Perceptions of slow codes by nurses working on internal medicine wards

Ganz, Freda DeKeyser; Sharfi, Rotem; Kaufman, Nehama; Einav, Sharon

doi:10.1177/0969733018783222

Cited by 9 publications

(6 citation statements)

References 34 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In regard to pretended care to convince families that all care was performed, this has been reported during CPR in other studies. 60,61 Study findings also revealed specific ethical challenges in the field of post-resuscitation care, which were disclosure of information, withdrawing care, and withholding therapy. Participants felt the disclosure of information to patients' family members is stressful and a source of ethical conflict, and that nurses can be hesitant to provide information.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis

et al. 2022

View full text Add to dashboard Cite

Background Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care. Objective To explore nurses’ experiences of ethical and legal issues in post-resuscitation care. Research design This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis. Participants and research context In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional content analysis. Ethical considerations The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected. Findings Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care. Conclusion There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges.

show abstract

Section: Discussionmentioning

confidence: 93%

“…In regard to pretended care to convince families that all care was performed, this has been reported during CPR in other studies. 60,61…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…How, then, does something occur that is inconsistent with legal obligations to patients and that seems so counter to ideas of compassionate and respectful care and so oblivious to the notion that there are things that medicine cannot achieve and should not do? Harms from futile CPR include disrespect for the dead individual resulting from traumatic and invasive procedures, potential harms to family members from learning that their loved one's body was subjected to these procedures, and harms to hospital staff from the moral distress resulting from participating in resuscitation efforts on someone who is dead or in “slow codes” (intentionally slow or incomplete responses to patients in cardiac arrest) 3 . So how do clinicians and hospitals arrive at the point where patients who are clearly dead, patients who have no prospect of successful resuscitation, are subjected to unequivocally futile intrusive and potentially damaging resuscitation efforts?…”

Section: Faulty Justifications For Performing Cprmentioning

confidence: 99%

Raising the Dead? Limits of CPR and Harms of Defensive Practices

Skowronski¹,

Kerridge²,

Light³

et al. 2022

Hastings Center Report

View full text Add to dashboard Cite

We describe the case of an eighty‐four‐year‐old man with disseminated lung cancer who had been receiving palliative care in the hospital and was found by nursing staff unresponsive, with clinically obvious signs of death, including rigor mortis. Because there was no documentation to the contrary, the nurses commenced cardiopulmonary resuscitation and called a code blue, resulting in resuscitative efforts that continued for around twenty minutes. In discussion with the hospital ethicist, senior nurses justified these actions, mainly citing disciplinary and medicolegal concerns. We argue that moral harms arise from CPR performed on a corpse and that legal concerns about failing to perform it are unfounded. We contend that such efforts are an unintended consequence of managerialist policies mandating do‐not‐resuscitate orders and advance care plans and of defensive practices that can value the interests of institutions and practitioners over those of patients. Health management teaching should include managerialism and its pitfalls, while clinician training should prioritize ethical reasoning and legal knowledge over defensive practice.

show abstract

“…Ein „slow code“ ist ein umgangssprachlicher Ausdruck für die irreführende Praxis, absichtlich eine suboptimale Reanimation durchzuführen, mit dem Vorwand, das Leben des Patienten zu retten. Es gibt Hinweise darauf, dass sowohl beim innerklinischen als auch beim präklinischen Kreislaufstillstand „slow codes“ durchgeführt werden, selbst wenn die Reanimation als nicht vorteilhaft für den Patienten angesehen wird [ 157 – 159 ].…”

Section: Evidenz Die Den Richtlinien Zugrunde Liegtunclassified

Ethik der Reanimation und Entscheidungen am Lebensende

Mentzelopoulos

Couper

Voorde³

et al. 2021

Notfall Rettungsmed

View full text Add to dashboard Cite

Diese Ethikleitlinien des Europäischen Rats für Wiederbelebung enthalten evidenzbasierte Empfehlungen für die ethische, routinemäßige Praxis der Wiederbelebung und für die Betreuung von Erwachsenen und Kindern am Lebensende. Die Leitlinie konzentriert sich in erster Linie auf wichtige Maßnahmen in Bezug auf ethische Praktiken (d. h. Patientenverfügung, vorausschauende Behandlungsplanung* und gemeinsame Entscheidungsfindung), die Entscheidungsfindung in Bezug auf Wiederbelebung, Ausbildung und Forschung. Diese Bereiche stehen in engem Zusammenhang mit der Anwendung der Prinzipien der Bioethik in der Praxis der Wiederbelebung und der Betreuung am Lebensende. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s10049-021-00888-8) enthalten.

show abstract

Perceptions of slow codes by nurses working on internal medicine wards

Abstract: Nurses should be educated about the legal and ethical implications of slow codes, and qualitative and quantitative studies should be conducted that further investigate its implementation.

Cited by 9 publications

References 34 publications

Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis

Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis

Raising the Dead? Limits of CPR and Harms of Defensive Practices

Ethik der Reanimation und Entscheidungen am Lebensende

Contact Info

Product

Resources

About