Survey: Should family be present for a code?

ZASHAGALKA, RN · Sep 12, 2006

This is a five yr old thread. It's been discussed much more in-depth since then:

https://allnurses.com/forums/f8/family-witnessing-code-activities-117691.html

What I said there:

Alot of grieving is perception. I'm supposed to be crying. I'm supposed to wear black. We're supposed to have a funeral.

Funerals are almost universal, even if cremated, because there is a strong societal pressure/need for closure.

If you allow the opportunity to witness, a large percentage of the population will preceive it as a requirement, else they aren't grieving like they should.

We've let our TV facination with the macabre dominate our lives, and now we are passing it off as advocacy. I said in my previous post that it might be family advocacy but not patient advocacy. I change my mind. It's not even family advocacy.

codes are ugly nasty business. It's cruel to let (require) a family member to witness.

Funerals are where closure happens. It's a time tested, time honored process. Save the macabre for those who are trained to deal with it.

Families in codes is bad medicine, all the way around.

Fortunately, in my area, the doctors aren't far-sighted enough to adopt such lunacy. But I'll say this, most policies that address such issues have a 'in the nurse's opinion/assessment of its appropriateness clause'. I would NEVER find it appropriate and would always invoke the policy to object to the family's presence.

Why? Because I'm an advocate.

~faith,

Timothy.

PANurseRN1 · Sep 12, 2006

A lot of nasty stuff happens during a code. The only way I can see it working is if there is one staff member devoted to nothing but being with the family to support and explain. Given the crappy staffing we deal with most of the time, I don't see that happening.

Maybe I'm just old and set in my ways, but I don't really see this as a positive. There are few people, in my exp., who can handle witnessing the code of a loved one. Heck, I was anxious just watching a close relative getting Adenocard for SVT, and I'm an ED nurse.

CaseManager1947 · Sep 30, 2006

My one and only experience with this situation, was on a fairly young woman who coded with end stage COPD/respiratory failure. Husband was present, I took him outside at this request, and found him a chair, stayed with him. About 1/2 way thru the code, the resident came out, and offered for the assembled family to come into the room. That's when things began to go south. Code was going well, teamwork very good, but no response from the pt. after several drug pushes, attemps to defib, etc. Daughter got to the room, bringing her daughter and a friend (whom we all thought was another family member. By this time, the doc was gently telling family, that it didn't look very promising that they were going to be able to revive her,

and several of these people became hysterical, screaming and crying. I had to escort them out and down the hall to a waiting area for families. Not every family will be able to handle this, especially those who are either not prepared or cannot let go or perhaps has issues with medical procedures as a general rule anyway. I think in some cases , it might be good, but not all.

Corvette Guy · Sep 30, 2006

This is a five yr old thread. It's been discussed much more in-depth since then:
https://allnurses.com/forums/f8/family-witnessing-code-activities-117691.html
What I said there:
Alot of grieving is perception. I'm supposed to be crying. I'm supposed to wear black. We're supposed to have a funeral.
Funerals are almost universal, even if cremated, because there is a strong societal pressure/need for closure.
If you allow the opportunity to witness, a large percentage of the population will preceive it as a requirement, else they aren't grieving like they should.
We've let our TV facination with the macabre dominate our lives, and now we are passing it off as advocacy. I said in my previous post that it might be family advocacy but not patient advocacy. I change my mind. It's not even family advocacy.
codes are ugly nasty business. It's cruel to let (require) a family member to witness.
Funerals are where closure happens. It's a time tested, time honored process. Save the macabre for those who are trained to deal with it.
Families in codes is bad medicine, all the way around.
Fortunately, in my area, the doctors aren't far-sighted enough to adopt such lunacy. But I'll say this, most policies that address such issues have a 'in the nurse's opinion/assessment of its appropriateness clause'. I would NEVER find it appropriate and would always invoke the policy to object to the family's presence.
Why? Because I'm an advocate.
~faith,
Timothy.

Not all family members can handle witnessing their loved one in a code, but to never find it appropriate seems like a blanket statement, IMHO. I know I'd want to be present in a code situation involving a close family member. BTW, when my Dad had CABG I was able to pop in during the procedure since I was a staff nurse in the OR, at the time.

MOOSEMAN · Apr 27, 2007

I say yes. Have had good outcomes with family being present.

margaretptz · Apr 27, 2007

I was present when my husband coded, I was the one who actually started CPR. I was a bit hysterical when the EMT arrived and was instructing a new EMT intubating him, It wasn't going easy and unthnkingly I kept trying to tell them he has a stent iin his esophagus. They threatened to make me leave and I became quiet,rode in the ambulance to the hospital with him and after a brief registration process I was allowed back in the room. This was an army hospital. I think they would have had a very hard time trying to keep me out I needed to be there and was able to give them permission to stop even though I know it was only a formality, it helped. I think if the family wants to be present their wishes should be respected.

Margaret

Trauma Columnist · Apr 27, 2007

Oh Margaret - my heart goes out to you. You are so right that you should be there. Take care.