family presence during CPR

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nurselily3

54 Posts

I have been on both sides of this issue. I started out as a nurse tech/aide on a telemetry floor, then went to the ICU. I saw several people code, some survived, some didn't. At the time, I got an adrenaline rush from it - helping the nurses, saving someones life, or trying the best we could to defeat someones "time to go".

Then, about a little less than a year of working my father had a lung transplant. He coded in the ICU after several bounces from unit to floor to rehab to floor etc. My mom called me on a wednesday to tell me he had been readmitted and was going to the unit. At 5 am the next morning she woke me up to tell me he was coding. Since I had seen people in the unit code several times before, I knew it was "controlled chaos" if you will. I asked to speak to the nurse. After she told me it had been 40 minutes, I knew it was over.

I drove like I was at the Indy 500 to the hospital...hoping by some miracle that he would be alive when I got there, knowing he wouldn't be. We they let us in the room, he was cleaned up with a sheet over him, a mess of heplocks and stuff under the bed. All I could think about was what they did to him..just like I'd seen so many times before. I thought about that for a LONG time. :crying2:

NO, as an RN...I don't think this should be common practice..to let your family in to watch this traumatic event. It gave me nightly nightmares for months and I didn't even see it! People want to remember their loved ones in a good light, not laying blue with someone pounding away at their chest.

In retrospect, this whole experience....HARD as it was...I feel made me a better nurse. Each family is different and being a nurse with good intution will make the right judgement call.

I also think that this is exactly why people should be told what it means to be a DNR. SO many times patients and families don't want to be pounded on but still want to be treated....they don't understand exactly what it means we will be doing, or not doing.

beth38

20 Posts

Could you clarify your question a little bit?

Is this a patient that has been brought to the ER by EMS, or family. Or is it a pt who is an inpatient? And should there be a difference?

bob

I am writing this paper based on the professional issues that nurses face when a patient is in the beginning of or the middle of resuscitation and the family request to stay with their loved one. Is it unethical for a nurse to go over the request of a doctor to have the family leave and allow them to stay anyway? What percentage of hospitals out there have policies protecting the nurse in this situation and can action be taken against the nurse by the attending physician if this happens? I have finished my paper but am interestin in hearing others perspectives on this subject.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

It is very true this is an ethical dilemma, but one you will be faced with throughout your career. In my hospital, we provide patient-centered care - so all of our doctors are very pro-family. I always offer to let the family in during a code. However, the caveat to this is, there must be a nurse ONLY for the family - no clinical duties at the moment. It can work.

lee1

754 Posts

community.nursingspectrum.com/ MagazineArticles/article.cfm?AID=9515 - 16k -

Try that link I found under a google search

AACN also has information

lee1

754 Posts

As a critical care nurse of more than 35 years I can tell you that you need to know the family and patient. Some families do NOT understand no matter what you tell them of the seriousness and futile efforts that extending life in terminal conditions is irrational. Letting them see for themselves what is done during a "code" to save their loved ones can give closure and help them understand as most people do not like to see their loved ones suffer pain. They will also be able to see that you have truly done all you can for the patient.

You also must dedicate a person to be with that loved one. We would let them stay outside the room able to look through the window as generally our ICU individual rooms were too small to allow personnel that was not actively involved in the code attempt. Some families can handle this, others cannot. They become an emergent medical problem themselves.

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