"Thumping" out the door....?

[optimist]

Ok so Im in SNF. We had a code today. By the time we get to the room with the crash cart its obvious we're too late to do any good but because she was a full code we jumped in (or on) full steam ahead until EMS can get there.EMS rolls in, hooks up the monitor....flat line. They shock...nothing. They do all they could possibly do but like I said, it was obvious we were too late. So then they hook up this thing they called the "Thumper" that performed mechanical compressions and was basically hands-free CPR. They prepared her for transport with this attached and loaded her into the truck. My question is, why did they continue these compressions when it was clear that she was gone? My first thought was that perhaps it was to keep the circulation going in case she was a doner. But if that were the case wouldnt they be bagging her also? and are the elderly with multiple chronic diagnosis even eligible to donate? It was just disturbing watching this little ole lady convulse as shes being pounded on leaving our facility instead being treated gently in her passing.

[diva rn, BSN, RN]

Ok I am finally asking. What is LOL referring to in the medical world?? I have wondered for well over a year and asked someone and they didn't know either.

LOL

Is Little Old Lady.....:)

[diva rn, BSN, RN]

By the way, in Hospice, we pronounced death all of the time.

We had a set policy we used.

Then we would notify family, if they weren't already there and the funeral home.

We did not have to notify the medical director, he would round in the morning and sign off.

And dear Lord, we would NEVER call 911.....

[RNlovesherPharmD]

By the way, in Hospice, we pronounced death all of the time.

We had a set policy we used.

Then we would notify family, if they weren't already there and the funeral home.

We did not have to notify the medical director, he would round in the morning and sign off.

And dear Lord, we would NEVER call 911.....

Because you were HOSPICE. Most hospice facilities/programs require DNRs to be signed before accepting admission.

[diva rn, BSN, RN]

Dear RN,

I was alluding to a post where someone had stated that someone had paniced in a hopice and called 911

Do you know what the word "facitious" means............?

[RNlovesherPharmD]

I do know what the word facetious means, and how to correctly spell it--thank you.

Additionally, the quote button is certainly helpful in replying to certain posts when there are so many responses.

I do not claim to be an expert in any way, shape, or form on this forum--but I do have common sense, and proper spelling/grammar. I would think any nurse or student nurse would learn what I stated. Panic in your first, or any code for that matter, can happen----even in hospice.

[CT Pixie, BSN, RN]

It was a rhetorical question, Pixie. What also gets me are the Limited codes who want drugs but no compressions or shocks.

My bad, thought you were seriously asking why LTC had full code status residents :)

What really chapped my butt were the residents POA/guardian etc who couldn't be bothered to come in and sign the Code Status after several phone calls, letters etc to them. Until it was signed we were legally bound to initiate CPR. Then they would blow a gasket if we had to initiate CPR on their "loved one" you know,,the one they couldn't bother to come visit, call etc.

[diva rn, BSN, RN]

My understanding is that Hospice RN's can also determine death and set the appropriate events in motion for disposition of the body, but prehospital personnel won't likely deal with those situations very often because of the nature of Hospice... unless someone panics and calls 911.

I was assuming that you had read and perhaps remembered the former posts.

My bad.

Ah, yes, about the spelling. I apologize. It was not an area of concentration in my Bachelor's or Master's programs. Mea culpa.

I was also in a hurry and did not peruse my work before hitting the reply button.

Lesson learned. It shan't happen again.

All the best, in that long and illustrious career.

[akulahawkRN, ASN, RN, EMT-P]

[My understanding is that Hospice RN's can also determine death and set the appropriate events in motion for disposition of the body, but prehospital personnel won't likely deal with those situations very often because of the nature of Hospice... unless someone panics and calls 911.

I was assuming that you had read and perhaps remembered the former posts.

My bad.

Ah, yes, about the spelling. I apologize. It was not an area of concentration in my Bachelor's or Master's programs. Mea culpa.

I was also in a hurry and did not peruse my work before hitting the reply button.

Lesson learned. It shan't happen again.

All the best, in that long and illustrious career.

I've seen it happen. I've seen SNF/LTC facilities call for transport to an ER for a DNR patient that's in the Eternal Celestial Vacation... and they don't want the departure to happen there....

[VivaLasViejas, ASN, RN]

Ok, everybody, time out................take a deep breath, think before you hit the "post reply" button, and ask yourselves, "Is it true?" "Is it necessary?" "Is it kind?"

If your response is none of the above, PLEASE don't post it. Thank you.

[NRSKarenRN, BSN, RN]

Can we please remember to be nice to each other and forgive internet posting faux pas... I make plenty myself when tired or in a rush to work.

Per Medicare regs, Hospice can encourage but not require DNR status.

Had a request Friday afternoon for a Palliative care referral--that when I ead noted from VA hospital, showed that patient agreed to DNR and wife agreed to Hospice for spouse End Stage COPD with Stage 4 Lung CA, declining chemo + XRT .

Called wife to set up visit kept saying wanted Hospice for Oxygen "bad weather days... his brother suffered through treatment, we don't want that...don't talk to the sons who are home from college now, only to me...I work Mon thurs so you can come on Fridays to visit...he doesn't need a nurse now but latter".

Held three way call with Hospice program agreeing to Saturday admit visit. Lot more work to be done with family that Hospice Social Worker and nurses well equiped to handle IF they can get into home to visit.

[TheCommuter, BSN, RN]

Most hospice facilities/programs require DNRs to be signed before accepting admission.

In my five years of practice, I have unfortunately cared for several hospice patients that were still full-codes.

[~Mi Vida Loca~RN, ASN, RN]

In my five years of practice, I have unfortunately cared for several hospice patients that were still full-codes.

A lady that runs the Hospice in my county came and talked to our clinical group and she also stated they have full codes. She said although usually the person is DNR it's a myth that they HAVE to be, that there are always exceptions.