Need info from ER RNs for RN-BSN paper

[Annabelle07]

I need some info please. As an OR RN I don't know much about what goes on before the patient crashes into the OR trauma room, but I need some info for a paper I am writing. When a pediatric trauma patient comes into the ER, who bears the responsibility for communication with the parents and keeping them informed? When it is obvious that the patient will not survive, what resources do you have available to help deal with parents/families?

Thank you in advance!

[grapejuice01]

We have a team of 2-3 social workers who are in the dept from 7a to about 2 or 3a to assist families, keep them updated, etc. If its after 3a and we dont have a social worker available, usually it will be the clinical coordinator or the charge nurse.

In our ED, parents (or any family members that want to, really) are allowed to be in the room to witness the code if they wish. Our hospital has different grief resources and the social workers usually provide the family with all of the information before they leave-- they also call the parents a day or two later to follow up and answer any additional questions that they may have or assist in getting counseling, finding a support group etc that may be needed.

In the event of a miscarriage, our social workers work with the parents as well, but if the fetus is >20wks, the mother is taken to L&D where their social workers/nurses will clean up the fetus, take pictures for the parents if requested (very tasteful, by the way-- the fetus is wrapped in a blanket- usually a tiny cap is placed on its head, etc) and we have a garden where (if the parents choose) the fetus can be cremated free of charge and the ashes can be spread- there are also several support groups for miscarriages through the hospital as well.

[rjflyn, ASN, RN]

With 20 yrs. experience and several facilities behind me i can say that answer varies. It might be the charge nurse, the doctor, the social worker, the trauma surgeon, the nurse caring for the patient or even the paramedic who just rushed the patient in. Each situation is individual and fluid. There are no set rules. It is best to allow the ones who are the best at doing it do it and the ones who are best doing other tasks do what the do best.

Rj

[KatieBell]

I need some info please. As an OR RN I don't know much about what goes on before the patient crashes into the OR trauma room, but I need some info for a paper I am writing. When a pediatric trauma patient comes into the ER, who bears the responsibility for communication with the parents and keeping them informed? When it is obvious that the patient will not survive, what resources do you have available to help deal with parents/families?

Thank you in advance!

This so varies from hospital to hospital.

As a traveler I can give a few examples.

At a large metropolitan ER we had a kiddo code and die (Was actually dead before arrival). We mobilized the hospital chaplain, CHarge Nurse, a "resource Nurse" and Social Worker. and the primary nurse since there were 3 of us. On occasion the nurses aide has developed a good rapport with the family too and we use them (Depending on the aide).

At the tiny hospital I am at now, its the charge nurse, or the doc...there is no one else at night. During the day we have a case manager who I would call, but I never work days....

Hope that helps.