[scattycarrot]

Originally Posted by happyloser

I dont think family should be present during a code. It creates too many complications and makes the staff really nervous especially when the said family member(s) cannot be controlled. The other day we had a lady who coded while the family members were in the room and they started yelling and cursing at us and would get in the way of the code team. So I would have to say no.

Its not about us healthcareworkers though, is it? It shouldn't be about whats easier for us. It should be about whats right for the family members and as uncomfortable as that makes us during a code, they should be allowed to be there. Having said that, if your unit does not have a policy on this than that may be why problems emerge. There needs to as assigned nurse who talks to the family before they go into the resus room (and will stay with them through the whole CPR attempt)and is very blunt with them about what they will see. No time for beating about the bush here or being nice to save feelings. If they still want to go in then its no more than 2 people that stand away from the patient(unless its a child)and do not get invovled.
Obviously, this is said in as nice a manner as possible! If there is a problem, than they need to be asked to leave the room and by that, I don't mean the family member being emotional, I mean them shouting at staff members and/or getting in the way. The patient is the primary concern and while it is unpleasant to get security involved, if that is what you need to do than do it. This a coutesy being extended to the family not a right. But, in my exerience, not alot of family members want to come in after being told what to expect and if they do , they don't tend to stay for long. However, when a patient codes with family present, that is more of a tricky situation but again the patient is the primary concern and if the family members are being disruptive they should be asked to leave. I would say the vast majortiy of codes that I have been involved in that have family present have gone very smootly and were of great help to the family members. As some one else said, it allows them to see that everything that could have been done, was done.

[oljoern]

I've been in a few codes where family members where present. It has never been a blanket policy allowing family in codes in any place I've worked, but rather a case-by-case basis. The few that we've had family present went very well. The families were, needless to say, inconsolable. Some were quite vocal, but all were very grateful to us for what we had done and commented on the effort we put into trying to resuscitate their loved one. I remember the wife of an elderly gentleman who asked us to stop once she saw what her husband was going through and later told the social worker that she had had no idea what people went through during a resuscitation until then. I've heard of a few codes that went badly during family presence, one a pediatric code in which one of the parents kept throwing herself over the child and begging God and the team to save her child, but not staying out of the way so that they could. I'm glad I haven't had to deal with a situation like that.

I had my reservations about ever allowing a family to see what we did to trying to save their loved one, but I think it's mostly been a good experience for me and my co-workers. One must choose the family well, however.

Joe

[traumaRUs]

In a busy ER most nurses and staff are very comfortable in codes. In my 10 years in a level one truama center, I never had an issue with families being present. Our codes were calm, precise and very focused on the pt. We tried to allow the family to touch the patient if only for a moment and if only a foot or hand.

Never had any issues. The ENA fully supports family presence. Its not about us its about the pt and their family.

[ZippyGBR]

the answer is a case to case approach

assume that generally , if you have staff available, that family will be allowed in , who the member of staff is is immaterial, as long as they have enough knowledge to support the family - a higher levle Support worker is sufficient, as others have suggestedmaybe a social worker ... the 'Nurse' bits once the conclusion is reachedwill still be done by RNS, usualy by the 'lead' RN for the team

[littleRNthatcould]

In my facility as well it is a case by case basis. We do however experience more family members present during pediatric codes rather than adults. We have never had a problem with family members being present in the room (other than keeping our own emotions in check upon hearing the gut wrenching wails of the parents..a natural process IMO)

I will say there have been a few times (just a few that I can recall) where it has been my opinion that the family members should not be in the room. Examples: traumatic arrest where the patients body is so broken and disfigured that I can not see how any good or closure would be gained from the viewing experience. In these cases, I think it's better clean and arrange the body as quickly as possible prior to family viewing. Just my opinion..results may vary