A Descriptive Study of Chaplains' Code Blue Responses.

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Family presence during resuscitation is the compassionate practice of allowing a patient's family to witness treatment for cardiac or respiratory arrest (code blue event) when appropriate. Offering family presence during resuscitation as an interprofessional practice is consistent with patient- and family-centered care. In many institutions, the role of family facilitator is not formalized and may be performed by various staff members. At the large academic institution of this study, the family facilitator is a member of the chaplain staff.


To examine the frequency of family presence during code blue events and describe the role of chaplains as family facilitators.


Chaplain staff documented information about their code responses daily from January 2012 through April 2020. They documented their response time, occurrence of patient death, presence of family at the event, and services they provided. A retrospective data review was performed.


Chaplains responded to 1971 code blue pages during this time frame. Family members were present at 53% of code blue events. Chaplains provided multiple services, including crisis support, compassionate presence, spiritual care, bereavement support, staff debriefing, and prayer with and for patients, families, and staff.


Family members are frequently present during code blue events. Chaplains are available to respond to all such events and provide a variety of immediate and longitudinal services to patients, families, and members of the health care team. Their experience in crisis management, spiritual care, and bereavement support makes them ideally suited to serve as family facilitators during resuscitation events.






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Tennyson, Carolina D, John P Oliver and Karen R Jooste (2021). A Descriptive Study of Chaplains' Code Blue Responses. American journal of critical care : an official publication, American Association of Critical-Care Nurses, 30(6). pp. 419–425. 10.4037/ajcc2021854 Retrieved from https://hdl.handle.net/10161/24033.

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Carolina Tennyson

Assistant Clinical Professor in the School of Nursing

Dr. Tennyson is a board-certified Acute Care Nurse Practitioner who provides evidence based care to advanced heart failure and critically ill patients in a fast-paced academic hospital. Her Doctor of Nursing Practice degree was awarded in 2016. She is an Associate of the American College of Cardiology and a Certified Healthcare Simulation Educator.

She is the Director of the #1 ranked Adult-Gerontology Acute Care Nurse Practitioner program in the United States at the Duke University School of Nursing and an Assistant Professor in the Masters of Science in Nursing programs. She is an avid advocate for Advanced Practice Nursing, particularly their role on the Cardiac Critical Care team. Her research interests include resuscitation quality improvement, Family Presence During Resuscitation, and microlearning education.


Karen Roussel Jooste

Assistant Professor of Pediatrics

Karen Jooste, MD, MPH is a palliative care physician and pediatrician at Duke University. She works on the Pediatric Quality of Life team at Duke Children’s Hospital and Health Center, and with adults in both palliative care and hospice care. She completed her residency in Pediatrics at the Children’s Hospital of New York at the Columbia University Irving Medical Center, her Master of Public Health at the Mailman School of Medicine, Columbia University and her Hospice and Palliative Medicine Fellowship at Duke. She trained as an Integrative Health Coach at Duke Integrative Medicine in 2012. Her passion as both a clinician and an educator, is the intersection between communication, racial and gender equity, ethics and medical humanities (narrative medicine). 

Dr. Jooste teaches narrative medicine to interprofessional students (Medicine, Nursing, PT and PA students) through the Trent Center at Duke and co-leads annual workshops at Duke Integrative Medicine in Leading Others in Writing for Health.  She is a Faculty leader and educator in the Clinical Skills Foundation Course at the Duke School of Medicine.  She is trained as a VitalTalk trainer and facilitator in Advanced Communication Skills and teaches as part of the PEACCE Corps Education Team (Promoting Equity and Alignment of Care via Communication Education).  Dr Jooste is the Vice Chief of Diversity, Equity and Inclusion of the Division of Palliative Care. She facilitates workshops at Duke called Conversations with Colleagues to promote and strengthen diversity, inclusion , antiracism and belonging.  

One of her favorite roles is as a coach for the Duke Residency Professional Development Coaching Program.  She also serves as an Ethics Consultant at Duke University Hospital and as a member of the Professional Accountability (PACT) team, promoting professionalism.


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