DISCLAIMER: I am not a nurse, I am not a nursing student, this is not a homework question, etc. Please don't flame me if I get the lingo wrong. I am just curious.............
I was watching a show called, "Trauma: Life in the ER" last night. There was an older man who was flown in due to a MVA. Well, he also had a MI when he got into the accident. He coded a few times and they eventually took him to surgery to stop internal bleeding. While on the OR table, he coded again. The doctor said he didn't feel any aortic (?) pressure. He then preceeded to ask everyone in the room "if they had a problem with that" (calling his death). My question is, would it really have mattered if anyone would have spoken up? What would the doctor have done if one of the nurses said yes? Just curious....
Also, often times the person who knows the patient's health history best is not the physician running the code, but the nurse (at least where I work, ICU). A wise physician would ask if anyone else has any ideas before ending the resuscitation effort. Most, if not all, our docs do this.
Specializes in Critical Care, Flight Nurse, LTC D.O.N.
I agree with others that I have experienced the physician asking for "permission" to end resuscitation efforts. Nearly all hospital resusitive efforts are by a code "team", either specific teams or groups of professionals who have experienced multiple codes. The physicians are asking for other suggestions or comments before directing the team to cease efforts. It is frequently an emotional time for staff, and it allows us to "let go" as well. This is especially true in younger victims, trauma, or self-inflicted injuries resulting in death.
Even in the ED when we have a code the doctor running the code will ask that question before he/she decides to basically end a person's life.
Ummm, i hate to pick but when the patient is being resuscitated they are dead. Thus, stopping resuscitation does not "end a person's life." It is simply a recognition that continuing treatment on the dead person will not work.
i have never seen a doctor pronounce a pt. dead. when pronouncing,does he/she simply say time of death and give the time or does he/she say "i am pronouncing this patient dead"?
I have to say, sometimes the doc can be blunt. We had a case of the 3+ (bunch) of codes back to back, ending in death, where a family member was having problems getting the bleep out of the room so we could do the post mortem cleanup, and the doc finally came back in, made a point of doing the exam again, and told the family member, "Ok he died. He's dead."
Ummm, i hate to pick but when the patient is being resuscitated they are dead. Thus, stopping resuscitation does not "end a person's life." It is simply a recognition that continuing treatment on the dead person will not work.
Understood...however, the time of death is the legal time for end of life. Until the doctor says, "Time of death 1332" the patient is legally still alive.
i have never seen a doctor pronounce a pt. dead. when pronouncing,does he/she simply say time of death and give the time or does he/she say "i am pronouncing this patient dead"?
I have never seen them say "time of death blah blah blah" I have only seen them say "ok lets call it" Or "go ahead and stop everybody" the person doing the charting notes the time. Thats just my personal experience.
We set the time of death at the time on the telemetry strip where either the pt went asystole (DNR/no code) or when the scribe on the code team writes "reces. efforts terminated"
Understood...however, the time of death is the legal time for end of life. Until the doctor says, "Time of death 1332" the patient is legally still alive.
Agreed.
We like to think of death as a black and white thing. But in fact there is a little gray in between...
mochamonster
66 Posts
Also, often times the person who knows the patient's health history best is not the physician running the code, but the nurse (at least where I work, ICU). A wise physician would ask if anyone else has any ideas before ending the resuscitation effort. Most, if not all, our docs do this.