Family In The Room for Code?

edmia, BSN, RN · Aug 30, 2013

I suggest you read some of the many research articles that support family presence. It doesn't matter if you're not comfortable. That is your personal issue that has no place in your practice. This is a good opportunity for you to do some reflecting.

As you can see, I'm an advocate of family presence during codes and procedures.

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Biffbradford · Aug 30, 2013

It has to be done with some prudence. It get's complicated when you're coding the patient and a family member passes out too. (been there, seen that!) :wideyed:

Penelope_Pitstop, BSN, RN · Aug 30, 2013

When I worked midnights on the floor, families were never around during codes. By the time the family made it to the hospital, the patient had been pronounced or was in the ICU.

Now that I'm in the ICU, families are around 24/7. I had my first experience with a family in the room. It was a younger patient, and her husband was quite stoic. Still, I felt very uncomfortable.

Was someone explaining to the family member what was happening? I think if a family member is in the room, there needs to be a designated person who is there for JUST that family member. I am the only person in my family who has any kind of healthcare knowledge, and I know if any of my loved ones, God forbid, coded, someone would need to explain to the rest of the family what was happening. Even very educated people don't understand...just how my dad has to explain financial stuff to me because he's an accountant. I may be educated, but I don't understand that stuff!

Someone on here once posted that the patient belongs to the family - not to you, and the family has a right to be there. Even if it is a horrible image, it is the last image that person has of that loved one. And a lot of people are comforting knowing the loved one was not alone.

psu_213, BSN, RN · Aug 30, 2013

I have changed my opinion on family presence in codes. I used to be steadfastly against it, and I now realize the benefits to the family members to be there. However, it must be done right. The family member(s) who are going to be present must be properly prepared for what they will see and they must have a nurse "assigned" to them who will explain everything that is happening, comfort them, and make sure that their presence does not interfere with the running of the code. This staff member needs to be dedicated to the family member and at their side the entire time--not running into help with the code then going back to the family member, etc.

Nursingbride12 · Aug 31, 2013

I suggest you read some of the many research articles that support family presence. It doesn't matter if you're not comfortable. That is your personal issue that has no place in your practice. This is a good opportunity for you to do some reflecting.
As you can see, I'm an advocate of family presence during codes and procedures.
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While I have also read these articles, I was concerned about the family members disrupting the code itself and making the code less effective. Before you make assumptioms about my personal practice, why not ask more information so that you better understand my question. I understand your position but the way you phrased this is abrasive and not helpful. My care and advocacy for my patients are my practice.

edmia, BSN, RN · Aug 31, 2013

While I have also read these articles, I was concerned about the family members disrupting the code itself and making the code less effective. Before you make assumptioms about my personal practice, why not ask more information so that you better understand my question. I understand your position but the way you phrased this is abrasive and not helpful. My care and advocacy for my patients are my practice.

Right, but in your answer is the problem. Your place of work is uncomfortable with this situation and does not have a properly designed and evidenced based protocol to fall back on. You could spearhead the committee!

What you just mentioned, about the family disrupting the code, is one of the myths that people cite to not allow family presence.

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SwansonRN · Aug 31, 2013

Agreed, I have read quite a few studies that I have dispelled the "family will interrupt" myth. In one study there was no significant delay in intubation, central line placement, etc. nor was there a difference in success with those procedures with family present vs not present. Families are always going to be disruptive from time to time. It's the nature of working with people in high stress situations, that doesn't stop us from having visitors altogether.

If it was my family member I would absolutely want to be there. I've seen a woman sitting at the foot of the bed while her husband was coded. She rubbed his feet quietly until she said "I think that's enough". I'm glad we were able to give her time with him in his last moments. It does take some coordination with staff (docs, RNs, chaplain, social work), but when it works out well it can make all the difference.

This is actually a project I'm working on, can you tell? Lol

umcRN, BSN, RN · Sep 9, 2013

I have written a post about this previously, found here: https://allnurses.com/picu-nursing-pediatric/sometimes-hits-you-809739.html

I am strongly for family presence and at my hospital we have a family presence team. We try to have enough nurses trained to have a few every shift and when there is a code, just like someone becomes the recorder, or the med nurse, someone becomes the family presence facilitator. These people are specially trained for the job in a easy, couple hour course offered a few times a year.