Related Experiment Video
Updated: Sep 9, 2025

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Impact of "The Pause" on the Code Blue Team and Exploration of Witnessing Death
Kathryn Samai1, Jennifer Bonamer2, Shannon Ziegler3
1Kathryn Samai is a clinical pharmacist, UNC Health, Pharmacy Department-Decentralized Services, Chapel Hill, North Carolina.
Background:
Experiencing a patient's death after a resuscitation effort can be emotionally traumatizing to health care professionals. In a large community teaching hospital, the code blue team implemented "The Pause" as a coping strategy to support the well-being of the interprofessional health care team.
Objectives:
To assess the impact of the Pause on compassion fatigue, distress, and mindfulness and to explore clinicians' experiences with patients' death after a code blue event and use of the Pause.
Methods:
This multimethod study included preimplementation and postimplementation surveys and interviews of clinical and nonclinical health care staff who respond to house-wide code blue events.
Results:
The Pause intervention was implemented in fall 2021; 64 preimplementation surveys were collected in May 2021, and 74 postimplementation surveys were collected in August 2022. Compassion fatigue scores decreased after implementation, and mindfulness scores increased; however, neither change was statistically significant. During the COVID-19 pandemic, participants reported more distress from patient deaths after a code blue event. Qualitative interviews yielded themes such as the impact of the COVID-19 pandemic on death, emotionally coping with death, and the Pause as humanizing.
Conclusions:
The Pause was perceived as a helpful coping strategy for code blue-related patient death; however, the COVID-19 pandemic made it difficult to measure intervention effects. The Pause may also offer an opportunity to support and empower health care professionals during an impactful moment, such as witnessing death.
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