First code, question about family notification
- 0Mar 10, '13 by blackvans1234Hey all, I'm just wondering if you can give me some clarity.
To put it shortly, I am a PCT / CNA, I was floated to another unit, the code was called, patient successfully resuscitated. I believe I overheard the Doc talking with a family member over the phone, but I didn't catch much of what he was saying. From what I heard, "She went into cardiac arrest, CPR was performed and she was successfully resuscitated...."
Pt was intubated and on a ventilator, necrotizing faciitis, possible sepsis?
The code was at about 630pm, I was floated to another unit at 730pm, so I didn't have time to ask questions to the staff about the prognosis, future for this patient, ''what now?", etc.
As I was leaving (1130PM), I saw that family arrived to see the patient. There were like six or seven people in the hallway.
Normally families don't visit at midnight, so I'm wondering what the deal is?
My assumption would be that maybe the outlook for this patient is no good, and they may discontinue life support or choose to have a DNR for this patient?
Or maybe just because of the uncertainty of her future they advised the family to see her.
So in your experience, why would a family be advised to come visit a patient after a code?
- 16Mar 10, '13 by Best_Name_EverLet me ask you this. Say that your mom was in the hospital, and the doctor just called and informed you that she went into cardiac arrest, they performed CPR, and resuscitated her. Wouldn't you want to go see her? I mean, coding is a pretty serious thing. The patient could have died. I think it would be normal for a family to come see a patient who just went through that?
- 6Mar 10, '13 by sissiesmamaUnfortunately, when a patient codes, it ends up being the "first" code. Some patients, young ones, traumas, ect can bounce back or come back from a devastating injury or illnes. Others that have a lot of preexsisting conditions / long illnesses just can't recover, and if they recover to a certain extent, they may not come back to the mental status they were before. The ones you mentioned above are some that a patient may not come back from.
Some time as the code blue nurse working in the ER, I have been to a code upstairs, and the pt make it and transfer to ICU only to end up coding the same patient one or even two more times in the same shift. I've heard the doc tell the family on the phone after them surviving the code "if u want to see your mom, you may want to come now." That's what the ER doc and the cardiologist told me after my dad had his MI. Thankfully, he was one of the ones to survive and go home.
- 5Mar 10, '13 by coco317In my personal experience with codes in the hospital, the family is called in because we don't know if they will continue to code again and again during the night. If the outlook for the patient is looking grim the physician will usually discuss it with the family and open up discussion regarding changing the code status.
If the patient does not make it there is also paperwork the family needs to fill out.
- 6Mar 10, '13 by VespertinasThat was a near-death experience. The patient lived thanks to the efficiency of her team and the grace of god. Is it possible you don't feel the gravity of that situation because since the patient was intubated and thus had a depressed level of consciousness, you can't observe the difference in how she's faring before vs. after? I can imagine with the clinical picture you painted before, she looked quite sick to begin with. I assure you, she's worse for the wear now. Besides what bsnstudent said which I think should be obvious, you're right that after a first code is a good time for families to re-think code status.
- 4Mar 10, '13 by turnforthenurseRNAs for visitors after midnight, there are always exceptions, such as in this case. The patient had a near-death experience. How do you think that would look if the hospital said to the family, "sorry, it's after midnight, and we know your loved one almost died but you cannot visit because it's after hours."
- 1Mar 10, '13 by blackvans1234Thanks for all of the responses, this was on the CCU, so there was no / minimal delay in the initiation of CPR and subsequent code protocol.
When I came on, she was very sick looking, we were doing some care and she had a few runs of V-tach (one was like 30 seconds)
Her nurse actually called the Doc and said ''she just doesn't look good'' about an hour before the code.
A nurses intuition huh?
I assumed the family was notified because of the gravity of the situation (everything you guys said above), I just wanted to make sure.