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Sunday, September 1, 2013

Should loved ones watch a Code Blue?

There's an interesting article I found at by Julia McConnell called "Code Blue: Should A Loved One Watch?"  My gut instinct upon reading this title was: why would they want to? I mean, we're going to invade every piece of privacy that person has, and it's not pretty.  To watch that on a loved one would cause more grief than it's worth. 

Then again, I watched as my mother-in-law was being intubated, and my wife was in the room too.  We are both medical people, and we wanted to be there for her.  However, what good did it do?  It's just another memory that's never going to go away. 

On the plus side, though, it provides us both with some reassurance that everything was done and done right.  The doctors, nurses and respiratory therapist did everything they could, and they did it right.  That alone provides some reassurance.  Yet for someone whose not medical savvy, I can see no benefit from watching. 

Although, I think it should not be up to the medical professionals to decide.  If a family member wants to watch, so be it.  I would, however, recommend that they not watch.  I would kindly ask them to step out, although I would say that it's up to them.  We're going to be doing some things to your loved one that you might not want to see.

I think McConnell says it best as she writes:
I will venture to guess that family members who would opt to watch imagine that it 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 and 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.
Plus, when the family is watching, codes tend to last a lot longer. More sweat is used in CPR and bagging, more doses of epinephrine are inserted into the patient, and this is often done despite the people running the code knowing what the result will be.  Then, at some point, the doctor will say, "Well, does anyone else have any ideas?  I'm open to suggestions."  When you hear that, and no one has any answers, you know the outcome: "Okay, everyone can stop!"

Sorry to say, codes are not pretty.  I would recommend loved ones not stick around, yet it's their decision -- as is the way in our great nation. 


Anonymous said...

I think I agree for someone who is not medical savvy a code blue is not a pretty thing to watch if anything it can be traumatic for them. I honestly don't think I could watch a family member go through a code myself especially if that was going to be my last memory of them

steve respiratory said...

This topic is very open and highly debatable. Ultimately it is up to the loved ones to decide whether or not they want to witness this type of event. It is monumental though for the grieving process. One minute you bring mom into the ER for a fall and then while being informed of her status diminishing you are sitting in a waiting room. Someone walks through the door introduces himself as the Dr. and informs "we did everything we could and she didn't make it". So they invite you into the room and there lies a lifeless corpse that was you mother. How would you feel? Would you know everything possible was done? Would you feel responsible for lack of caring for her and making sure everything possible was done?
While it is a traumatic thing to watch your loved one being coded, it also leaves you with that understanding and memory of you tried your best to ensure that everything was done to save mom. As healthcare workers we understand what happens when the body enters that vicious cycle which turns to death. We see pupils blown and other significant findings which are sure signs of mortality. So we understand, but that doesn't mean that this medically lay person does.
The truth and reality are very uncomfortable, especially when you associate life with drama TV episodes. Most people would not want the memory of anything traumatic. It might give them "issues", but we live in a society in which we believe what we see and what we see is what we choose to. As healthcare providers we need to what we can for those who are under our care.

The 5 Stages of The Grieving Process:

1. Denial and Isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Anonymous said...

Never under estimate the power of denial.