Families at the bedside during codes?

[CountrifiedRN]

Hi everyone! I am finishing up my ADN program and we just had to read our chapter on emergency medicine. I am especially interested in the ER, have always been, and I have an offer to work in the ER of a local hospital after graduation.

Most of the info we were responsible for self teaching out of the book because the instructor who was to teach the material became ill.

There was a small paragraph in my book advocating for family at the bedside during a code, as long as there was a nurse available to explain what was being done. The author felt that it helps the family to accept the situation, and facilitates the grieving process if the patient dies.

I was just wondering if this is done anywhere, and what your opinions are. And for those who do agree with it and/or have seen it done, how likely is it that there is a nurse available to explain procedures to the family member?

Thanks for your opinions!

[CountrifiedRN]

Hi everyone! I am finishing up my ADN program and we just had to read our chapter on emergency medicine. I am especially interested in the ER, have always been, and I have an offer to work in the ER of a local hospital after graduation.

Most of the info we were responsible for self teaching out of the book because the instructor who was to teach the material became ill.

There was a small paragraph in my book advocating for family at the bedside during a code, as long as there was a nurse available to explain what was being done. The author felt that it helps the family to accept the situation, and facilitates the grieving process if the patient dies.

I was just wondering if this is done anywhere, and what your opinions are. And for those who do agree with it and/or have seen it done, how likely is it that there is a nurse available to explain procedures to the family member?

Thanks for your opinions!

[Desert Rat]

From what I have seen, nurses and families handle the situation much better than anyone expects. Doctors are the ones who question families at the bedside. Families usually approach us after a code and express appreciation about how much we tried to do everything we could. It also makes it easier for the family to decide we have tried enough if they make the decision to stop treatment, or to observe that we are not stopping if that is their wish.

[Desert Rat]

From what I have seen, nurses and families handle the situation much better than anyone expects. Doctors are the ones who question families at the bedside. Families usually approach us after a code and express appreciation about how much we tried to do everything we could. It also makes it easier for the family to decide we have tried enough if they make the decision to stop treatment, or to observe that we are not stopping if that is their wish.

[altomga, ADN, BSN, MSN, DNP, RN, APRN]

We have had a family at the code 1 time that I can think of.....the patient was an unfortunate 20 something yo that had severe medical complications after childbirth...we wanted the mother of the pt to see that we were hurting her daughter more than helping her (the pt had absolutely no chance and had already been basically brain dead....brainstem function only)..yes she could still breath on her own and had a heartbeat before she coded, but no hope at any quality of life.

The mother was to distraught (quite understandably) and just kept telling the pt that the lord was going to make it better, not to leave her, and you know the rest...

I felt so bad for this mother...her last memories of her daughter are going to be....her daughter basically naked for the line insertion, shocking with the defib, staff pushing on her chest, vomit coming from her mouth/nose, blood, etc.....

I wish she had the memory of her precious daughter looking like she was sleeping peacefully with her eyes closed tucked into bed.

The other staff on other units that have had families at the bedside said they were more of a hinderance than anything else. Got in the way of compressions, intubation, pushing meds....

This decreases the chance of bringing the patient back...lack of oxygen, blood flow to the heart, and life saving techniques are delayed....

I for one am not for this idea for reasons stated and many more..

Codes can get nasty and dirty, docs and nurses yell "stuff" (ya know what I mean)...families should not have this memory of their loved one and should not be present just to get in the way.

Someone there to "explain" is not going to help...the family is only going to see and "HEAR" what they want and then it will be tangled in their head due to the emotional heartbreak....

opens up a new pandora's box for lawsuits.

[altomga, ADN, BSN, MSN, DNP, RN, APRN]

We have had a family at the code 1 time that I can think of.....the patient was an unfortunate 20 something yo that had severe medical complications after childbirth...we wanted the mother of the pt to see that we were hurting her daughter more than helping her (the pt had absolutely no chance and had already been basically brain dead....brainstem function only)..yes she could still breath on her own and had a heartbeat before she coded, but no hope at any quality of life.

The mother was to distraught (quite understandably) and just kept telling the pt that the lord was going to make it better, not to leave her, and you know the rest...

I felt so bad for this mother...her last memories of her daughter are going to be....her daughter basically naked for the line insertion, shocking with the defib, staff pushing on her chest, vomit coming from her mouth/nose, blood, etc.....

I wish she had the memory of her precious daughter looking like she was sleeping peacefully with her eyes closed tucked into bed.

The other staff on other units that have had families at the bedside said they were more of a hinderance than anything else. Got in the way of compressions, intubation, pushing meds....

This decreases the chance of bringing the patient back...lack of oxygen, blood flow to the heart, and life saving techniques are delayed....

I for one am not for this idea for reasons stated and many more..

Codes can get nasty and dirty, docs and nurses yell "stuff" (ya know what I mean)...families should not have this memory of their loved one and should not be present just to get in the way.

Someone there to "explain" is not going to help...the family is only going to see and "HEAR" what they want and then it will be tangled in their head due to the emotional heartbreak....

opens up a new pandora's box for lawsuits.

[gwenith, BSN, RN]

I know a facility where they will bring the parents into the room while resuscitating a SIDS and they will do this even if the baby is in rigor mortis. It is done so the parents can reassure themselves that everthing possible was done.

[gwenith, BSN, RN]

I know a facility where they will bring the parents into the room while resuscitating a SIDS and they will do this even if the baby is in rigor mortis. It is done so the parents can reassure themselves that everthing possible was done.

[angelbear]

Recently I was present for my sons intubation. The medical team knew that I was a nurse but I dont think that made a difference. They also knew that my hubby is not in the med prof. The entire time they were working on him we were allowed to stay. Yes the MD did holler and he even swore a time or two but that just convinced me that he was worried about my son and really working hard. The lead nurse was absolutely awsome even while pushing meds and assisting the MD she was explaining things in a very calm voice to my unconcious son and my hubby and me. We of course stayed out of the way and stayed calm save for a few tears. The MD even encouraged me to rub my sons feet while they were intubatiing him. I will always be eternally grateful to the entire team in how they handled my son and my hubby and me. I do think that if the family is hysterical and in the way they should not be allowed to stay after all the pt is still the first priority. I guess I can see both sides of this issue.

[angelbear]

Recently I was present for my sons intubation. The medical team knew that I was a nurse but I dont think that made a difference. They also knew that my hubby is not in the med prof. The entire time they were working on him we were allowed to stay. Yes the MD did holler and he even swore a time or two but that just convinced me that he was worried about my son and really working hard. The lead nurse was absolutely awsome even while pushing meds and assisting the MD she was explaining things in a very calm voice to my unconcious son and my hubby and me. We of course stayed out of the way and stayed calm save for a few tears. The MD even encouraged me to rub my sons feet while they were intubatiing him. I will always be eternally grateful to the entire team in how they handled my son and my hubby and me. I do think that if the family is hysterical and in the way they should not be allowed to stay after all the pt is still the first priority. I guess I can see both sides of this issue.

[ScarlettRN]

The new ACLS guidelines suggest that family be allowed to be present at the bedside during a code and also are much more vocal about knowing when to call the code and stop all that abuse we heap on that poor body. PALS also suggests allowing parents to be in the room but strongly suggests that a pastor or a nurse assigned to be liason is present to help them understand all that is going on. Hope this helps. I just finished a gruelling month of recert on both ACLS & PALS, so this is all fresh in my overloaded brain right now.

[ScarlettRN]

The new ACLS guidelines suggest that family be allowed to be present at the bedside during a code and also are much more vocal about knowing when to call the code and stop all that abuse we heap on that poor body. PALS also suggests allowing parents to be in the room but strongly suggests that a pastor or a nurse assigned to be liason is present to help them understand all that is going on. Hope this helps. I just finished a gruelling month of recert on both ACLS & PALS, so this is all fresh in my overloaded brain right now.