Family members at the bedside during a code blue?

Home Health Columnist / Guide · Jun 19, 2003

2 Nsg Spectrum articles listed just yesterday on topic:

https://allnurses.com/forums/showthread.php?s=&threadid=38836

canadiannurse21 · Jun 19, 2003

Hmmmm, I have seen it many times. I have been involved with the situation personally (one of my own family members). I think it does not benefit the family at all to witness a code blue--I mean, I have been professionally involved with codes, but when I saw my own family member in the same situation, I had nightmares for years. However, what it all comes down to I suppose is Rights. It is the family's right to witness the code if they are REALLY firm about it. However, in my personal opinion, it should be discouraged. Simply telling the family, "you might not want to see this," could help. When there is a code going on, the family is in shock (bless them(L)), and a little guidance could save them from an experience they could do without.

zambezi, BSN, RN · Jun 19, 2003

I think that it depends on the code/family. I have participated in codes with family members in the room. One code, a respiratory arrest, went well with the pt's wife it the room, we saw the code coming so we were able to prepare her and we were ready for it. Another code, cardiac, thank goodness that pt's wife was sitting down or she may have hit the floor...other than that she did ok too, it was a long night for the patient and family...I think that if a family is to say in the room, an rn needs to be with the family and explaining what is going on... Another issue in our unit is space, after RT/Docs/Pt. Tech for CPR/lab/pharmacy/and three our four RNs, etc there just isn't a lot of room left...We had a code the other night and I so glad the family was not there for, gi bleed, pt nude, blood pretty much out of every orfice/vomit everywhere (sorry for the gross mental picture, like I said, I am glad the family was not there)...three or four unsuccessful attempts made at intubating, level one putting blood in that was just coming back out...etc...pt did not make it, nothing worked when we tried it...I was glad that the family did not have to see their loved on like that, it was not pretty and no family should have to see that, I know that I wouldn't. I guess it depends on the family though...I am still up in the air on this question, I believe in family centered care but I think that for most codes, the family should be taken out of the room into the hall, again each situation is individual...if there had been family in the room for the last code I don't know what the plan would have been...Also there is so much going on, if the family is not being talked to, they may not understand, things may be intrepreted the wrong way, especially if it is a tense code...FYI, there was a thread about this not long ago, I can't remember exactly which forum it was under...Good luck on your ethics paper, it is an interesting topic, that's for sure.

mistersleepy · Jun 19, 2003

Originally posted by canadiannurse21
I think it does not benefit the family at all to witness a code blue-- However, what it all comes down to I suppose is Rights. It is the family's right to witness the code if they are REALLY firm about it. However, in my personal opinion, it should be discouraged. Simply telling the family, "you might not want to see this," could help. When there is a code going on, the family is in shock (bless them(L)), and a little guidance could save them from an experience they could do without.

I agree, it is an ugly picture to have as your last image of dad, mom, child, etc. That said, however, I have occasionally had those obstinate family members of a "This pt WILL die and wants to be a dnr" pt who I wished I could make watch the code so they could see what they did for their loved one but I guess that is another thread...

K O'Malley · Jun 20, 2003

I agree with zambezi, a code blue is not a pretty sight, with mucous, vomitus, and other bodily fluids, not to mention the awful mottled color of the patient. The room gets very crowded and there is hardly room for those involved in the code. Get the family out to another room! I have been involved in many codes as I worked in ICU for most of my career but I sure wouldn't want to be present during a family member's code. Who would want that ingrained in their memory for the rest of their life? Just thinking about it gives me the willies.

dana d · Jun 20, 2003

I work in an Emergency room. Family members want to be present. But I agree with the majority. Its not a pretty site. And unless someone is explaining things families do not always understand which means more time spent with the family after the code. The only time I saw a positive outcome, involved a 1 month old infant. The parents where there at the bedside the entire time, almost 2 hours. They knew we did everything we could and later told us it helped them except and cope a little better. It was their first child. But I stayed over and explained the process as the 2 doctors, 2 RNs and RT worked very hard. I'm with the others. I would not want to see my family members being coded. I think if the public was educated on the process of what may take place, they may in fact change their minds. Good luck.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Jun 20, 2003

I agree that family needs to be present if they choose to help with closure issues. However, if the code is going on in one of our small rooms (don't they always) getting the crash cart, anesthesia, flight, CCU RN, pharmacy, 1-2 docs, RT, Patient RN, Lab person all in a 7x10 room just doesn't work. Don't forget the gawkers that just stand there but also feel they have to be in the room. In our large rooms (15x10), anybody who wants to be in the room, ok by me.

allnurses Guide · Jun 20, 2003

Since becoming a nurse 5 years ago I've read numerous articles on this issue. I get a couple of nursing journals but don't remember which ones had the articles. Seems like it would be pretty easy to find one.

I think it depends on the family and situation. You can't make a hard and fast rule here. I surely do agree that it isn't pretty and that family do not need that as the last vision of their loved one.

steph

nimbex, RN · Jun 20, 2003

I can't direct you to literature, but inspite and despite any literature, EVERY situation is different, every family reacts different. I do what I feel in my head and heart to be right at that time. I've removed, as well as called families into codes.

Sometimes you just "know" what to do. good luck

CountrifiedRN · Jun 20, 2003

I posted a similar question in the emergency nursing forum and got a lot of great responses. Here's a link to the thread:

https://allnurses.com/forums/showthread.php?s=&threadid=35879

NurseLili · Jun 22, 2003

Inevitably most of us will be in that situation, and it wil all depend on the culture of the family.

I agree it's pretty ugly to witness all the rib-cracking, skin-fizzling shocks and nasty intubations that occur during a code, but if I can give a little advice, it's essential that SOMEONE stays with the family, at least initially to explain what's going on and to give a little of support in this awful moment. There's nothing like knowing your loved one is in peril and you don't know what's being done...

I remember an incident when everyone ran to the room and no one stayed with the family. The pt's daughter walked in at the end of a 20 min. code & her mother had expired, spread on the bed like a sacrificed animal...

It was an awful scene... The daughter let out a scream and passed out on the floor.:stone