What to do with family members in a code?

Editorial Team / Admin · Feb 1, 2006

I recently took a PALS course and the MD who was the instructor made a comment that recent studies indicated that when a patient is in full arrest it is better for the family members to stay in the room if they desire. Parents have reported after a death it was comforting to be with their loved one during the last moments of life. In our institution we have always removed the family member and provided support for them during the code. Alot of the times the code can become very messy and if not conducted properly arguements can occur between staff. I was just wondering if anyone had any thoughts on this issue. Should the family be allowed to stay or should they be made to leave the room? I guess I would let them stay because I would want to stay in the room if it was my family......Michael :)

Here is a link on this very topic, mlock:

https://allnurses.com/forums/f8/family-witnessing-code-activities-117691.html?highlight=Codes+families

Keysnurse2008 · Feb 1, 2006

It depends on the family. If this is the parent of a adult/young child...who wanted everything done for that patient...and understood the staff had atttempted to "do everything" prior to them coding...it might assist them in the grieving process to realize how much effort went into saving their loved one. You should not not not have families in there who have been beligerant to staff etc etc etc...bc they are likely to escelate during the code. You should ONLY ONLY ONLY - no exceptions have a family member present when you have a staff member present whose only job is to fully explain what is going on.If you do not have that extra staff member present to fully explain what is going on .....then you may do more harm than good.Chest compressions, intubations, defibril(along with the subsequent burns afterward) etc etc....if they dont understand what is going on....if they dont have someone to explain it all to them......it could "appear" to an untrained lay person that you are actually harming them and cause more emotional trauma. So...really it depends on the family, their emotional state, and the presence of someone who can be designated to explain what is going on.I am not a big fan of it....I think for some family members...only some....that go thru those stages of grieving...they might get hung up on the angry phrase and it could cause litigation issues.Everything they witnessed could be called in to question....with families suffering from misplaced anger during this awful time for them. Even in the best run codes......you might have things go wrong.Medicine-nursing we all give it our best....but things can still go awry...it is an imperfect art.And for families loosing their loved one- they quite understandably want it to be a "perfect art". :saint:

mlock · Feb 1, 2006

Thanks you are very helpful. Never been on one of these before. This is all so new to me.....Michael

ZASHAGALKA, RN · Feb 2, 2006

Oh, I think my POV is sufficiently stated in the linked thread. . .

~faith,

Timothy.

noc_owl · Feb 2, 2006

I looked at the link, and it seems it was quite an interesting debate, but woo - 17 pages long! I read the first and last pages.

In most cases, I have to say that I don't like family in the room during a code, but it depends on the individual case. I think depending on the person, it could help bring closure, or be a traumatic memory.

Having said that, I have to say that I was present during a code on a child in which the mother stayed. There was a staff member who stayed at the mothers side and was very good at explaining everything that was going on. I think that due to that staff members expertise, the mother was able to stay calm, was able to understand what she was being told, and it was beneficial to her in her decisions regarding the childs care later. However, I don't think that would be the norm for most cases. It just happened to be the right people and temperments for it all to come together.

I know I would not be good at calming a family member and explaining everything in a code situation. Since this new way of, as it was said 'touchy feely', thinking has come about, who has had training on how to assist a family member through a code? No one I know of. Someone always comes up with these innovative bright ideas, but does nothing to facilitate the actual implementation of them.

moz · Feb 2, 2006

A few months ago I was called to the hospital because my grandmother was "sick". I met my grandfather sitting in the family room with 2 of my coworkers. I didn't know what was going on...I was under the impression she had died when I was called out of the room to "talk" to the doctor. I was actually, unknown to me, led to the room where they were coding her. I think if I had the choice and had been told what was going on, I would've went in...but I was sort of thrown into it. Then they asked if I wanted them to continue. I had no idea how long they'd been doing cpr or what drugs had been given. It was a very hard spot to be put in, and of course a burden I carry alone because my family would have a hard time understanding, no one else had made it to the hospital yet.

Just a different perspective to think about.