The CPR Code of Ethics for Nurses

The code of ethics for nurses states that they should make decisions in the best interests of the patient. Near the end of life, nurses often must decide whether cardiopulmonary resuscitation (CPR) should be performed or not, and if family members should stay in the room while CPR is being performed.

Patient Advocate

• The nurse should be the patient advocate and the liaison between the patient, family and other medical personnel. If the patient has an advance directive that describes his wishes, or a Do Not Resuscitate (DNR) order, the nurse makes sure it is followed. If not, the nurse should talk with the family about what the patient would want based on his beliefs or other decisions he has made, as well as whether or not CPR will enhance the patient's quality of life or prolong suffering.

Family Members

• Whether the family should stay in the room when CPR is performed is often debated. Patients may say they are comforted by having family with them during a critical procedure. Family members may say they want to be there for support. Often, it is their only chance to say goodbye.

Doctors

• Doctors often do not want the family in the room during CPR, saying they find it distracting at a time they need to focus. They are also afraid of lawsuits or personal attack if the CPR does not work and the patient dies. Doctors also say the family may be traumatized by seeing their loved one in distress.

Nurse as Liaison

• With so many differing opinions and wishes, the nurse acts as the liaison between the patient, family and other medical personnel. According to the code of ethics for nurses, however, a nurse is primarily the patient's advocate, and must always push for action that is in the best interests of the patient.

Expert Insight

• Both the American Heart Association and the Emergency Nurses Association advocate having the family stay in the room during CPR. They conclude that it is clearly what the patient and the family want; families do not report being traumatized by staying; and medical intervention does not appear to be compromised when the family is in the room.