notifying family

Creamsoda, ASN, RN · Jun 8, 2007

One can only hope that the Doc would be the one to call, but if it was the middle of the code and they were still trying, then that may not have been possible.

If I had to call I would say

" Mr. so and so, you need to come to the hospital right away, your family member is extremely sick, and you should be here. " Dont go into long details, just that they need to get to hospital right away.

I dont think we as nurses are suupposed to tell the family they have died or not though.

TazziRN, RN · Jun 8, 2007

There is nothing that says nurses cannot tell the relative that the pt has died, but it's preferable that the news come from a physician if at all possible. In my initial phone call I give minimal info because I don't know what the person is capable of handling at the moment. If they ask questions then I will go into more detail....."Your father has taken a turn for the worse and the doctor is with him right now. Can you get here as soon as possible?"

At the end of the conversation I remind them to drive safely because they won't do the pt any good if they are injured.

CHATSDALE · Jun 8, 2007

in the hospital setting it was usually the md who called at the end of code if you have time to call in the middle of the code it could be anyone from ward clerk to available nurse

in the ltc facilities if a resident is pronounced at there then it is the obligation of the nurse who is assigned that resident to call family and break news and determine their wishes, frequently this is after a long illness and the news is not unexpected but it can be sudden also...very difficult part of nursing

SharonH, RN · Jun 8, 2007

I know this is a somber topic but I had to chuckle. On TV, they always show an attractive physician who comes out to explain to the family what has happened to their loved one and tell them there is nothing else they can do. In my experience, that almost never happens. In fact, I've had to call many a physician and explain to them what they needed to do after a death and even had to demand that a couple of them at least speak to the family and say sorry or something.

Since the task of telling the family that their loved one has passed or near death has fallen to me at least 90% of the time, I would tell them that there has been a change in their loved one's condition and they need to come to the hospital as soon as possible. You should sound serious without sounding panicky since the last thing you want to do is upset someone to the point that they are unable to drive safely to the hospital. If they sound emotional on the phone, ask them if there is someone available who can drive them or if there is someone they want you to call who can support them.

zacarias, ASN, RN · Jun 8, 2007

This is weird situation, I mean the code can be such a fast thing that how does one really go about calling the family and getting them to come before the docs call the code? Plus, there's usually confusion as to who should call. In my mind, the charge nurse should call because the primary nurse must be in the room during the code.

mom4josh · Jun 8, 2007

In my hospital, it is usually the charge nurse or the nursing supervisor who calls MD and family when a code occurs. We, too, usually just tell them that they need to come ASAP as there has been a condition change.

On my last code (at shift change, of course), the hospital chaplain called the patient's wife and told her that her husband had taken a turn for the worse and she needed to come to the hospital because he may need to be transferred to ICU. As the patient's primary nurse as well as charge nurse, I decided to wait with the chaplain until the wife arrived so I could speak with her. She lived close, so it should have only been about 15 minutes. Finally, AN HOUR LATER, she shows up, asks "where's my husband" WITH McDONALD'S FOOD IN HAND!!!

The chaplain took her to a quiet place to tell her that her husband didn't make it.

TazziRN, RN · Jun 8, 2007

It doesn't even have to be a nurse who calls. When my brother coded the unit clerk called and said "Dr. C--- wants you to come in as soon as possible."

mediatix8 · Jun 8, 2007

I try to avoid vague wording in situations like this. I know one nurse who, after the patient died, called the family and said their relative had "taken a turn for the worse" and they need to come right away. I would just hate to see people expecting their loved one to be sick but alive and walk into the room and see them dead. If they passed away, I tell them so. I work nights so getting an MD form the ER can take hours so if they haven't been pronounced yet, I tell them so. I say they passed but we are wating for them to be officially pronounced. I had a DNR patient on the verge of death and called the family. First I called the MD so I could tell them what the doctor said and what orders he gave. I told them flat out that he was dying and might not make it by the time they got there. I would just hate for them to come thinking he was alive but wasn't. That patient did make it for his family and died shortly after. In your situation, I would tell them that CPR is being performed on him and he may not make it. Although, I personally like to wait until I know the conclusion... they were coded and made it and are now in ICU or that they passed. You could suggest they have someone drive them to the hospital if you are worried about them getting into an accident.

TazziRN, RN · Jun 8, 2007

Although, I personally like to wait until I know the conclusion... they were coded and made it and are now in ICU or that they passed.

And if the code goes on for an hour and the family lives 15 minutes away? If I had found out that my brother had been coded for a while and nobody had called my parents and me, I would have been beyond pissed. Families have a right to know as soon as a change for the drastic worse has occured.

Blee O'Myacin, BSN, RN · Jun 8, 2007

Well, in that woman's defense, the chaplain didn't exactly tell her that time was of the essense - just that the patient "might be transferred to the ICU", that implies that he might not be transferred either. T he mind does strange things when a loved one is ill and that woman probably wanted an egg mcmuffin, doubtful that it had any meta-statement about her love or lack of love for her husband. My brother and I went out for breakfast the day our father died, because we were just tired of waking up at dawn and sitting at his bedside waiting for the inevitable. We slept in, had a late breakfast and when we got home, there were a few frantic messages from our relatives who were at the hospital. We got there 10 minutes before he died. I don't regret having breakfast that day - or sleeping in - but I wonder if the nurses thought that my brother and I were somehow odd for not keeping up the vigil when death was so close.

Blee

In my hospital, it is usually the charge nurse or the nursing supervisor who calls MD and family when a code occurs. We, too, usually just tell them that they need to come ASAP as there has been a condition change.
On my last code (at shift change, of course), the hospital chaplain called the patient's wife and told her that her husband had taken a turn for the worse and she needed to come to the hospital because he may need to be transferred to ICU. As the patient's primary nurse as well as charge nurse, I decided to wait with the chaplain until the wife arrived so I could speak with her. She lived close, so it should have only been about 15 minutes. Finally, AN HOUR LATER, she shows up, asks "where's my husband" WITH McDONALD'S FOOD IN HAND!!!
The chaplain took her to a quiet place to tell her that her husband didn't make it.

SharonH, RN · Jun 8, 2007

And if the code goes on for an hour and the family lives 15 minutes away? If I had found out that my brother had been coded for a while and nobody had called my parents and me, I would have been beyond pissed. Families have a right to know as soon as a change for the drastic worse has occured.

I think Mediatix was speaking of his/her personal preference.

Also, there really is no hard and fast rule for dealing with this situation. We should take our cues from the family. I have called more than one family to tell them that their loved one has taken a turn for the worse and one lady flat out told me not to call back until it was over. I've had others refuse to come for fear of assuming some financial responsibility. And still others who said if their loved one is dead, just let them know then and there.