Family in room during a resusitation?

camay1221_RN · Jun 1, 2004

I understand your discomfort!!

And who is going to hold back the frantic family member who is trying to pull a staff member off the pt who is getting chest compressions? Good grief, just what the staff needs is to worry about someone interfering with their jobs of saving the pts life!

Wait, maybe the administration who comes up with these assinine ideas should be present to hold off the family!

suzanne4, RN · Jun 1, 2004

In an emergency room setting I don't like it, but in ICU or on the floor, no problem with it. They have done multiple pilot programs over the years and waht has worked the best is when the family has already met with the chaplain and social worker and are prepared for it. Many times families are unable to make other family members, who are terminal no "no codes"----that being said they ahve found that usually the family asks for things to be stopped very quickly.

Emergency rooms can be hard because no one has had time to deal with anything rationally.

Personally, I don't have a problem with family being there, and never have.

teeituptom, BSN, RN · Jun 1, 2004

I cant see why not have them in there

They get a chance to say goodbye

Often when they see you trying to hard, they ask you to cease

Brownms46 · Jun 1, 2004

I don't think it's appropriate, nor do I believe you can ever know if someone is really "prepared"! And many times there are too dang many families in the room for you to adequately take care of the pt. with you in the room, let alone a code team! Having family members faint, start screaming...no I don't think so!

Had a family PERFORM so badly we had to call security! NO THANK YOU!

LT Dave · Jun 1, 2004

I work at a teaching hospital, who do you think runs the codes at night? RN with 10 yrs ICU experience? Medical Resident who has been in the ICU 3 weeks?

What will the family think when they see a Resident who is scared and cluless?

Our Residents have it hard enough with out the stressor of "performing" for an audience. I don't want to put them in that situation.

Imagin being a new grad nurse in a code with the family...

Then what about the family interfering? Not a good idea. Is it more accepting to witness your loved one being shot dead in a robbery? What about watching them killed in a car accident? Who thinks of this stuff? Foolishness

Administraters who are not nurses or doctors. Wait till the first law suite due to families perception. It will end.

suzanne4, RN · Jun 1, 2004

Where I have seen this work, and quite successfully, was not in the ER, but usually on oncology floors or even some ICUs but only when the family had gone through an approved program put on by chaplain services. Some families are unable to sign for a DNR order, and they found that if a family member was there, things were stopped rather quickly by them.

They actually felt more comfortable with this...............

fourevern4alwayz · Jun 1, 2004

I have never been present during a code, but my husband (he works with Vent patients) has. He says the families of patients whose status were originally DNR change for everything to be done (last minute) when the families see that their family member is about to go. I realize that it is hard for the family to let their loved one go, but I think it is unfair for the patient. That's why I say that people other than the code team should not be allowed in the room.

Trauma Columnist · Jun 1, 2004

The ENA (Emergency Nurses Assoc) fully endorses family presence in the ER with the caveat that you have to have one person able to be there only for the family. I'm an 8 year ER veteran and always encourage family presence. I have never received any negative feedback from families, never had anyone throw themselves on the patient or interfere in any way. The scenario is almost always that I approach the docs/RNs involved in the resuscitation and ensure they are comfortable with it, then I approach the family sometimes with the chaplain. I always tell the family exactly what they'll see and that it will seem very chaotic and offer them the chance to be with their loved one. Our trauma bays are fairly small, so I try to limit it to two people at once. In fact, last week, we had a child who was hit by a car and helicoptered in - her parents arrived shortly after she arrived. From the beginning it was clear that she had injuries inconsistent with survival. The parents were allowed in and they held their daughters hand and stroked her head and told the doc to "let her be an angel". The entire trauma team was impressed that we had done everything possible for her. This has worked very well at our level one trauma center. The ENA has a fantastic presentation that favors family presence.

camay1221_RN · Jun 1, 2004

Suzanne,

I see your point in this instance, but I will stick to my original thought when it comes to the ER.

Where I have seen this work, and quite successfully, was not in the ER, but usually on oncology floors or even some ICUs but only when the family had gone through an approved program put on by chaplain services. Some families are unable to sign for a DNR order, and they found that if a family member was there, things were stopped rather quickly by them.
They actually felt more comfortable with this...............

mattsmom81 · Jun 1, 2004

I believe it is possible for this to be a good experience in specific circumstances, but at facilities where I have worked there is never an extra person to 'be there just for the family', nor has it been a predestined code where family has been prepared.

90% of codes I've attended where family has been present caused more trauma to them and more chaos for the staff.

So off the cuff I am against this except in prepared circumstances with all the right conditions. Without sounding callous, I don't care what any 'associations' or 'studies' say about this...there are too many variables involved to make a general statement that this is always a good thing.

zambezi, BSN, RN · Jun 1, 2004

I think that it depends on the code...some codes are really ugly...Blood everywhere/naked patiet/multiple transfusions/compressions etc...I would not want a family member watching that...I would not want that to be the last memory of their loved one...I feel that a "cleaner" code: intubation/compressions can be okay depending on the family...I have been in respitory arrest codes with families at the bedside and it went ok...I think that if family is going to be in the room, there needs to be someone there to stand with the family (RN/chaplin/social worker) to explain what is going on and to support them...I also think that only one or two should be able to be in the room (mostly for the space issue...). Family during codes can work, but i feel that it needs to be on a case by case basis...I won't usually invite a family back duing a code but if they ask I would let them observe if we have enough space and personnel to be with them--again situation dependent!