Traditionally, when a patient arrests in a hospital the family is taken away from their beloved ones to a waiting room while life-saving measures are initiated. For many years family members were not allowed in the room during the resuscitation because healthcare workers thought family presence would interfere with the resuscitation process, but the approach towards family presence has improved in recent years. (Wacht, Dopelt, Snir & Davidovitch, 2010). Professional organizations and national guidelines recommend family presence (FP) during resuscitation, and interestingly only 5% of US hospitals have a written policy on the family presence concept and follow the guidelines according to the policy (Oman & Duran, 2010). Evidence based practice has initiated the action for health care systems to ensure best practice and improve patient care and outcomes (Nykiel, Denicke, Schneider, Jett, Denicke, Kunish, Sampson & Williams, 2011).
Family presence during resuscitation is a new concept and is controversial in many situations. Healthcare provider’s attitudes, especially physicians and nurses, regarding FP have been studied for years. Emergency Nurses Association (ENA) defines FP as “the presence of family in the patient care area, in a location that affords visual or physical contact with the patient during invasive procedures or resuscitation events” and the guidelines define “family members as individuals who are relatives or significant others with whom the patient shares an established relationship” (Oman & Duran, 2010).
One of the first documented FP events occurred in 1982 at Foote Hospital in Jackson, Michigan. This hospital began the FP practice after two families had requested FP during resuscitation attempts. A surv...
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...ider, R., Jett, K., Denicke, S., Kunish, K., Sampson, A., & Williams, J. (2011). Evidence-based practice and family presence: paving the path for bedside nurse scientists. JEN: Journal Of Emergency Nursing, 37(1), 9-16. .
Oman, K., & Duran, C. (2010). Health Care Providers' Evaluations of Family Presence During Resuscitation. JEN: Journal Of Emergency Nursing, 36(6), 524-533. doi:10.1016/j.jen.2010.06.014
Twibell, R., Siela, D., Riwitis, C., Wheatley, J., Riegle, T., Bousman, D., & ... Neal, A. (2008). Nurses' perceptions of their self-confidence and the benefits and risks of family presence during resuscitation. American Journal Of Critical Care, 17(2), 101-112.
Wacht, O., Dopelt, K., Snir, Y., & Davidovitch, N. (2010). Attitudes of emergency department staff toward family presence during resuscitation. The Israel Medical Association Journal , 12(6), 366-70.
As a nursing student, I have had some exposure to death during patient care. My first encounter with direct death was witnessing a patient after attempted resuscitation efforts die in the emergency department. As I observed others reactions, I noticed I was the only one who seemed fazed by the preceding events and the end result, although I didn’t show it outwardly. During my Aging and End of life clinical rotation, I have been exposed to a near death experience with a family and I had the rewarding experience of forming a relationship with the patient’s wife during the short hour I was in their home. From reading the accounts in this book, it confirmed to me the importance of catering to the needs of the family and the dying as an important issue to address as they are critical to overall care.
Perceptions of Adult Hospitalized Patient on Family Presence During Cardiopulmonary Resuscitation. American Journal of Critical Care, 26(2), 102-110. doi:10.4037/ajcc20175550
When a patient is unable to make care decisions for themselves, it is necessary to involve those closest to them, most often family members. Providing a supporting environment to family members is another way that the best interest of the patient can be maintained. Families and friends can make a huge difference in the life of the patient after discharge. Instructing families in a way that is easy to understand helps eliminate potential barriers to communication. Families should be aware of what things to look for, what would constitute an emergency, and how to safely handle
Cullum, N. Ciliska D. and R. Haynes, Marks (2008;) Evidence – based Nursing: An Introduction.
Treating the patient and family as one, can have improved outcomes, decrease hospital stays, increased patient satisfaction, and improved reimbursements for the hospital. Developing a relationship with not only the patient, but family as well, can pay off in the long run by providing better communication, better quality of care, and trust. The patient and family can be strong advocates for improved performance improvement efforts. Including family in the treatment of the patient treats the “whole” patient through their hospitalization. Involving the family can enhance the patients care.
(2007). The 'Standard' of the 'Standard'. A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478. Patton, D. (2004).
The societal taboo associated with death and dying is only worsened when death becomes imminent for an infant or child. Pediatric death and dying is a seldom discussed and often evaded topic in healthcare. This topic, although somber and challenging, is relevant for those nurses who encounter pediatric death and dying first hand. The following discussion will define death and dying in a pediatric population, identify the role of the bedside nurse in support of the dying child and parents of child, the bedside nurse’s role in an interdisciplinary team on a floor where death is a common occurrence, and promotion of nursing self-care to combat compassion fatigue and burnout.
Puckett , P., Hinds, P., & Milligan, M. M. (1996). Who supports you when your patient dies?. RN, 59(10), 48-50, 52-3. doi: 1996037794
This is achieved through the close relationship of the family members the pediatric patient. Safety is increased because the family members are treated as part of the health care team and not simply visitors (Moore, Coker, DuBuisson, Swett, & Edwards, 2003). Furthermore, the patients are able to communicate with personnel about what they see happening to their child as well as making decisions regarding what treatments they want their infant to receive (Moore et al., 2003). The input from the patient 's family is very important in ensuring patient safety because the family members know the patient much better than medical staff (IWK Health Centre, 2016). This allows family members to more acutely notice changes in the pediatric patients status which allows them to quickly notify health care professionals. This could prove very beneficial when providing care for a pediatric patient in intensive
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
Wall, Y., & Kautz, D. (2011). Preventing sentinel events caused by family members. Dimensions of Critical Care Nursing, 30(1), 25-27. doi: 10.1097/DCC.0b013e3181fd02a0
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
The American Heart Association states that the goals of cardiopulmonary resuscitation are, “to preserve life, restore health, relieve suffering, limit disability, and respect the individual’s decisions rights and privacy” (AHA Guidelines for CPR). The practice of offering family members the opportunity to be present during CPR is a controversial ethical issue in emergency medical services. While the results of the study published on this topic in The New England Journal of Medicine clearly show no negative side effects from having families present during resuscitation attempts, the limitations of the study lend to the need for more research before it could be universally accepted.
Jacobson, Joy. "Tackling PTSD and ICU patients and their caregivers: studies suggest approaches to averting PTSD." American Journal of Nursing 110.12 (Dec 2010): 18(1). General OneFile. Gale. UMass Dartmouth. 22 Feb. 2011