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Implementation of a Post-Code Pause

Extending Post-Event Debriefing to Include Silence

Copeland, Darcy RN, PhD; Liska, Heather RN, MPA

doi: 10.1097/JTN.0000000000000187

This project arose out of a need to address two issues at our hospital: we lacked a formal debriefing process for code/trauma events and the emergency department wanted to address the psychological and spiritual needs of code/trauma responders. We developed a debriefing process for code/trauma events that intentionally included mechanisms to facilitate recognition, acknowledgment, and, when needed, responses to the psychological and spiritual needs of responders. A post-code pause process was implemented in the emergency department with the aims of standardizing a debriefing process, encouraging a supportive team-based culture, improving transition back to “normal” activities after responding to code/trauma events, and providing responders an opportunity to express reverence for patients involved in code/trauma events. The post-code pause process incorporates a moment of silence and the addition of two simple questions to a traditional operational debrief. Implementation of post-code pauses was feasible despite the fast paced nature of the department. At the end of the 1-year pilot period, staff members reported increases in feeling supported by peers and leaders, their ability to pay homage to patients, and having time to regroup prior to returning to their assignment. There was a decrease in the number of respondents reporting having thoughts or feelings associated with the event within 24 hr. The pauses create a mechanism for operational team debriefing, provide an opportunity for staff members to honor their work and their patients, and support an environment in which the psychological and spiritual effects of responding to code/trauma events can be acknowledged.

St. Anthony Hospital, Lakewood, Colorado (Dr Copeland and Ms Liska); and University of Northern Colorado, Greeley (Dr Copeland).

Correspondence: Darcy Copeland, RN, PhD, Department of Nursing, University of Northern Colorado, Gunter Hall 2400, Campus Box 125, Greeley, CO 80631 (

The authors would like to thank the following people for their contributions and support: Jonathan Drout, Sara Rose, Melissa Thatcher, Beth Dunn and Jenny Lannom.

The authors declare no conflicts of interest.

Copyright © 2016 by the Society of Trauma Nurses.