Hi everyone! I am finishing up my ADN program and we just had to read our chapter on emergency medicine. I am especially interested in the ER, have always been, and I have an offer to work in the ER of a local hospital after graduation.
Most of the info we were responsible for self teaching out of the book because the instructor who was to teach the material became ill.
There was a small paragraph in my book advocating for family at the bedside during a code, as long as there was a nurse available to explain what was being done. The author felt that it helps the family to accept the situation, and facilitates the grieving process if the patient dies.
I was just wondering if this is done anywhere, and what your opinions are. And for those who do agree with it and/or have seen it done, how likely is it that there is a nurse available to explain procedures to the family member?
Personally I think it is important to allow the families to have the choice to be present or not. I don't mind family members being present and in many cases they are the ones to initiate discussion regarding ceasing CPR. Although it is never easy to accept the death of a loved one, family members who are present usually seem to accept death easier and help other family members deal with it. They are confident when talking to other family members that every thing that could be done was being done.
As far as who is with the family, in our facility the Nursing Supervisor responds to all codes, even in the ER and usually takes that responsibility. If she is not available it is usually the charge nurse. During daylight hours we also have an ER specific Patient Rep.
Specializes in Step down, ICU, ER, PACU, Amb. Surg.
It is becoming a trend to allow the family in the room during the code, so that they know exactly what is happening and are able to make informed and independant decisions, based on information from a health care provider that is at their side during the entire scene, and they are there when the physician makes the suggestion to call the code.
However, every facility has their own policy on this and how they handle code situations and the family involved.
Yes, I think the family should be involved in all decisions made in a code situation, however, I have mixed e motions when it comes to allowing them in the same room as the code is occuring. Sometimes, a traumatic code might be more upsetting to the family than the code its self is. Plus, during a code the patient is not usually covered witha sheet and things get very messy and these things also upset the family.
I personally prefer that a hospital rep stay with the family in a secluded room to provide support and comfort to them while the code team works on thier loved one, with 1 person designated to relay updates to them, to keep them informed and updated, so that their input is taken into consideration in the treatment of the patient.
I think family presence during a code is very appropriated under some circumstances. Many nurses I work with are uncomfortable with the family being in the room and we have had many heated discussions regarding the situation. But a ED educator (who is one of the smartest people I know) told me something when I graduated and began working in the ED as a staff nurse that has always stuck with me. #1 - That person coding does not belong to you. They belong to that family member and you have no right to keep them away if they want to be present. AND if you are uncomfortable with the family being present, you are either unsure of your skills or unsure of how you feel about death. And these are two issues you have to deal with if you're going to make it in this profession.
I realize that it sounds harsh. But it is really the truth.
I am not sure how to put this but your comments really touched me. I totally believe in that philosophy and how it effects others. Thank you for your statements, they really mean alot to me as both my parents are pretty ill at this time and a code is probably pretty inevitable at this point in their health and I want to be there when it does, to let them know I was there for them in life and when it comes down to it, in death. Thank you atownsendrn:)
I work at a teaching pediatric specialty hospital, and we allow families to stay. We were very wary at first, and the first instance happened by chance. The squad that brought the kid all had white shirts and blue jeans on. One of them stuck around and watched from a distance, and when the doc asked if anyone had objections to stopiing he spoke up and basically said no you tried everything thankyou. turned out he was the DAD! Thats a shock! But since it had gone so well it became a policy. One to 2 persons, usually parents have a specialy place to stand with a liason, a nurse, social worker or med prof. , and are told clearly before they go in that if there is behavior that threatens staff or interferes with care security will help them leave the room. it has worked well. I have heard that families have much the same comments already expressed earlier in the thread about having better closure and knowing that the team really cared and did everything they could. I think not allowing them there is a cop out for us sometimes, the same as waiting until there is someone doing last ditch cpr til they come in, kind of makes it look good without the effort of allowing them there the whole time.
sure, you bet, as long as they are not falling into the floor hindering the process. I have had the chaplain get the MRS. a chair so she could view us thru the glass doors & know we were trying to save MR to best of our ability. It also keeps the foul language a little better under control! & esp when a child codes, if parents can stand it, they will know we tried our best to save jr's life.
debbyed
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Personally I think it is important to allow the families to have the choice to be present or not. I don't mind family members being present and in many cases they are the ones to initiate discussion regarding ceasing CPR. Although it is never easy to accept the death of a loved one, family members who are present usually seem to accept death easier and help other family members deal with it. They are confident when talking to other family members that every thing that could be done was being done.
As far as who is with the family, in our facility the Nursing Supervisor responds to all codes, even in the ER and usually takes that responsibility. If she is not available it is usually the charge nurse. During daylight hours we also have an ER specific Patient Rep.