps you're going to take. We practice that they can do it in 2 minutes or less, which, by the way, is really cool research thing, by the way, also speaking. Of nursing students graduate nursing students I love working with them as well because they always need a project. So Co Prep is a perfect. Med School project for your for your Masters or your doctorate and you just take my work as a template. Then and then apply it from your lending of your specialty so it could be you could be or you could be. It doesn't matter where you are, you would apply it to your area and then do the research so it works. I I have and it so it works with people in the clinical ladder, magnets, magnets, research and then. I have a. Really cool thing that Speaking of students again. That analyze function, that button that turns it into an AED, by the way, and then it then it talks people you know that. So let's just say it's not a shockable rhythm and you know it not shock, not advise what we do back on the chest we're doing press. But what amazing research to to because we can get the timestamp from when they push the analyze function. Right. So let's just say there wasn't shock advise, but every time they push that button and the time stamped, what amazing research we could capture. Interprofessional who's pushing that button and the time and we can change that nine minute thing in a in a heartbeat. This is 9 minutes is ridiculous. So, so love the students, whether they're Brandy, new Brandy, Brandy, Brandy, new or graduate, there's a place for code prep. And it just feels good. It feels good. You feel like you're if you're going to be spending all those hours in Graduate School doing a project, this is a feel good one. It's it's good.
Beth Quaas
Right. This excites me because I teach doctorate level anesthesia students. I'll need a. Subject And if you don't think I'm going to talk to them about this, that's incredible. And to have that information and you know, part of their doctoral education is teaching. They have to have a teaching component. And so to take this and educate whoever whoever they think needs it, what an incredible project. I am so happy that you said that.
Susan Davis
Well, thank you. And you know I I get, I get the benefit. Of their results. And so I love and I'm a DMP, you know, mentor I I do. And I precept as well. And I'm always like well, I've got a kind of a cool project up my sleeve. But you know, I'm the program is not perfect. I I implement it myself everywhere I go. But the beauty of having. Is their perspective. They can help me make it better because the more areas we do this. The better we all get because, for instance, OR or OB, you know all that specialty equipment and you know I've been an expert witness in the past and and and read some of the stuff and they they go on and on and on. But I go to those first 2-6 minutes. I'm like the game was over right here. The game was over right here. There's no need to deliberate on all this other stuff. They didn't do basic life support. So, and they say, well, it's very different in the OR because we don't have this and we don't have that and it's the anesthesiologist who calls the code. Well, people we say, well, how can we do? Code prep. Here's code. Prep works wherever a cardiac arrest occurs. We work with what you have. It could be in your living room with your cell phone in your hands. It could be in the OR with all that equipment, the patients draped, they're sterile, fueled. What do we do? Nurses. You should talk to our nurses. How scared to death they are. Because the anesthesiologist runs the code. And we're supposed to be doing what we're supposed to be doing. But there's such a hierarchy in there. So again, I love the opportunity to work with grad students on Co Prep because it really just makes it better.
Beth Quaas
And I will throw in the plug for nurse anesthetists running those codes as well, including the anesthesiologist. You're right, this can be pertinent.
Susan Davis
Absolutely anywhere. That's why I love it as a project because it doesn't matter where you are in healthcare, you can you can do Co prep if, let's say you're an admin you we would look at what's the ROI, what's you know where can it be fitted into my system, you know whether it be through a magnet, through P nap through, you know, clinical ladders, it could be quality improvement, it could be. Pure governance. And there's a there's a view cause, believe me, I wrote from every view because I studied code Prep was the with the focus of both my masters and my doctoral. So every single class in both my masters and doctorate was written through the lens. Of code prep. So it's there isn't a specialty, you could be an education specialist, could be leadership specialist. You could you could be you know clinical and and so again applies anywhere.
Beth Quaas
I again I just am so incredibly thankful for what you were doing and teaching and not just the hands on stuff, but just the to say it's OK that you don't know. It's OK to feel scared. We all are. And let's admit it and move on from there. I I love that so. What tips? Because this podcast is for nurses, what tips would you give nurses right now? Just the down and dirty to move forward and and move past that fear.
Susan Davis
You know, I suggest one tip that I have is, you know, we always say, and especially the course, the title of your show is very fitting. But they always say, you know, I always try to get especially new nurses or any nurses to have a, a wingman when it comes to that decision making process. And often, you know, nurses are jerks, and they make they don't, they don't support the question you just asked me. So I lately one of my cool tips has been pal up with a respiratory therapist. Because they are a set of eyes and ears that are really, really good at cardiac arrest, people don't realize that respiratory therapists they go to every single unit in every single area. So they see codes a lot. A lot of our nurses are on that same unit for many, many years, or they've been in two or three units so that their lens of cardiac arrest is just that. And when you have that yellow, that green, yellow, red moment as a nurse and you're unsure. And there might be a hierarchy in your unit. Slash your hospital slash in your rapid response teams. That doesn't make you warm and fuzzy and want to ask. Ask the respiratory therapist. You probably have a PRN something. Anyway, have them come in and assess with you, and then they'll reassess with you. And that can be a way to confirm your gut instinct to call the Met, call or to call the higher level of care confidently. So that's kind of a sneaky tip. I've been using teaching nurses lately is. You know, and I I don't want to talk badly about nurses. I don't mean it that way. But sometimes having a wingman that's out of your specialty is is a good idea. So that's one tip, the second tip. Truly, it's meat and potatoes. It's the meat and potatoes. You know, the the. The fear from cardiac rhythms get rid of it. The machine knows, and then step 123, literally. And in the beginning of our show, I went over the entire CLS class. You know, if it's too slow, we're going to speed up like like. Who cares what type of block it is? A Winky one or a Winky three? I mean, just the. Unless you're in cardiology and it's something like, very diagnostic, it doesn't matter. It just means it's too slow. And then the patients sick or? Not sick and we know what sick looks like. We know what sick vitals look like. So sick again. We're going to go straight to the electricity. So if it was too slow, that would be pacing. If it's too fast, you know we're going to slow it down. So I think it's. Have a chat with me because I'll make you feel better about it and then, you know, even if you're, I mean, I speak to intensivists and and and a lot of people and they are just that they're very intense with their knowledge and it it it sets up a hierarchy of less than and I'm I'm I'm I'm against less than in any manner. So cardiac arrest is the same for everybody, whether you're at home or whether you're at work like we've got this.
Beth Quaas
I love that. What incredible advice? And I hope that your code prep explodes in 2024 because there isn't one person that I can think that doesn't need it that doesn't need. To go back to the basics, even if you've been doing it a long time, if you do. One code your career like you said or you do it all the time because of where you work. Everybody needs to have confidence in what they do and know that we're all on an evil, even playing field. And I love that. I thank you so much for sharing what you do.
Susan Davis
Well, it's my pleasure. And you know, I I would like to add that it's important especially with. My visual acuity. I have these badges. I put them in my badge, but you know we trained the non clinical staff too. So I think there's nothing worse than a nurse feeling like she's alone with a super sick patient. You know, she's got six, she or he. You know, we have 6-7 patients and one of them's really sick. You know that that that already sets up your day to be just horrid because you're so worried about this one. But you still have the. Care of all these other patients. And so we really need. Eyes on the prize. Everybody should be green, yellow, Redding. And by the way, I use RPM's, respiration, perfusion and mental status and it's thumbs up or thumbs down. So I train this whether I I I train this with our community members because they don't know when to call and in the hospital it's the same, you know, housekeeping, transport PT. Co tea nutritional services. You know, there's a million people on that floor and they're looking at the patient more than the nurses. So it really does take a system to save a life. So we include, I do just that one module on visual acuity for everybody. Everybody gets the visual cutie so that we are all communicating. If your instinct, it's kind of like the internal rapid response call number that people. But but this is just more intuitive. We're not putting I I'm we have enough numbers. This is like the person's yellow. I think it's something's off. It's making you uncomfortable. And then this is what we're going to do. So it really does take a system. And I don't I hate when nurses feel. But they don't have a wingman. They should have support from everybody.
Beth Quaas
I love that you're right. Anybody going in that patients room could have the ability to help out.
Susan Davis
And and they should be able to do CPR, right? Because it doesn't matter, right? You target but doesn't care who you are or your job description. We gotta get on crazy inside the hospital. I mean, hands only CPR if you think about this. A system usually in a healthcare system, about half of the people that work for that system have some type of basic advanced or pediatric life support, but that leaves another 50% that have nothing. So how about make sure that they have at least hands only CPR and visual acuity. So when I go in to to hospitals and do evaluations, I always look at the number of non clinical and say hey listen I'd like to. Throw in. Please let me throw in just this training for everybody else. Hands only CPR, which you can do and you know a 92nd. Ongoing. And then and then the visual acuity training because we need them. And they want to feel part of what we're doing. They're scared, too, and we all go home. We're all people. We all go into the community. So these are the. Exact same things that was. The beauty of the pivot when I went to the community was I realized, Oh my gosh, you know, I've been focusing on the hospital so long, but we're all human, and we all go home. 70 to 80% of cardiac arrest happen at home. We need to know what to do and to help arrive, no matter where we are. So that's that's how the rescue are and started getting a little.
Beth Quaas
Crazy. You are doing great work. And I would say anybody listening. Check out Susans code prep and her rescue RN website. And then tell your family members about it too. Your friends, healthcare workers, non healthcare workers. Everybody needs to know what she's teaching. So I really appreciate what you're doing, Susan.
Susan Davis
Thank you so very much for for letting me carry on about it. It is. It's my favorite topic.
Beth Quaas
I am so glad you were here today. I hope this goes far and wide to those that are in the hospital or not in the hospital so that your work can save a life, save many lives.
Susan Davis
That's the goal. Thank you. Thank you.
Beth Quaas
Thank you for being here today.
Susan Davis
My pleasure. Bye bye.