[bjsmsn]

Could you all please give me suggestions as to what your policies or current practices are when one of the team has a family member having surgery. What is your position on having that family member on the OR team who is operating on that family member. I've got a nurse (team leader) who insists on participating on her father's total knee replacement surgery because she doesn't feel anyone else is competent to do the case. Are there any resources out there for support against this practice? Ethically I don't feel it is the right thing to do, but we currently do not have a policy addressing this practice. Thanks.

[Marie_LPN]

Our policy is that family is not to participate because (as your exaple shows) emotions get too involved, and can wind up hindering the care, or even worse. If this person thinks that no one else is competent, what makes her think that she will be emotionally and mentally stable enough to get the job done?

We have 2 OR floors, so what they try to do is assign the OR employee to the opposite floor that the family member is on.

[stevierae]

I don't think it's a good idea. My daughter, at age 4, was in a horrible auto accident and needed an emergency laparotomy for a lacerated liver. I was the OR night scrub nurse on call, and in fact had to go over to the ER at the end of my 3-11 shift to assess the trauma--it was my daughter. My husand was being brought in in a separate vehicle along with my other daughter.

I would LIKE to think that I could have put emotions aside and scrubbed the case as a detached but efficient and caring professional; however, someone wiser than I didn't give that option a second thought--she called in a replacement after explaining the situation to that person not on call. I really should not have even sat in the staff lounge--they ran by with the code cart, and I jumped to all kinds of horrible conclusions--she was fine; but they needed some pediatric intubation equipment that was on there. This was back in the early '80s.

No, I think a family member who is OR staff should function as FAMILY when a family member has surgery--wait in the lounge designated for families, let the OR staff do their jobs. Better for all concerned.

I would contact AORN at www.aorn.org for their thoughts, guidelines and any specific standards addressing this practice.

[bjsmsn]

Thanks. I have contacted AORN, but they don't guarantee a reply for 7-14 days and I need suggestions sooner than that. I fully agree with all the suggestions and reasons that have been given so far. I think it is a very unethical practice that could do more harm than good.

[stevierae]

Originally Posted by bjsmsn

Thanks. I have contacted AORN, but they don't guarantee a reply for 7-14 days and I need suggestions sooner than that. I fully agree with all the suggestions and reasons that have been given so far. I think it is a very unethical practice that could do more harm than good.

If you CALL AORN at the 800 number listed on the website, they will get right back to you, or you can even tell them that you have an urgent matter and need to speak with one of the experts NOW--or even the librarian--they will do their utmost to transfer you right then so that you can get an answer to your questions, and authoritative literature faxed to you, if need be. (They may, however, charge you for the articles, if you are not a member of AORN.)

I really would not call the practice UNETHICAL--I know surgeons who have operated on their inlaws---I just don't think it's using the best judgement.

[carcha]

Cant you go to your line manager and request advise at all. I would be very uncomfortable in this situation not to mention annoyed. one this person obviously dosent realize the tension her presence in the OR during this case will cause. None of the team should be under this pressure. Two dosent she trust anyone else to care for her relative, if not I would remind her that trust is a 2 way street. She needs to step aside or if not be forced to back away from this one.

[mcmike55]

I'm not sure what AORN says, but I whole heartedly agree that you should not be involved in the care of a family member.
Our hospital does not allow it. There is somewhat of a difference of opinion on what a "family member" is. Your dad, daughter, etc....sure, no question.
But what about a niece or other distant relative, like a 3rd, cousin, twice removed, what ever that is!
But seriously, most of the things we do are by instinct and training, ANYTHING that would cause you to vary could cause the outcome that you are working so hard to prevent.
That goes for family members, or if that happens to be the hospital CEO, on the table, like it happened to me.
He got my best effort, just like the pt before him and the ones that followed.

p.s. when I read the thread title, I thought you were going to talk about bringing family members in, like for induction before a T&A or somthing like that. My response was going to be..no way in H*LL !!!

[Marie_LPN]

Heck, one of the surgeons let his 18 year old daughter watch a hysterectomy he was doing the other day. What bothered me about it was that the pt.'s permission wasn't obtained for it.

[stevierae]

Originally Posted by Marie_LPN

Heck, one of the surgeons let his 18 year old daughter watch a hysterectomy he was doing the other day. What bothered me about it was that the pt.'s permission wasn't obtained for it.

That's a very legitimate concern, Marie, and I don't think OR management should have allowed it.

I know, even pre-HIPAA, when we did "Take Your Daughters to Work Day, " we had to specifically ask our patients if it was all right if our children, there for only that day, (and to whom we introduced them) observed their surgery. Most were very pleased to contribute to the childrens' learning experiences--however, it was absolutely their right to say no, and we had to respect that.

[caroladybelle]

Originally Posted by bjsmsn

I've got a nurse (team leader) who insists on participating on her father's total knee replacement surgery because she doesn't feel anyone else is competent to do the case.

Then the surgery should be done somewhere else where there are "competent" staff.

Not to mention, maybe she should go to work where she is surrounded by competent staff, if those that she works with are not "competent" enough.