I know this question is very similar to the other debate about family being present in a code, but it is something that really interests me.
As nurses, how do we approach the topic of code status? It is something that we have to deal with on a daily basis. When I’m getting report from the night shift, the first thing mentioned is the patient’s code status-whether it is full, limited, or DNR.
We deal with family a lot more than the doctors do, so my question is: When a family wants to discuss code status and whether or not to change from a full code to a limited or DNR, where do I begin? Obviously, I know to not give my opinion because that can get me in a lot of trouble. But, when you know that the patient is in critical or poor condition with a not-so-great prognosis, what do you say?
And if a family isn’t addressing code status and there is a need to talk about this, how would you go about talking about it?
As a new nurse always looking for new information, any you could provide would be great!
April 6th, 2009 at 11:36 am
You are actually the perfect person to talk to families about code status. You said yourself, you spend much more time with families than the docs do. You can explain what different things mean to them, like you would a surgical procedure.
Coming to terms with an inevitable death is also something you can help them with. If you know, and lots of times, they know as well, that the patient is dying, you can start the conversation about what the patient would “want”. Remind them that not attempting ressusitation does not mean, not providing care. Some people think that if their loved one will be ignored if they don’t want to be coded. Offer chaplain services. Chaplains are a great resource.
And, anytime you think code status needs to be addressed, call the doc and have him/her talk to the family about it.