A Summery Of Family Presence During Resuscitation And Invasive Procedures

From a pediatric perspective, the family is an integral part of the healthcare team. Parents are the primary ally and resource in providing individualized care for their child. Even in adult patients, who they are is impacted by the relationships that they have. Serious or chronic illnesses and injuries affect the entire family. The family, then, becomes the patient, particularly when it is necessary to make lifestyle changes.

Including the client as an expert member of the team creates an enhanced quality of care (Coad, Patel & Murray, 2014). In pediatrics, parents are often at the center of the child’s care. When asked to define what made the client care experience positive, parents stated that sensitivity, empathy and honesty were key factors (Coad, Patel & Murray, 2014). Working in healthcare, nurses can become desensitized to difficult experiences because they deal with them daily. Integrating the client and family as part of the healthcare team, allows the nurse to see the patient and family as a people first. By avoiding using illness as context, and instead using person as context, care will be more holistic (Coad, Patel & Murray, 2014). A family-focused approach helps to ensure that the whole family feels a part of the experience and is valued. In the case of bereavement, family centered care is particularly important. If the family is not included in the care from the start, it can provide barriers for grieving and impact how the family deals with loss (Jones, Contro & Koch, 2014). Nurses have an opportunity to help support the family through the grief process (Jones, Contro & Koch, 2014). Families have a significant impact on how the client heals, so by caring for the family’s needs, the nurse is indirectly caring for the patient. It is in the client’s best interest for the care to be holistic for the patient as well as the family (Jones, Contro & Koch, 2014). All

An interpretative phenomenology study is titled Family Presence During Resuscitation: A Double Edge Sword (Hassankhani et al., 2016, p.127). Family presence during resuscitation of a loved one can have benefits and risks (Hassankhani et al., 2016, p. 127). According to Hassankhani, Zamanzadeh, Rhmani, Haririan, and Porter (2016), family presence during resuscitation means that the patient’s family arrived or were already present where the resuscitation is taking place, which means that the family members can see and touch the patient (Hassankhani et al., 2016, p. 128). Some of the hesitations that medical staffs have about family being present include environmental, cultural, and social factors (Hassankhani et al., 2016, p. 128). Another factor that can be involved are the previous experiences that the medical staff has had with family presence during resuscitation (Hassankhani et al., 2016, p. 128). These experiences can have a positive or negative affect on the medical staff and affect their allowance of other family members during a resuscitation (Hassankhani et al., 2016, p.128). The study conducted by Hassankhani et al. (2016), included 12 nurses and 9 doctors in Iran that were interviewed about their feelings of family presence during resuscitation for 6 months (p. 128). The participants of this study worked in the most crowded hospitals and worked together during the resuscitation (Hassankhani et al., 2016, p. 128). The nurses in this study had to have at least a bachelor’s degree and the doctors had to have at least a general medical degree; all participants had to have 2 years of clinical experience (Hassankhani et al., 2016, p. 129). Initially, there were 500 codes during the 6 months (Hassankhani et al., 2016, p.129). After the interviews were conducted there were two themes identified: destructive presence and supportive presence (Hassankhani et al., 2016, p. 129). The destructive presence theme included the medical staff experiencing family interruption in their attempt to save the patient (Hassankhani et al., 2016, p. 130). One instance of this involved a family telling the doctor what medications should be given (Hassankhani et al., 2016, p.130). Another occurrence a nurse

In this view, the healthcare provider may include the family in terms of socioeconomic and functional support, but really focus on the patient as an individual (p.36-37, 2003). Family as Sum of its Members sees each member of the family in the foreground and care is provided to all family members. (p.37, 2003). Family Subsystem looks at the significant relationships in the family; parent-child, marital interactions, caregiving issues, bonding-attachment concerns (p.37, 2003), where Family as Client looks further into family’s internal dynamics, relationships, structure and functions and its relationship with the outer environment (p.37, 2003).

Discussion of family presence during invasive procedures has been ongoing for many years. Some healthcare organizations have instituted policies to allow family members to be present during invasive procedures, which they would previously forbid during these procedures. Attitudes of healthcare provider’s differ drastically. (MacLean et al., 2003) This paper will illustrate the important benefits of having a family member present during these procedures. Terms used in this search includes: Pro family at bedside, Importance of family at bedside invasive procedure, Family centered car in the operating room and position statement on Family presence. The following articles were deemed appropriate for this paper.

According to Erlingsson and Brysiewicz (2015), family is considered a core, social institution and is our first interaction with human beings. When viewing the family as a context, the nurse assesses the patient that is in need of care while in the background, there are the family members of the patient. According to Kaakinen, Coehlo, Steel, Tabacco & Hanson (2015), the source of support to the patient is his or her family members. Usually family members are in attendance with the patient. This approach is used when a mother is admitted to the intensive care unit after falling and sustaining head trauma. The patient is the mother. The nurse is focused on the mother and care was directed

Some family members seen family presence not only as an essential right but likewise as a mode of giving support to their loved ones in this emergency of life crisis. Though, some family could have concern about feeling sensitively traumatized and beholden to observe the code when families may prefer to decline. Patients besides believed that the family had the right to have their families present. Some patients alleged to felt safer and less frightened when family was present. But, other patients described that they desired to face death alone and did not want estranged folks to be permitted to invade their own privacy. Healthcare workers seen family presence as an occasion to preserve the self-respect and personhood of patients but be frightened physical assault by distressed family members, augmented threats of legal responsibility and subsequent litigation, and loss of control above the code situation. Captivatingly, all parties involved arranged that family presence during the code could result in exposing patients to extended resuscitations in medically fruitless circumstances because the trauma team may be unwilling to call the code in the presence of the family of the patient. In the past decade, nurses have progressively promoted for family presence. Nurses mostly agree that family presence could be favorable for both patients and families, if patients and families wish it. For the reason of this belief, nurses endure to advocate for their patients by making an effort to revise policies that limit family presence in the

If a family member goes into the hospital, it is not uncommon to have extended family visit the person in the hospital and even stay there. If a mother has her child in the pediatric ward at the hospital, all efforts to allow her to stay in the room with the child should be made.

Family members play a big part of providing care to a patient, rather it be comfort, or education, I would involve them in my patient care. To me, the patient isn 't just the "person" laying in the hospital bed. Every person has values that need to be respected and nurtured.

Restricting family presence contradicts patient- and family-centered care (PFCC). Within the PFCC paradigm, the patient and family relationship is recognized as an inseparable entity. Encouraging unrestrictive family presence through an open visitation policy can ensure patients and family members are provided with the opportunity to remain connected during a hospitalization experience.1 Despite professional organizations for critical care nursing and patient- and family-centered care advocating for unrestrictive family presence, many critical care units have not adopted an open visitation policy. According to the American Association of Critical-Care Nurses (AACCN),

Coping with a parent being seriously ill or the death of a parent can be extremely hard for children. They go through the feelings of loneliness, depression, and grief. When children are a witness to an ill parent or a deceased parent it causes an extreme amount of stress according to Buchwald, Delmar, & Schantz-Laursen (2011). Buchwald et al., (2011) also mentions that children may lose a sense of security when confronting a parent’s illness or death. Because of this, the child’s relationships are changed dramatically as well. The child must reestablish a relationship with the “healthier” parent since the other may be seriously ill or deceased. Like Buchwald, Koblenz (2015) also believes that maintaining a healthy relationship with the surviving or “healthier” parent will ultimately produce more positive results for the child that is coping.

Parents were shown to prefer shared decision making with the entire healthcare team. This lends support to the importance of teamwork and also its positive impact on families. Pediatric palliative care teams focus on coordination of care and collaboration with families and the team. This demonstrates how well suited integrative palliative care is to the provision of care for medically complex infants with life limiting conditions.

“Improved communication is noted as one of the most important factors in enhancing end-of-life care in a pediatric setting” (Hsiao et al., 2007). These factors are beneficial to maintaining the best care for the child. The relationship between hospital staff, the child, and the child’s family is crucial. “Parents have emphasized the importance of receiving honest and complete information from staff, having ready access to staff, and having continuous, caring relationships with compassionate staff “(Hsiao et al., 2007). Along with the parents’ communication with staff, parents feel it is important to have the child communicate directly with the physician when appropriate. They feel “gaining the child’s perspective is critical if there is to be a cohesive relationship among the child, parent, and health care provider” (Hsiao et al., 2007). Also, children who are able and comfortable enough to communicate with physicians benefit

Family is playing an important part in helping to ensure that patients are fit and following the advice of health care professionals. This is because the family is a foundation of support for everyone. At the same time, members can learn about what is impacting their loved one and what kind of procedures need to be followed. When this happens, there will be higher amounts of compliance as they will ensure that the patient continues to stick with their treatment protocol. (Saleeba, 2009)

According to the Society of Critical Care Medicine (SCCM), over 5.7 million patients are admitted annually to the intensive care unit (SCCM, n.d. ). Despite these high numbers, clinicians continue to debate about family presence during cardiopulmonary resuscitation (CPR). On the mist of these crisis, family members may not want to abandon their loved ones. Some would argue that families have a right to choose and ease their anxiety. Family presence during resuscitation (FPDR) comes with multiple advantages. One of the advantage of FPDR is, giving the family an opportunity to morally support their loved ones (Leske, McAndrew, & Brazel, 2013). Another benefit of FPDR is being exposed of the resuscitation process, which may help family member process their loss post-death. Despite these advantages the controversies include, the fear of the invasive procedure traumatizing families. (Leske et al., 2013).