Code Pink: Florida Nurses Jump into Action

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Melissa Defalco, LPN, a nursery nurse at Northwest Medical Center, Margate, Fla., experienced one of her worst nightmares when the crib of one of the newborns in her care was empty. Her heart and brain raced as she told a coworker to call a code pink, setting off a hospital-wide alert for a possible infant abduction.

“Another nurse and I started going down the hall and counting each baby and making sure all the other babies were in place,” Defalco says. “We were searching for the baby and making sure the parents stayed calm.”

She and most of her colleagues working that day had no idea the infant abduction scenario was a drill.

One of the few who did know, Sharon Sabb-Oce, RNC, BSN, MBA, director of women and children’s services at Northwest, says the hospital’s code pink drill helped test the human systems in place, to ensure the security of newborn and pediatric patients.

The drill, which tricked staff into thinking the real event had occurred, was more effective than having staff go through the motions with eyes wide open, says Peg Lackner, RN, Northwest’s environmental care coordinator and emergency preparedness manager.

“This was one of the most effective drills we’ve ever had. Virtually no one in the organization knew it was a drill,” Lackner says.

Careful Planning

Sabb-Oce asked a postpartum mother to participate in the drill by discreetly taking her newborn to Sabb-Oce’s office. Sabb-Oce then gave the baby to an off-duty nurse who agreed to help with the drill. The nurse took care of the baby, while Sabb-Oce made herself available and visible and accessible to staff.

The real patient mom returned to her room, as the crib that had the baby in it stood empty in the middle of the hallway. The mother called the nursery and inquired about the whereabouts of her baby.

“I knew that would start the ball rolling,” Sabb-Oce says. “That started the code pink … and there were teary eyes in my department.”

Lackner had asked a colleague from another hospital in the system to act as the abductor. It had to be someone the staff would not recognize.

“I had flowers that I had gotten for him to take up to the patient. He was pretending to go visit this new mom. So, he waited in my office until Sharon called me and said the baby was secure in her office. I released Steve [the acting abductor] to go upstairs and go through the security doors, saying he was going to visit the mom. The mom knew about it, of course; he left the flowers with her and picked up a doll and put it in a shopping bag that he had under his arm. He went through the elevator. I asked him to go to the second floor, which is one floor below postpartum and hide out in an empty room for a while,” Lackner says.

The Margate Police Department knew about the drill and agreed to do what they would normally do in an abduction case.

The next step, after announcing a code pink, was to call a code yellow, which is a lockdown of all exits, Lackner says.

“Once this got called out, you wouldn’t believe the flurry of people running up to the floor and exits and elevators. I will tell you that even though I was involved in planning it, my heart was going … when I saw that empty bassinette, I almost came to tears, even though I knew,” Lackner says.

One of the hospital’s directors took over as incident commander, and eventually found the actor-abductor hiding on the second floor. The actor told the director that it was a drill and Lackner, using a two-way radio with the abductor, instructed him to keep going.

“I wanted to see how many more times he would get caught,” she says. “In the meantime, the police arrived and they surrounded the four points of the building, and the sergeant came up to the third floor and started interviewing the mom.”

The hospital’s chief financial officer caught the abductor as the actor tried to escape the building and stalled him for the police.

“My biggest concern with our people was covering all exit doorways. And they did,” Lackner says.

Drill Dos and Don’ts

While staff did not know about the drill, the newborn’s mother on the floor did. Lackner also made sure that when the call from the hospital came through 911 the dispatcher knew it was a drill. Otherwise, she says, newspaper and other reporters watching police scanners might get wind of the abduction, causing a potential public relations nightmare for the hospital.

Those planning the drill decided early on that it would be a test of human reaction and not technology, according to Lackner. That’s why the baby was hidden on the floor and not taken on an elevator, because all newborns on the floor wear umbilical cord sensors, and taking the baby on an elevator would have caused a shut down of elevator service.

“We know that system works. We wanted to test the people in the building,” Lackner says.

Bottom Line: React

“Use your gut. If anything seems out of place, it probably is, and if it isn’t [and you react anyway], it’s OK,” Lackner says.

Defalco says she took note during the drill that none of the sensors had gone off, but decided to react as if someone could have circumvented the system.

“Rather than ever think it’s a drill, just treat what’s going on immediately and get the problem solved,” Defalco says.

Lackner says she’ll use this type of approach to test other hospital systems, such as evacuation, in the future.


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