NP role in a code

[NickB]

I am graduating in three weeks from an AC-PNP program and curiosity has gotten the best of me. I plan to work in a Peds ED and I'm curious if anyone can provide me with some info. I am curious if there is any state law pertaining to a nurse practitioner stopping life sustaining efforts in a code situation. I will be practicing in Florida and have not been able to find any definitive information on this topic. I have been a neo/peds flight nurse for the last 5 years and I have made the decision to stop efforts on a neonate, but I have called a physician into the room to agree with me before we stop and they have officially been the one to call it. Will this be the same if I am running a code as an NP? Thanks in advance.

[pro-student]

"Under current law, [APRNs] are able to pronounce death, ascertain the cause of death and provide the medical information required by the death certificate, but by Florida law, they are not authorized to sign the death certificate." This would seem to suggest that you could decide when to "call it" in a code but not sign the death certificate. In reality, however, this would depend on any policies the facility and/or collaborating physician have. I cannot imagine a scenario, however, when a kid is dying in an ED and a physician won't at least step into the room. Regardless of your previous experience, I would highly doubt you would be left alone to run a code in a hospital setting, particularly in the ED.

[traumaRUs, MSN, APRN]

As an APRN working in an outpt situation with a very ill population and no MD on site yes I do

[Dodongo, APRN, NP]

Our NPs staff the ICUs alone at night, and they do this. During the day, an intensivist is there and s/he will usually be present for each code, if able.

[NickB]

Thank you for your post. I just searched the bills referred to in the word document you attached and they both show that these bills were withdrawn. Where did you gather this information from? Do you have an internet link? Thanks again.

[OllieW, DNP, PhD, NP]

I worked in an LTACH in Florida as an RN (in a past life) and on the off shifts the RN ran the code and pronounced. We did always confirm with the attending via phone that he/she would sign the death certificate.

[Spadeforce]

back when i worked in the hospital the ER doctor would usually but some just called and asked if I needed a line if they did not have one or anything else (hard intubation, etc)

Codes are not entirely the most complex things to run, essentially just protocol, H and Ts and some common sense.

On paper hospital protocol said "NP/PAs can run codes and intubate in an emergency" so Unless it was an elective code (lol) then yes we could

[NickB]

Not questioning running a code. I'm questioning stopping a code.

[Neuro Guy NP, DNP, PhD, APRN]

Well there does come a point that the patient isn't responding to treatment. Can't expect to run the code indefinitely so there comes a reasonable point at which you abort. That's that. Now in the pediatric world that is an understandably hard thing to do, but after an extended period of true effort, nobody could blame you. No law against ceasing a resuscitation effort after its futile.