Family Witnessing Code Activities

Published

  1. Would You Want to Watch a Family Member Undergoing a Code>?

    • 125
      Yes, I want to see all that was done.
    • 178
      No, I wouldn't want to see a family member go through that type of pain.
    • 51
      Unsure at this time.

354 members have participated

With the new changes in allowing family members to witness code activities, would you want to watch your family member go through a code? I've heard this is done so that the family knows that the staff did all they could do, and to take the mystery out of codes. But would you want to watch a family member go through the pain of a code and all that it entails? What do you think?

Considering that upwards of 85% don't survive, and there is a probably a distinct difference in watching somebody survive vs. watching them die, the real question is, how many of the DEAD patients would complain?

If the answer is 1, then you've just violated that person's rights.

~faith,

Timothy.

Timothy, I've been a nurse for a long time. And i have watched an individual's rights being violated by professionals, as well as family members. And I've listened to professionals justify their actions without any reliable data. I know, the codes where a family member was allowed to stay, regardless of the outcome, were calmer on the patient and the family member. I was present at the code of the 19 year old son, of two of my closest friends. They were both RNs. They were not allowed to stay. The only reason I was, was because the Chief of ICU knew me. The young man die but he didn't die alone, despite the attempts of the professionals to remove me. And I could share with his parents what the staff did and his final moments. So, the issue of violating a patient's rights is a moot one, as far as I am concerned.

Grannynurse

Up Vote Up Vote ×
Specializes in Emergency Nursing.

Wow, I replied to this thread a couple weeks ago, and now I can honestly say that I have had it happen to my patient. He came in this morning, and while we were doing CPR, giving meds, etc, we heard the family requested to be in the room. I have to say it was difficult seeing them in there because the mom and dad (he was in his 20s) were so sad, crying, and it just had an effect on everyone in there. But the mother distinctly said, I don't want him to be alone right now. And I know that as much as it hurt them to see their son like that, it meant the world to them to be in the room. They were so appreciative of us to let them stay. We had them stay at the foot of the bed, and wow...he was my age...I couldn't even begin to imagine what they were going through.:sniff:

Up Vote Up Vote ×
I agree, maybe it's time to start including this kind of thing in advanced directive, even though most advanced directives I've ever see state the patient as being a no-code, the question should be answered "do you want the family present at the time of your death". So we should advance toward this.

Well perhaps it's true that we should include this issue when the patient is preparing for advance directives.

However believe me the answer is probably no especially in my culture.

Preparing an AD is not commonly practice here but the idea is moving on but for me the answer is NO NO. :nono:

Up Vote Up Vote ×
Specializes in Critical Care.
the mom and dad (he was in his 20s) were so sad, crying, and it just had an effect on everyone in there.

This is one of my main points.

The family's presence had an effect on everyone in there, thereby changing the focus of that code from true all out rescue to 'closure'. This is the Heisenburg Uncertainty Principle in action (the act of observing an event CHANGES the event).

And how many people are going to die that could have been saved because FP 'had an effect on everyone in there'?

~faith,

Timothy.

Up Vote Up Vote ×
Specializes in Med-Surg.
Well perhaps it's true that we should include this issue when the patient is preparing for advance directives.

However believe me the answer is probably no especially in my culture.

Preparing an AD is not commonly practice here but the idea is moving on but for me the answer is NO NO. :nono:

Maybe for a lot of people the answer would be "no". But for a lot of others it might be "whatever my loved one chooses is o.k., if they want to be there, great, if not, then that's o.k. too.".

I don't relish in the idea of my spouse seeing me being resuscitated (believe me it would be an unexpected emgerncy resuscitation as I'm a DNR), but I would not be bothered if he choose to be there. On the contrary I would be rather touched that he put aside personal fears to be with me until the bitter end. Also, I wouldn't judge him if he choose to not watch.

Up Vote Up Vote ×
Specializes in Med-Surg.
This is one of my main points.

The family's presence had an effect on everyone in there, thereby changing the focus of that code from true all out rescue to 'closure'. This is the Heisenburg Uncertainty Principle in action (the act of observing an event CHANGES the event).

And how many people are going to die that could have been saved because FP 'had an effect on everyone in there'?

~faith,

Timothy.

No one is arguing that the presence of family in a code doesn't changes things or the atomosphere. (And yes, for every good code, you'll find a story of family presence gone bad, I'm aware of that). If the focus is taken away from all out rescue, then shame on the code team for being negligent and unprofressional.

As you say, 85% of codes are unsuccessful anyway, can not a person or two focus on the family? I'm not talking about the code team, but a chaplain or another nurse? Someone is going to have to deal with them anyway. When you tell them "we did all we could", they will definately know that you did, and if you didn't do all you could because they were present then more training is obviously needed.

Up Vote Up Vote ×
Specializes in NICU/Neonatal transport.

I work in a Children's ER and we allow parents for codes. I've only witnessed one code personally with a parent there. It was a SIDS case. But in any situation in the trauma or critical care rooms, we always have a social worker and chaplain to care for the parents. They have a right to stay with their child. In our SIDS cases, I'm sure it is helpful to see people working diligently to try and save the child, but nothing they are doing is bringing back a heartbeat. It's hard but would it be any easier for the parent if they thought that the case was treated like a lost cause by the staff? We know it is most likely a lost cause, but we do our best anyway just in case it isn't. We pray for a child that will not be deprived of 02 for long who can be revived. It just sadly rarely happens. :(

Up Vote Up Vote ×

i dont know what happen to the survey. I think most people wants to see their loved ones during codes. I understand many people want to see their loved ones being taken care of by all means. I also understand that some patients dont mind letting their loved ones remain in the room during any procedure that has to be done for them. But what about the nurses, doctors, anesthesiologists, nursing aides, and respiratory techs during the codes???? In my opinion, i dont mind really for them to watch as long as they dont interfere. Lets say Im inserting the IV line but I keep on missing the vein and look at the patients wife and saw her crying, telling me "what are you trying to do?" i will politely ask her to leave the room. What do you think? if you are the wife, would you feel offended????

Up Vote Up Vote ×
Specializes in eye.
i dont know what happen to the survey. I think most people wants to see their loved ones during codes. I understand many people want to see their loved ones being taken care of by all means. I also understand that some patients dont mind letting their loved ones remain in the room during any procedure that has to be done for them. But what about the nurses, doctors, anesthesiologists, nursing aides, and respiratory techs during the codes???? In my opinion, i dont mind really for them to watch as long as they dont interfere. Lets say Im inserting the IV line but I keep on missing the vein and look at the patients wife and saw her crying, telling me "what are you trying to do?" i will politely ask her to leave the room. What do you think? if you are the wife, would you feel offended????

YES I would, I am there because I chose to be with my loved one,not to criticise you on what you are trying to do. I WANT TO BE THERE, and if this happens to be my husband for instance, I WILL NOT LEAVE. On the other hand, I have been a EMT for many years, and done CPR on a few persons. I was focused on what I was doing, and did not even know who was in the room at the time.

Up Vote Up Vote ×
Specializes in Med-Surg.
i dont know what happen to the survey. I think most people wants to see their loved ones during codes. I understand many people want to see their loved ones being taken care of by all means. I also understand that some patients dont mind letting their loved ones remain in the room during any procedure that has to be done for them. But what about the nurses, doctors, anesthesiologists, nursing aides, and respiratory techs during the codes???? In my opinion, i dont mind really for them to watch as long as they dont interfere. Lets say Im inserting the IV line but I keep on missing the vein and look at the patients wife and saw her crying, telling me "what are you trying to do?" i will politely ask her to leave the room. What do you think? if you are the wife, would you feel offended????

Valid concerns of course, and if you allow family members in there is going to be the occasion when the family member gets hysterical and tries to interfere.

While I do advocate for family presence, there are some families that should not be invited in or should be asked to leave. Nothing should disrupt the code. Families should not be allowed in without a specific person, preferably one who has been inserviced, preferably a chaplain, assigned to be there with them. Not always possible in all situations, particlarly short-staffed rural areas.

Most concerns of staff members present in the code are usually lessened after they experience family presence a few times. Some studies show that while many object to family presence, after training and after experiencing it a few times, less object afterwards. These studies of course are biased because they are only done in one hospital at a time and not widescale, so the results can't be generalized to all hospitals. But the results are encouraging nonetheless.

Up Vote Up Vote ×
Specializes in er, pediatric er.

I would want to be there if one of my family was in a code situation. I work at a Children's Hospital where parents are allowed to be present with their child even during code situations. I am all for this if the family does not get in the way. We usually pull up chairs just outside the room. We have a staff member who explains what is going on. If the parents are not agitated or becoming a danger to the staff, I am an advocate of the family being present. I think it can actually cut down on lawsuits because the family sees firsthand how hard the staff worked to try to save their family member. When they don't see what is going on, they have to take our word for it and they might be more suspicious of us because they did not personally see what transpired.

Up Vote Up Vote ×

I have done alot of research on this...

bottem line ....

it is great for families, lawsuits go down, they recognize how hard we work, they greiving time is lessened as they were there when the patient died.

bad for staff, no black humour, no off the cuff remarks, fear of not being "perfect" with family watching leads to staff burnout, and hence the best staff to care for the patient leaving.

Now becomes a rock and a hardplace.....what is better......families or staff.

I wish I knew the answer, but I do not have a master's or work in an office, I am on the floor so someone bigger then me will answer this question.

Up Vote Up Vote ×
+ Join the Discussion