I. Just. Can't....

Nurses Relations

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91yr old, end stage everything, family wants "everything" done despite multiple talks with MD's regarding what exactly is their expectation and how its not going to happen quite that way.. So when the pt coded, we got the family all close and personal with the code and all the rib breaking so that they could see that indeed we are doing "everything" .

Now they want to sue the hospital for battery and ABUSE because we broke the pts ribs during cpr....

I. Just. Can't......

Well that family certainly put you and and the hospital in a LOSE/LOSE situation. Very sad… all the way around. Poor Grandma. and poor nurses. I really don't think there is a case here… but the hospital has lawyers to deal with these things that probably happen a lot more than we realize. :/

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Specializes in nursing education.
I think it should be part of an ethical intervention that family members view what's going to be done during a code.

There should be a short video of what it looks like when a 150 lb nurse with adrenaline pumping, starts pounding on a 90 year old 80 lb chest.

Most of us form our opinions about healthcare by watching hospital shows on TV. Can you imagine a code on General Hospital? Is that even on anymore?

I totally agree with this. A video of what really happens would be great. CPR is the only thing you have to opt OUT of rather than make informed consent to, with the benefits and risks laid out. TV CPR is sooooo gentle and would never be effective in real life!

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Specializes in geriatrics.

91 years old? You're going to break ribs. When I'm admitting a patient, I review the code status with families. 9/10 they agree to no cpr when I explain that we will break ribs. That's absurd that some people would attempt to sue.

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
I totally agree with this. A video of what really happens would be great....TV CPR is sooooo gentle and would never be effective in real life!

I've not yet had to do or witness CPR. However, I saw an old episode of the tv show Cops in which a lady was found unconscious r/t ETOH and a trauma to her head.

They showed the police pumping so hard on her body, the officer himself becoming SOB and the camera man had to put his camera down to assist. It was very sad and emotional to watch. You could see the strain on everyone due to the emotional intensity and physical effort.

People don't understand that. )-:

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That's so sad, makes me really sad

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Specializes in Critical care.
I totally agree with this. A video of what really happens would be great. CPR is the only thing you have to opt OUT of rather than make informed consent to, with the benefits and risks laid out. TV CPR is sooooo gentle and would never be effective in real life!

I think I read somewhere that some hospitals are showing an educational dnr video showing a code to help a pt and their family decide. Most people make themselves DNRS after viewing. I might have read about it on this site.

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Specializes in Med/Surg, Academics.
They were irrational jerks before her death.

Still irrational jerks.

Wanting to sue and suing are two different things.

Suing and winning are two different things.

And thank god for that!

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Specializes in critical care.

We get patients all the time who in no way can be saved from their fates, and families overriding their wishes to simply die. I had one particularly heartbreaking one recently. She was in so much uncontrolled pain, with so many interventions being made, simply to keep her around longer. With tears in her eyes, she told me she just can't do this anymore. It is heartbreaking.

The family in the OP really needs some education. That's so sad. It sounds like they are trying to redirect their emotions toward something more tangible, since anger probably feels better than grief. I hope they find peace.

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Specializes in LTC.
Trust me, some smug, self righteous attorney will slither out from the under rock covered in fecal matter he inhabits and take the case.

Oops. I meant "under the rock." :)

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Specializes in LTC, assisted living, med-surg, psych.

Reminds me of the first time I performed CPR. The patient was in her late 80s and weighed about 90 lbs dripping wet; she had fallen at her nursing home and fractured her hip, so the family demanded an ORIF and insisted on full code status. Not surprisingly, her blood pressure tanked a couple of hours after she was brought up to the floor, and since I was the one to find her unresponsive and not breathing, I called the code.

I'll never forget that first compression. CRUNCH! The shock waves ran up my arms and made me hesitate for a couple of seconds. By then the code team was on board and someone yelled at me to continue. In the meantime, I could hear the family out in the hall arguing loudly with the attending that "everything" had to be done for Grandma or they'd sue the hospital. We wound up flogging that poor woman for what seemed like ages before the ER doc finally called it. What a mess.....the family was PO'd and accused us of not working hard enough to save Grandma. They just couldn't understand that the battle was over before it began.

I don't think they ever sued the hospital; we never heard from them again. Maybe they came to realize that we'd done everything we could. After that I went to my PCP and told him I wanted to be made a DNR. He was reluctant to sign the order---said I was "too young" to be a DNR---but he did it, and it remains in place to this day. No way do I wish to have my ribs separated and broken and my body pumped full of drugs, only to wind up on a ventilator and in pain. I've even warned my family that I will haunt them if they go against my wishes.....that's how strongly I feel about not being coded. :no:

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Oh wow. What a sad and horrible situation :( Ribs will crack no matter how old and fragile the patient is, so there's no law suit there. But how sad that the elderly patient couldn't go as peacefully as possible :( Some relatives never pass the denial phase, and they are the ones who always insist on a full code.

Death is a natural experience that everyone has to go through. Sometimes it's just best to let it happen when it's supposed to.

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Sometimes I want to see what is inside the heads of family members when they make these decisions. Do they hear what they want to hear and are in big denial? Are emotions and fear over-riding common sense and compassion?

How do you educate families, especially ones with a non-medical backgrounds and limited education about what happens in our world?

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