From Code Blue to CODE YOU

A RAPID RESPONSE TO REVIVE YOUR TEAM'S WELLBEING

By Phyllis Mortin MSN, RN, SD and N. Tamara Ramirez MASF, BSN, RN, SD, Co-Executive Directors of CODE YOU

INTRODUCTION

Imagine you’re working on a bustling surgical unit. It’s late, and the team is already stretched thin due to weekend staffing cuts. Suddenly, the dreaded announcement pierces the air: “Code Blue.” Adrenaline surges as you rush to the scene, where chaos reigns. The patient appears to have been unresponsive for a significant amount of time. A resident frantically performs compressions, shouting contradictory orders; nurses scramble for equipment, and a medical student struggles with the Ambu bag. You step in, attempting to bring order to the uproar and calling anesthesia for IV assistance. This scenario, all too familiar, underscores the critical importance of Code Blue training, where every second counts, and every action can mean the difference between life and death.

Take a second. Reflect on your team. Is anyone on your team coding? How would you know?

IDENTIFY, ASSESS, RESPOND

What if the emergency isn’t a patient in cardiac or respiratory arrest? What if it’s a team member silently coding under the weight of trauma, compassion fatigue, moral injury, or burnout—a “Code You?” In this article, we invite healthcare leaders like you to consider being equally prepared to identify, assess, and respond to “Code You.”

What if the emergency isn’t a patient in cardiac or respiratory arrest? What if it’s a team member silently coding under the weight of trauma, compassion fatigue, moral injury, or burnout—a “Code You?”

IDENTIFY A CODE YOU

Consider the opening story. How effective was the Code Team? Consider your team. Would you know if someone was coding from compassion fatigue, burnout, or trauma? Reflecting on my (Tamara) experience as a hospice nurse, working 1700-0800, seven nights on and seven off while homeschooling my daughters, one struggling with self-harm and an eating disorder, I was overwhelmed and exhausted. One night, after a patient’s death, I did something I had never done before—I left a message for her daughter, notifying her of the death. I didn’t think twice about it until I was called into my supervisor’s office a few days later, where she told me a complaint had been made. I had no excuse; I knew it was terrible, and yet I felt numb. My heart still breaks for that family and the harm I caused. In retrospect, I can see that I was experiencing classic symptoms of what some might call compassion fatigue.

I was experiencing significant stress from working too many hours and trauma in my personal life, yet I told no one—not even my supervisor. I was Coding and needed someone to identify, assess and to respond to my “CODE YOU.” Meanwhile, experiences and interests, while intellectual connections offer a shared mission and values. Nurses experience transparent communication, respect for differences, and well-defined roles and goals in connected cultures. Team members support one another and listen actively.

Finally, an empowered workplace culture offers healthcare professionals the environment, tools, and support needed to become their best selves in the care of others. Research has shown that leadership is integral to creating a workplace culture where nurses feel empowered to be autonomous and exercise their agency.

Empowerment improves job satisfaction, affecting employees’ decisions to remain within their organizations and the profession. It also enhances safety and the quality of patient and family care.

In much the same way that before moving into action in a Code Blue, healthcare professionals know to check for a clear airway—you can’t pump life-giving air into someone with an obstructed airway. Assessment involves looking for the root cause of a CODE YOU symptom.

CONCLUSION

In conclusion, just as healthcare organizations prioritize Code Blue training, it is equally vital to be prepared to identify, assess, and respond to a “Code You.” By fostering brave, connected, and empowered cultures, healthcare leaders can ensure their teams are prepared to identify, assess, and respond to personal crises, ultimately enhancing the quality of patient care and the well-being of healthcare professionals.

Again, we encourage you to pause and reflect on your team. Is anyone showing symptoms of coding under the weight of compassion fatigue or burnout? Are you prepared to lead them through a “Code You” and create a supportive environment where they can thrive?

ABSTRACT

Code Blue training ensures nurses are prepared to identify, assess, and respond swiftly to save lives. This article extends this concept to “Code You,” a framework for recognizing and addressing compassion fatigue, burnout, and trauma among nurses. Through narrative examples and practical strategies, the article emphasizes the importance of creating brave, connected, and empowered workplace cultures. It outlines how leaders can identify signs of distress, assess underlying issues, and implement effective responses to support their teams. By fostering environments that prioritize psychological safety, emotional connection, and empowerment, healthcare organizations can enhance patient care and their staff’s well-being.

REFERENCES

American Association of Critical-Care Nurses. (n.d.). Nursing Excellence: Healthy Work Environments. Retrieved from https://www.aacn.org/nursing-excellence/ healthy-work-environments

Clark, T. R. (2020). The 4 Stages of Psychological Safety: Defining the path to Inclusion and Innovation. Oakland, CA: Berrett-Koehler Publishing.

Swensen, S. (2022). Assessing Unit Culture. My American Nurse. Retrieved from https://www.myamericannurse.com/assessing-unit-culture/