Allowing family members to remain with patients during CPR or resuscitative efffforts in the ED is not only a new concept but there are also differing views regarding this issue. Whereas some staff will do everything to keep family out of the room, fearing that the experience will be traumatic for them, others will keep them in the room thinking that they will see that staff has worked hard and done everything they could for their family member.
As an ER nurse, I think it is difficult to decide who can stay in the room and who cannot. There is not enouh time to get to know the family or assess how they might respond during treatment of the patient. I do not think that many people could tolerate seeing their loved ones intubated, central line place in the neck or groin, defibrillated, bedside tracheotomy, crichotomy or even a simple veinipunpure. This is a crisis situation for the staff as well as the the family.
List of reasons for family presence:
- Can advocate for the patient
- Provide emotional support, comfort and reassurance
- Ensure that all alternative therapies are considered
- Provide staff with important medical or social patient information
- Assist in decisions to end or prolong life
- Get the satisfaction of "being there" for the patient.
List of reasons against family presence:
- Unpleasant and traumatic memories
- Interferes with staff's plan of treatment
- Provide distraction to staff with frequent questioning and requiring explanation of treatment
- Presence at bedside might contribute to contamination of sterile field for example during insertion of central line
- lack of knowledge can cause family to believe that staff causes the patient more harm than good
Nurses are known as advocates, enabling and facilitating ways to assist patients and their families. In such critical times do we do enough to support the family, reducing their fears and anxiety and easing their bereavement?
Please see: http://www.emedicine.com/emerg/topic694.htm
5 comments:
Wow! I love the animated pictures! Good job. KK
Hi Loris.
I loved this page. First off, the moving photo of CPR in progress...well done... I tried for ages to have moving animations but I gave up...Maybe you could show me how to attach these files.
Also,
I worked in the adult ED for many years. At first, I was against families standing at the stretcher during resuscitation efforts. We often had to deal with the drama that unraveled secondary to witnessing a code.....however, I learned over time, that most people appreciate the efforts being made to save the life of their loved one...and often they feel as if "all that could be done...was done".
We have learned to anticipate all types of responses from family members...and for the most part...families do need to be involved and at the bed side/stretcher during a code...as long as resuscitation efforts are not hampered...
Thank you for sharing this page. You really did a nice job.
Ann-Marie
Hi Loris, it is nice to visit your blog again.
Maybe since you are in the education track, you can post instructions about how you put the animations into your blog. KK
I am very interested in the topic of family presence during resuscitation. Your posting was well organized and very informative. Does your hospital have a specific policy or statement in an existing emergency response policy relating to family presence?
Hi Loris,
Good job ! I love the animations, may be you can teach us to do the moving animations.I work in the ICU and we often come across tha families encounter during codes/ intubating the patient. What i have observed in my experience is that most of the family members appreciate what we do to save the lifes of their dear ones.They are more stressed when they stand outside the room unable to observe whats happening...
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