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Lessons From the Code

Lessons From the Code

Susan Leys

One of the greatest lessons I ever learned in healthcare happened a few years ago when I worked in an emergency department as a crisis clinician. An adolescent was brought into the code room after experiencing symptoms of asthma. The team worked quickly and collaboratively trying to save him, but their efforts were unsuccessful and he died after about forty-five minutes.

The physician who had cared for the patient asked me to go into a nearby room and sit with the family while we waited for a member of the pastoral care team to come and offer the family support and assistance during this difficult time.

I quietly sat with the family and watched the patient’s mom as she sat crying while his dad (comforting his wife) recounted story after story about his son: his academics, how he was working on bringing up his grades and how he had helped his son to improve his grades by structuring the time he needed to get his homework done. Then he discussed his likes and dislikes, his time playing musical instruments and his love of baseball.

As a clinician, usually my preference is to engage in a discussion to help, assess and resolve the symptoms that I see. But as I sat listening to this young father, it occurred to me that it was more important just to be with the two of them. I listened intently to their reflections of his young life, and because I’m interested in helping patients navigate through the loss and grief process, I tried to analyze the progression of his thoughts. He told story after story after story about his son; for at least 45 minutes. I sat listening mostly – thinking ‘where is he going with this?’ as it seemed he was trying to find a resolution to what had happened; or just to try to make sense of something that had just happened quickly and tragically.

After a few more minutes, he stopped talking and looked directly at me before softly saying, “my son died knowing he was loved”.

I will never forget the look on his face when he said this; while he was still crying with his arm around his wife, the look of shock and disbelief transcended to a more peaceful sadness. A resolution in what was only the beginning of the grief process for this family.

I learned many lessons on that day from sitting with this family; but two of them still stand out:

The first lesson involves the importance of helping the families in your care navigate the beginning of the grief process. It may start right there with you in the code room (or even before that if they have had a long illness). As much as healthcare professionals need the defenses necessary to navigate the stressful situations we all encounter on any given day, we need to help families begin the process by embracing the connection we have with the family members and friends of the patients in our care. Their perception of that connection and our relationship with them supports the foundation of their grief process and provides them with the ability to begin to move forward.

The second lesson lies in the nature of the defenses we use. We use defenses when we (can’t / don’t want to / don’t know how to) discuss the feelings that we have. We see defenses every day: rationalization, intellectualization, justification, and humor – you name it – it’s there. But underneath it all – all of it, is the need that we all have to feel loved.

The team at RN-Coach.com (a subsidiary of Critical Success Strategies, LLC) offers individual and clinical team coaching and debriefing for healthcare professionals needing assistance after stressful, high volume periods or difficult patient cases in any healthcare environment. Contact us at 1.301.512.9928 if you would like to schedule a debriefing for your team or to obtain additional information. You can also visit us on the web at RN-Coach.com. We look forward to hearing from you.


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