notifying family

[All_Smiles_RN]

The other night during a code, someone asked me to try and get in touch with the family. What exactly are you supposed to say to them when you call?

[ShayRN]

Working at a hospice, I tell them. I would be so scared that someone would come rush out to see their loved ones just one more time alive that they would have an accident. Also, some people don't want to come if they know that their loved one has died. They just ask us to call the funeral home and they go in the morning there to see them.

[Pepper The Cat, BSN, RN]

I've had to do this several times ( not always a code, but someone taken a serious turn for the worse).

I say " Your father/mother/wife/husband has taken a serious turn for the worse. The doctor is with them now. We are trying very hard to save them but I think you should come in right now". Sometimes I will elaborate and give more details, depending on situation (ie pt is having problems breathing, they are having chest pain, etc)

[TazziRN, RN]

Quote:

Originally Posted by TazziRN

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.

Posted by SharonH

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

Yes, I know it was Media's personal preference on how to deal with calling a family, that she (am assuming Media is a she) would rather wait until she knows the outcome before calling. I'm stating that if I were the family and someone like Media waited until the outcome was known to call me, I would be ranting and raving and screaming up and down the halls "WHY DIDN'T YOU CALL ME SOONER???"

[Rnandsoccermom]

I don't have a problem calling families in situations like this, I am generally very honest with them. I find most people appreciate someone they know telling them the truth at the end. I will only ask the doc to talk to them if they are known to be abusive or exceedingly unrealistic.

[mediatix8]

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 I disagreed with you politely on using vague terms when speaking to the family. While you're ranting and raving and screaming up and down the halls, let me stop you and tell you something. I've only been in one code where it was my patient who was coding. I admitted him, he was fine, and I was charting his admission on the computer. Then the telemetry monitor started alarming v tach. Went into he room with other nurses and he said he was fine. Then he died. CPR, code was called, crash cart obtained. One shock and he was in A fib, talking, and anwering questions. Then the code team arrived. ER doc was asking questions and I was answering them. By the time I had the chance to call his wife, the code had concluded and the patient was in the process of being transfered to ICU. There is no way I or anyone else could have left the patient to make a phone call any sooner than I did. I'm sure you would agree with me here and that was more like the scenerio I had in mind when I said I'd prefer to wait until the code has concluded. Not your scenerio, where the code is taking an hour and I'm twiddling my thumbs waiting to call the family. I've only seen a few codes and they are usually pretty fast, with the patient's nurse desperately needed in the room to answer questions, fumbling through the chart, reading their med list, history, latest vital signs, and how long ago they saw the patient. I think no matter how long the code is taking, if it is still going on then the patient's nurse should be in the room. I don't have a problem with idea of a nurse who is free to make a call to the family. However, from what I've seen, (especially night shift with fewer staff) everyone is needed and doing something in the code. In the few codes I've been in I have had to fetch many items- angiocaths to start IV's, dots, flushes, medications. Things come up and when one person is running to another floor to get more meds something else comes up and another person has to leave to fetch more things. What if the person calling the family ends up being needed (as happens more in the beginning, early stages of the code) for something and isn't available. This is a life or death situation and the patient comes first. When someone has the opportunity to call the family, from the few codes that I've been a part of, by that time the code is approaching an end. And yes, I do feel better calling the family with more information than the mere fact that they are being coded or "taking a turn for the worse." When you are honest and direct with the family, which is what I would personally want if it were me, they will ask you basic questions like what is being done and the patient's response. I prefer to have some answers and to give them an idea of what to expect when they arrive. I would hate to tell them their loved one was found not breathing and without a pulse and have no other answers or information beyond that, answering "I don't know" to all of their basic questions, such as how they are responding to treatment and if they alive. I think families have to right to know as soon as it is possible. Since anything can come up at any time during a code, I would wait to call the family until I'm sure I have a few moments time. I will not have a few moments time until the critical phase is over. The critical phase isn't over until you know the approaching conclusion to the patient's status.

[TazziRN, RN]

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.

Okay, let me tell you something:

THIS is the part I would be ranting and raving about. The quote above is from your first post and it's exactly the opposite of what you said in your post from today. Your post from today makes perfect sense and it's how codes usually go, whether they are successful or not. Your first statement sounds like you would prefer to wait until you know the outcome before calling family.

[pebbles, BSN, RN]

I wonder if the "calling DURING an emergency/code" thing is a matter of confidence and experience as well. I know the first four years (I swear it took that long) that I worked, any code or emergency would reduce me to a shaking bowl of jelly. I was ONLY able to focus on the task at hand. The TASKS. Much like a beginner nurse. The communication came later. First I was able to be the liason nurse going out to the waiting room to give the family info, and bringing them into the room. Only much later did I feel able to actually call someone on the phone. Maybe part of it came from being less certain myself of what was going on - it happens so quickly, and your mind takes time to process it all. I honestly felt that I would not know what to say.

Maybe units should be talking about this as a team. If it happens on their unit that family aren't getting called, talk about why. Maybe the charge nurse should be aware and either call herself or delegate making the call to make sure it gets done by someone who feels able to make that kind of call.

And yeah, I have no problem being the one to call to tell someone their loved one has died. If they have questions for the doc, I can pass the phone over. The doctor should definitely talk to them as well, either in person or on the phone if they are not coming in to the hospital. But i have no problem breaking the news. I don't see why that has to be the job of the doctor.

[Jilaweez, BSN, MSN, RN]

I agree with Tazzi, never wait, people always wish they had that one last chance to say goodbye. I'd never risk depriving somebody of that right. Call regardless of the outcome.

[acerila]

the social workers does it here. They are usually very brief, do it as soon as the code starts and go with the standard "the pt is not doing good right now, we would like you to come to the hospital right now". The family pretty much aways ends up making it and running in while the code is still going on.