Code blue: family at bedside????

Okami_CCRN, BSN, RN · Apr 23, 2008

I strongly believe family should not be present at the bedside during a code. I believe that there should be a designated MD to periodically go outside and inform the family members of what is happening and what the medical and nursing team is doing.

I have seen family members get in the way of a code and not let us do what we have to do properly. Some begin to shake the person as we do CPR, some push us away and begin crying.

All in all every code is a different and calls for different measures. But for the majority of situations I strongly belive family members should be asked to move to the patient lounge or outside the room, to let the health professionals work on their loved one

allnurses Guide · Apr 23, 2008

It may be worth you doing a google search for witnessed resuscitation or family presence during resuscitation. There is a great deal of literature out there that would be helpful for your paper.

http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-6

http://www.resus.org.uk/pages/witness.pdf

were some I came up with.

Personally I feel that family should be present but only if there one dedicated person to talk them through what is happening and all members of the team are comfortable.

jjjoy, LPN · Apr 23, 2008

Do you have access to CINAHL & medical/nursing publications through your school library? The librarian can be a great resource to help find exactly what you're looking for.

txspadequeenRN, BSN, RN · Apr 23, 2008

a-men to this .....

i strongly believe family should not be present at the bedside during a code. i believe that there should be a designated md to periodically go outside and inform the family members of what is happening and what the medical and nursing team is doing.
i have seen family members get in the way of a code and not let us do what we have to do properly. some begin to shake the person as we do cpr, some push us away and begin crying.
all in all every code is a different and calls for different measures. but for the majority of situations i strongly belive family members should be asked to move to the patient lounge or outside the room, to let the health professionals work on their loved one

aeauooo · Apr 23, 2008

In my experience, families do not behave well during codes. The last time I was in a code in which the family was present, every family member pushed their way to the patient's head - I was doing chest compressions and was being pushed out of the way by the family!

Would we let family members into the OR during surgery, or in the room while placing a chest tube? Why on earth should we let them in the room while we're trying to reestablish circulation?

Watching the birth of a child is one thing, but if you want to be in the room when your loved one checks out, make her/him a DNR - I'll make her/him look comfortable, put chairs at the bedside and bring in a couple of boxes of Kleenex.

I know there are people out there who advocate for it, but IMO it's a bad idea.

YellowFinchFan · Apr 24, 2008

We've had family members throw themselves on the coding person, while we're trying to do chest compressions - had to pry them off - they lay on the floor crying screaming as we step over them to run the code (patient made it - went to ICU)....but still....it's not good when they are there - codes are chaotic enough.

estherojin · Apr 24, 2008

We would allow the patient's family to witness the tail end of the code, after we had exhausted most of our resuscitation efforts, so that they would know that we had done as much as possible to care for their loved one and be able to spend the last few minutes with the patient. it's worked well the few times we did it, only because there was an APN to explain what was happening. i don't think it's appropriate to have family witness everything such as putting in invasive lines, drains, etc, but that usually happens in the beginning/middle of the resusitation process.

LuckyoneRN · Apr 24, 2008

I think that allowing the family to witness the efforts (and results or lack thereof) of the healthcare team during a code, as long as there is a dedicated professional who can explain what is being done and keep the family from interfering with the code itself. I've been at codes where the physicians are willing to continue (past a reasonable point, IMHO), but the family steps in and tells everyone to stop (I'm assuming because, let's be honest, codes can be extremely "brutal" to watch). I also think allowing the family to see their loved one, the loss of a rhythm when CPR is held for a check, allows them to realize that the patient is "gone", and this sometimes can be beneficial for them in letting go.

I believe that there was a study done within the last year at UW-Madison by ANP's that correlated a better move through the grief process by family members who were present during a code than those who were not. Sorry I don't have a ready reference for this...

Trauma Columnist · Apr 24, 2008

The Emergency Nurses Association is a leader in this topic: www.ena.org

Family Presence in the Emergency Department Summary

anurseuk · Apr 24, 2008

If my family member were being resusitated I don't think I'd want to be present. Although we try to treat the patient with dignity etc sometimes when you're doing everything you can to save someones life the patient becomes like 'a piece of meat' although I'm sure that could be phrased a lot better!

You may be able to find some good articles here:

http://www.nursingtimes.net/index.html

or go through the athens website :specs:

Lorie P. · Apr 24, 2008

:nono: Some families can not handle seeing what is done to their loved one during a code, so I think they should not be in the room.

One code where the family members wouldn't leave, ( big wigs in the community and doc said it was fine for them to stay) we ended up having to send one family member to the unit cause she passed out and hit her head on the crash cart, didn't respond had a pulse and heart rate, found out her BS dropped to 32, boy was that a crazy code!

Also codes can get crazy, too many people and too much going on to stop and make sure the family members are doing ok when all efforts should be focused on the actual PT.

If they truly want to be present, make the pt a DNR, which is a whole other situation!

Just me and my thoughts!