Should Nurses Allow Loved Ones to Watch a Code Blue?
Because I have been present too many times with my patients during the unnerving drama of a hospital CPR or a code blue scene, I question how good it would be for a family member to watch. It’s probably the most dramatically graphic and emotionally charged event I’ve witnessed as a nurse. The all-consuming helplessness that one can feel while it’s happening is probably the main reason I’d tell families not to stick around. Especially knowing that in all likelihood the outcome will be poor. How do families of a dying patient accept or cope with the result?
What Really Happens During a Code
Time stands still, from the moment the first responding medical team member pushes the big red emergency button next to the dying patient and yells “Code!” Staff members are drilled on how to act when it happens and everyone has an assigned role.
Within seconds the “code team” arrives. The room is filled to capacity with a frantic sea of nurses, doctors, respiratory therapists, lab technicians and voyeuristic students who stand against the wall straining to see what’s happening. It would look like chaos to a lay person.
I will venture to guess that family members who would opt to watch imagine that a code blue will be just like on TV—quick and clean with a happy ending. They need to be told it’s not like their favorite TV drama. It’s a long, drawn-out battle: blood, cracking bones, shouting, loud beeping, lots of needles and extreme roller-coaster-style energy — anger, joy, tears, smiles, terror, relief, frustration and exhaustion.
The team does their absolute best to have a positive outcome. This might be the sole reason for a family member to watch. They’ll see the dedication and effort that went into the attempt to save a life.
During my bedside nursing career at a hospital, I did a stint on a surgical step-down unit. It seemed that almost every shift I worked someone’s patient “crashed” and a code was called.
If it was my patient I would stay throughout the process. Even though I didn’t have a required role to play, I’d often step in and do a round of chest compressions. I felt that I owed it to my patient — a show of solidarity or support at the end. From a psychological standpoint, assisting with chest compressions helped me to feel less helpless.
A family member in the room wouldn’t be able to do anything but stand against the wall and watch. And they would feel extraordinarily helpless.
The WNYC Radiolab podcast “The Bitter End” (January 15, 2013) reveals some interesting facts about how doctors honestly feel about performing CPR when the outcome is often poor. During the podcast they discuss how many doctors, nurses, and other medical personnel do not want CPR done on themselves.
As a fail-safe, many have chosen to wear medical alert tags around their necks stating “No CPR.” Some have gone so far as to have it tattooed on their chests. If one of your patient’s family members asked if you they should watch what’s happening during a code blue, how would you respond?