Don't clean up patient after a code

chare · Dec 22, 2017

If the family was in the room during the resuscitation, after it is called we gently and respectfully clean the patient and remove as much equipment as we can. If the family is in the waiting area, after the physician makes notification they are provided the oppprtunity to immediately visit, or wait until we have cleaned the patient and removed equipment.

The family just experienced one of the worst days of their life; I can't imagine making this any worse by not cleaning the patient.

Been there,done that, ASN, RN · Dec 22, 2017

My understanding is.. we present the deceased, as well as we can. The family does not need to see the aftermath.

Please see my previous post, where my "patient" resumed breathing in his body bag. :)

Emergent, RN · Dec 22, 2017

If the family was in the room during the resuscitation, after it is called we gently and respectfully clean the patient and remove as much equipment as we can. If the family is in the waiting area, after the physician makes notification they are provided the oppprtunity to immediately visit, or wait until we have cleaned the patient and removed equipment.
The family just experienced one of the worst days of their life; I can't imagine making this any worse by not cleaning the patient.

She told me she learned this at a trauma conference.

RotorRunner · Dec 22, 2017

No. In my experience, the family is typically brought in while rescucitation is still underway at some point. However, once the code is called, and assuming it is not a case for the medical examiner, we tidy up the room and make the deceased person presentable. We clean up all the trash, dim the lights, and place a warm blanket on the patient. Then we place a couple of chairs in the room and a box of tissues. This is how I would want it if it were my family member. I wouldn't want to be tripping over code carts and used medical equipment. It is the respectful thing to do.

Been there,done that, ASN, RN · Dec 22, 2017

She told me she learned this at a trauma conference.

Who gives a rat's patooti about a trauma conference? I have been there, done that. Wanted to see my my loved one at peace. The aftermath after a code is ugly, it is nowhere near comforting or reassuring to see that bloody mess.

Castiela · Dec 22, 2017

At least cover the body with a blanket to hide the lines/blood

chare · Dec 22, 2017

A colleague told me that it's a consolation to the family if we don't clean up after a code. It reassures the family that we did all we could for their loved one.

Do you allow family presence during resuscitation? This is a much better way to show the family that you did all that you could.

TriciaJ, RN · Dec 22, 2017

Who gives a rat's patooti about a trauma conference? I have been there, done that. Wanted to see my my loved one at peace. The aftermath after a code is ugly, it is nowhere near comforting or reassuring to see that bloody mess.

I've picked up uncapped needles after an unsuccessful code. Also glass from a vase that broke when furniture was being moved out of the way. It's not even safe to leave an uncleaned-up room for the family to come in.

Here.I.Stand, BSN, RN · Dec 22, 2017

My thoughts: most people are reasonable, and I think will trust that we did everything we could. Those who don't trust us would probably be angry about us leaving them in such bloody disarray.

I work in the SICU of a level 1 trauma center. Frequently, the family sees their loved one for the first time on my unit (having not been allowed in the resus rm in the ED, or the OR.)

We try to make the pt presentable before they come in, but often times their face is battered, bruised, swollen, with some oozing from facial lacs. We have received pts with oozing brain matter, generally when it's obviously non-survivable, so pt was beelined to us. Bad head injuries would have gotten an EVD placed emergenly, possibly a Licox -- so then on top of everything else, the pts has gadgets inside their skull.

My anecdotal-but-consistent observation is that nearly all of those family members who initially fall apart, are the families of *these* pts. I can't see adding to their distress by leaving the pt like that

JKL33 · Dec 22, 2017

I can't agree with the rationale presented the trauma conference. Some of these scenes are gruesome, as we all know. Not to mention that real deceased people don't look anything like what they do on TV and just seeing a deceased body in real life is quite a shock. Sometimes this scenario happens to people who are having their first up-close-and-personal encounter with death, and it's thier own loved one. How terrible.

Why would looking at some gruesome thing let people know that we did everything? People don't know what we know, so why would that be their first belief - that's an assumed conclusion without any real reason to believe they will think that; in fact they might just as well think we caused some of the problems by the gory mess they see.

I think having family at the bedside during the resuscitation can be positive but one of the main reasons is because of the psychology involved in the idea that they were able to see their loved one "before they died." Just looking at gore after the fact when all is said and done wouldn't seem to be as helpful of an idea. I guess someone should study the issue to see if it has any effect on people...

Cowboyardee · Dec 22, 2017

When family is available, we try to have them present during CPR. It seems to facilitate them letting their loved one go, helps them feel they did what they could, and gives them a much more realistic understanding of what it means to keep a dying person full code.

If the family is not present for an unsuccessful code, usually we have time to clean up the room a bit before they see their loved one. Trash cans might be overflowing, the code cart might still be nearby, but typically the patient would be covered with a clean sheet, and the worst of the clutter will be gone. I see no reason for the family to walk into what was obviously a train wreck after it's too late to do anything else.

For whatever it's worth, I'm often hesitant to take out an ET tube while family is present. Not just because of medical examiner concerns, but because I've seen from experience that it's often somewhat traumatizing for family members to see their dead loved ones extubated - they expect them to look like themselves, whereas often they wind up looking more fully dead and gruesome than they did with the tube in. There's a reason people hire morticians before hosting an open casket.