[mitchsmom]

Yes, I would probably want to be there.
I definitely think it should be a choice.

[gr8rnpjt]

It's not anymore 'wrong' for me to hold to the status quo than it is for somebody to advocate changing that status quo.

Timothy, your views are intelligent and insightful.
This is not a situation that should be witnessed by family members.
What about the patients rights?
What if a family member who is visiting is not someone the patient wants to see them in this situation. Supposing he has a good outcome after the code.
He could get better, find out that his ex wife or his crazy cousin whom he hates saw him in this situation and the patient could turn around and sue, because his privacy rights were violated.
Just MHO, but there are a precious few people whom I would want to see me in this type of situation, and I would feel very violated. Just because the people are there at the time of the code, it does not give the staff a right to let my personal rights be violated in this situation.

[BabyRN2Be]

Originally Posted by DusktilDawn

I would be curious to see some posts where family members have been present and disruptive during a code. This is a situation I can easily see happening, although I believe it would be the exception.

I'm just curious if anyone has seen this happen, family members becoming disruptive during a code.

Anyone had this happen?

Also, gr8rn has some good thoughts. It would probably be wise to find out who should be present at a code. I wouldn't want my privacy rights violated because my MIL, for example, decided she wanted to watch me code. BTW, she lives for drama and I wouldn't want her entertainment to be at my expense.

[ZASHAGALKA]

If those that support families in codes move this issue along, it WILL remove choice in the matter from family members.

Once upon a time, family members weren't allowed in the L&D room. Now they are. And now, years later, do you think I had a choice to be there or not? I might have been able to tell the nurses no, but I certainly couldn't have told my then wife!!!!!!!!!!!!!!! (And if I had told the nurses NO, you can bet more than one of them would have commented about how unsupportive I was being) Nurses made this the standard, whether the people actually being escorted in wanted it or not.

When you set a standard, you remove choice from the equation (for all but the extremely initiated). Especially at a time when most people are paralyzed to choose. They will just numbly nod their heads and be led along.

But in the end, NOBODY is in the L&D room if the woman doesn't want them. It's now a right, but it's HER right.

And, unless specifically granted bythe patient in advance, HIS/HER right to privacy should rein paramount. I would argue that any less is not only a HIPPA violation, it's a violations of trust. It's an abrogation of our duty to protect.

We have mechanisms in place for closure without intruding into very personal areas - intruding without the permission of those whos 'rights' we are treading upon.

And like was mentioned earlier - codes are very stressful for nurses. That's why many hospitals have a time set aside to review those codes. Unless you are in a level 1 trauma center where codes are, yawn, routine, a code is the most stressful part of a nurse's job. And now we are expected to perform for an audience? Not cool.

I just don't understand where and when we decided that nothing is personal, nothing is private, and everything is subject to invasion. What next, will we set up cameras and sell DVDs of the code in order to help continue the 'closure' process? You think that sounds unseemly? Not anymore than allowing codes to become 'spectator sports' in the first place.

~faith,
Timothy.

[elthia]

Originally Posted by BabyRN2Be

I'm just curious if anyone has seen this happen, family members becoming disruptive during a code.

Anyone had this happen?
.

Unfortunately yes. They family members were shoving and hitting the nurses and then the code team when the code team arrived. They were screaming and cursing. Security had to drag them out of the room.
The patient did not make it, (80 something year old man, renal failure, hyponatremia, Stg IV decub that was infected).
the family threatened to come back and kill all the staff on the floor.
They were escorted off the premises by security.
Basically, the patient had been at home, brought in the day before by family, had large pension that family was "taking care of" for him.

[elthia]

I think it would traumatize me to see my loved one coded. Something that I would have nightmares about later. I'd rather not have a memory like that bouncing around in my head when I remembered that loved one.

[Tweety]

There are always going to incidences of family problems during resuscitation, particularly if staff isn't trained well in it, and there isn't someone specifically with the family member for support. There may even be a lawsuit or two.

To me that doesn't justify taking away the choice of family members.

Yes, a long time ago for some of the same reasons men weren't allowed with their wives during delivery. Yeah a few men have fainted, been disruptive and sued. Still no reason to go backwards and take away the right of men. That is has now become a societal expectation that men be there,
and men feel they have no choice is true. But family precense in recusication have been occurring over a decade and I don't see any societal pressure yet to be present. The option should be offered but not pressured.


Codes are indeed a tramatic experience. This is why mock codes, ACLS and other education is important to help the nurses through. Educating on the American Heart Association and the Emergency Room Nurse's association's recommendations for offering family precense should be an educational priority as well. There's too many fears and myths associated with this when the reality has proven different. Yes, of course there are going to instances of disruption, nurse discomfort, lawsuits, etc. My opinion is give it a chance. Train the staff, have support available, and offer to appropriately coping people.

Thanks for listening.

[BabyRN2Be]

Originally Posted by elthia

I think it would traumatize me to see my loved one coded. Something that I would have nightmares about later. I'd rather not have a memory like that bouncing around in my head when I remembered that loved one.

This is exactly what I think will happen to me. I will have nightmares about seeing my loved one coded and that's not how I would want to remember them. Also, I believe that my loved ones would not want me to have nightmares about their last moments here on earth.

As a pre-student nurse, codes scare me. I'll have to overcome that, yes. The thought of witnessing a code on a stranger scares me, and I think it would be worse for me if I witnessed the code on a loved one, such as my husband, dad, mom, or brother.

[Mommy TeleRN]

Here's my question:

When someone codes and a staff goes to get the family..is there ever any arguing over WHICH members are going to go? Obviously you can't let a whole family go... what if it ends up in a lot of resentment because Sue was allowed to be there when Mom passed but her brother, Aunt, etc weren't.

[ZASHAGALKA]

Originally Posted by Mommy Nurse2b

When someone codes and a staff goes to get the family..is there ever any arguing over WHICH members are going to go? Obviously you can't let a whole family go... what if it ends up in a lot of resentment because Sue was allowed to be there when Mom passed but her brother, Aunt, etc weren't.

This is why we need to sell DVDs - so everybody can watch.

A tad bit of sarcasm there, but I was doing some on-line 'research' on this and there was actually a debate in a VA teleconference on Ethics whether videotaping a code was 'over the line'. It was, barely. But it seems to be where we are heading.

I noticed, during my look, that the Docs are strongly against family presence (80%) and nurses are 57% against this practice - from a 2002 study from the journal 'Chest' as reported in the Wall Street Journal 10/12/04.

I also noticed that most of the so-called advanced nursing research on this issue was widely dismissed by the various DOC organizations because they couldn't find any studies that fielded more than 50 participants, and, in most cases, those studies included BOTH codes AND lessor invasive procedures. One of the so-called landmark studies involved only 19 resusitation events. 19!? And this is where we are hanging our hat for national standards?

I was also interested to discover that only 5% of hospitals have a family presence policy. By simple mathematics, I can deduce that 95% do not.

Finally, while I wasn't surprised to find that 'nursing research' stressed the need for more indoctrination (um, education) on the topic, I was fairly surprised that most organizations that addressed the topic emphasized that it was inappropriate in situations where staff members would be greatly distressed by its implementation.

I want to point out that I am not speaking of pediatric codes, and none of my comments thus far have been directed at pediatric events. Parents have the legal right to speak for their minors and to make decisions for them. While I have other concerns about family presence, my major concern is the unseemliness of trampling on somebody's right to privacy, a right that cannot be evaluated at that point. That's not the case in pediatric events. In addition, the death of a child mitigates my other concerns. It doesn't eliminate them, but it tips the balance to parental participation. But, the concept of full parental participation with a minor is not as new or greatly controversial a topic as the topic under discussion.

~faith,
Timothy.