Calling a code

[talulah1]

My patient was coding and the ER doctor and team began CPR and were setting up to shock. Before delivering the first shock, The hospitalist came in and stated that the code should be called, even though the patient had listed herself as a full code. She then said "She's been trying to die for years now" . The patient was on Medicaid and did not have family nearby. Something seems really wrong about this but I don't know who to talk to

[Esme12, ASN, BSN, RN]

Without more details it is impossible to say that something is wrong and I am sure it had nothing to do with that she has medicaid. It sounds like she had a long health history and there comes a time when enough is enough and you have to consider what are you "saving" her for? If she "survives the code....what deficits will she suffer? What quality will she have? More suffering and illness? It sounds like this MD knew her.

A valuable thing to remember.....There are much worse things than death.

[LadyFree28, BSN, LPN, RN]

My patient was coding and the ER doctor and team began CPR and were setting up to shock. Before delivering the first shock The hospitalist came in and stated that the code should be called, even though the patient had listed herself as a full code. She then said "She's been trying to die for years now" . The patient was on Medicaid and did not have family nearby. Something seems really wrong about this but I don't know who to talk to[/quote'].

I'm sorry...was the code not called??? By your wording, I'm a little confused on whether attempts were made.

If the hospitals it had a more knowledgeable history and knew about this particular history and decided to end the code because it was doing more harm than good;

OR

During the code, the hospitalist decided to abruptly stop the code or stated to end the code without even attempting to resuscitate because the patient "been trying to die for years now".

Which one was it??

Either way, sometimes quality of life has to-scratch that-MUST come into play for the patient as Esme stated; I am becoming more aware of it the more years I stay in this business.

[caroladybelle, BSN, RN]

There is no legal requirement in most states for a physician or facility to render what is considered "futile care". The patient may indeed be a "full code" all they want, but if the care that they desire, is classed as "futile", the MD may or may not choose to provide it .

Otherwise when would one ever stop a code.

This one of the problems with "Living Wills". Someone writes that they do not want to be resuscitated "if there is no hope of reasonable recovery". There is no concrete way of defining this point or predicting this in many patients or cases. Thus, MDs have an excessive amount of leeway in interpreting these things.

Presumably, the MD determined that continuing the code was "futile", and stopped it.