Emotional and Ethical Impacts on Healthcare Professionals Performing Cardiopulmonary Resuscitation

BackgroundMany studies exist outlining poor outcomes related to cardiopulmonary resuscitation (CPR) administered to patients who are elderly and/or have comorbid medical conditions with sudden cardiac arrest. Patients with asystole or pulseless electrical activity have worse outcomes. Studies show only 10% of patients with out-of-hospital cardiac arrest and initial asystole survive until they reach the hospital. Less than 5% survive until hospital discharge with good neurologic function.Research QuestionGiven these poor outcomes, the question arises: what are the impacts on the healthcare personnel providing this type of aggressive intervention?Study Design and MethodsThe study design was a cross-sectional, mixed-methods anonymous online survey of hospital personnel in one large academic setting. The survey included demographic questions and 6 questions regarding feelings around the use of CPR. Descriptive statistics were used to report on respondents and their responses. Thematic qualitative analysis of free-text responses was completed.ResultsOne-hundred fifty-four people of 780 (20%) responded to an anonymous survey sent to hospital personnel. Ninety-four percent of respondents were involved in a hospital code experience; 87% surveyed had performed CPR on an individual knowing there was a low likelihood of survival. Eight themes with subthemes were identified in the data. Participants primarily had challenging emotions associated with taking part in CPR including sadness and frustration.ConclusionsA large majority of healthcare workers surveyed in a single hospital system reported performing CPR on patients knowing there was a low likelihood of survival. Many respondents reported emotional effects.