Full Code resident in LTC

Specialties Geriatric

Published

I Work in LTC and a Full code Resident died. The doc was in the room and would not allow the nurse to perform CPR. What is the unwritten or written protocol? Was the nurse still responsible to perform CPR? Was the doc wrong for not allowing? Thanks so much

At the end of the day, it's his patient, his call.

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At the end of the day it's his patient, his call.[/quote']

Seriously?? Then what the heck is the point of a DNR or code status? If I as a patient want to be a full code, I am not agreeing to letting the doctor make the decision for me when I'm coding. Not his call..

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Yes, seriously. The MD is not obligated to initiate futile codes.

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This will also depend on the facility's protocols.. I have worked in LTC facilities that were "no CPR" and every resident was made aware prior to admission that should they go into cardiac arrest the nrg staff wouldn't initiate CPR. I have also worked in facilities where the protocol was CPR would only be initiated if the nurse was in the room and witnessed the resident stop breathing. CPR or no CPR no LTC facility that I have worked in had a defibrillator...

This is interesting to me. The LTC facility I work in has defibrillators and if you are not a DNR then CPR is performed. I guess it varies from place to place.

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It must vary from place to place, because I have never worked in a facility with those stipulations, either.

Also, how is it ethical for a physician to bypass a patient's code status? If a physician has a problem with a patient's code status, then either the doctor needs to address it and work with facility staff and the family to get it changed, or he needs to drop the patient. Choosing to ignore a black and white directive is unethical. That's been my training anyway and every facility I've worked in across the country has held the same standard.

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Specializes in ICU.

Whaaattt? A dr cannot just "play god" and decide not to resuscitate a patient who had a full code status in place. Unless it is clear the patient is unable to be brought back...ie rigor mortis, etc. If anything, a slow code would be appropriate, but to stop staff from performing CPR? I'm not sure I understand. As a PP stated- what, then, is the point of choosing a code status, full vs. DNR, if the doctor may go against your wishes?

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Specializes in kids.

Very interesting read....I am always amazed at the lengths some folks will go....working in LTC it is not usually an issue where I am, but the hopsital arena is a whole different ball of wax.

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Specializes in Trauma Surgical ICU.

It would be nice if the OP would come back and clarify some things !!

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Specializes in Emergency Nursing.
Whaaattt? A dr cannot just "play god" and decide not to resuscitate a patient who had a full code status in place. Unless it is clear the patient is unable to be brought back...ie rigor mortis etc. If anything, a slow code would be appropriate, but to stop staff from performing CPR? I'm not sure I understand. As a PP stated- what, then, is the point of choosing a code status, full vs. DNR, if the doctor may go against your wishes?[/quote']

The OP really was not clear if the doctor pronounced death on arrival and said not to di CPR for that reason or if the doctor simply decided to withhold CPR. Not sure why the question was not asked to the doctor right there in the room "hey doc why no CPR?, patient is a full code I have a duty to do CPR". There must be more to the story we are not hearing. I can't imagine the doctor would want to lose his license for deciding to "play god".

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