[iceyspots]

sounds like it's time for an inservice

[IowaKaren]

Unless we saw that last breath, we do not start CPR on our full codes. I just discussed this with my DON and NM during CPR recertification (we were all in the same class). We only have a few of them in the 100 plus residents (mixed with ICF, Alz, SNF) and one nurse is really trying to get them changed and realistically letting the families know the odds of survival, realities of injuries during a code. I don't know why the NM can't help with it but,... I don't know why the admitting coordinator (not a nurse) is asking for code status and have voiced this to the managers. It's not like on TV, bringing them back smiling, good as new. With the elderly, all I've seen with a REAL code is possibly, only possibly bringing them back to only be sent back to us to die.

[CapeCodMermaid]

Have you discussed this practice with yout medical director? If someone is a full code and is 'found without a pulse', CPR is usually initiated. I've never read anything on any consent form which says "If they see me take my last breath..."

[IowaKaren]

I guess during CPR class, no breath means no pulse. We don't check for pulses anymore when initiating CPR and someone has called 911 along with retrieving the AED. Anyway, if they're going south fast, we will do what it takes if full code or not (no code, no CPR) but will call family, then 911 if they want for no codes. If we walk into the room and they are dead (no pulse, no repir's), we don't do anything if they are a full code. That's what I was told by my superiors and will take a look at the P & P Monday night when I go back to work.

[michelle126]

This is a very real issue that I try to bring up at work. A lot of our residents have been getting younger and sicker (when they are admitted) In the past, we might have only had 1 or 2 full codes out of 50 pts. Now there are 10-15 or more!

I am very confident in our EMS response time...5 minutes max from time of call till they touch the pt. The PP that stated they are over 15 mintues....I'm guessing you have to be very rural? Even with a great EMS response time, it still matters what you do for those 5 minutes.

[celestial1]

This subject has been on my mind for some time now probably because I started helping out on the midnight shift. We have 60 residents. Most of the time at night it is one LPN and two CNAs. However our CNAs are not required to be CPR certified. We have in reality no crash cart and I could not tell you when the last time our facility ran a code drill. I mentioned that to my mom and she said that it is probably because if they ran the drill then they would see that due to be short staffed no one would know what they should be doing.