Why should family presence be allowed in the ER?

It's difficult to guage this considering you don't know the complexities of certain family members, which can lead to distractions.

Right. So many times we as trauma nurses have to concentrate so hard on the trauma or code that has rolled in, that at times the family member doesn't really have someone that can work as an advocate for them and also the patient. They can't just be on "autopilot", for lack of a better word, and be exposed to the things being done for their family member.

I was in a trauma one afternoon and we were in the middle of a recuss, one of the staff brought in the member. She just opened the door and sasid, "Here you go. Just try to stay out of the way, or you'll make the MD mad and he throws things."

TraumaRU - you are right that we need a staff member that has the knowledge of how to relate to them what is going on, what is being done for the patient and why. I do try to gauge the responses they have, and I try to get them back out if needed depending on how the code is going. We've all been in those codes where Murphy's law takes over and things are dropped, lost, damaged, not pkged right from central supply after sterilized - or at least I know I've been in them.

We need a staff member that knows how or has experience relating to the family member at this critical time in their lives, and that can explain not just what we're doing, but WHY we are doing that for the patient. A little TLC and compassion can go a long way in making the family know we are doing so much for their family.

In this kind of thing, ignorance is definetly not bliss.
Anne, RNC

I once had an experience like that, where someone was that thoughtless. Now you've got a TWICE as big situation on your hands, and Good Luck with putting that fire out.

Yes, it does - if someone on the staff does that, whether it is intentional or not, it can lead to a bad situation. You're already coding the family member, you don't want to add anything else to the already critical situation. In our ER, we had the same thing happen. A nurse who thought she was being "businesslike", I am guessing, and a family member, the grandmother of the 6 month old baby that came into the ER in full arrest, also an RN, by the way, had a syncopal episode in the middle of the nursing station and when she hit the ground she got a big head lac. She was altered when she did arouse.

She had been taking care of the baby at home, who had a congenital cardiac defect - the pediatric cardiologist had told the family on their last appointment that the baby was basically terminal. There was nothing else the doc thought may buy the baby any more time. Grandma would not gotten in the way- she would have been ok if the nurse had just let her stand in the corner of the room out of the way. She knew her little one was not going to make it, I just hate the nurse didn't even let her come be with him. She ended up in CT then getting her lac stapled.

The nurse wouldn't even let her be with the baby after he was pronounced. After that nurse left, I found one of our rocking chairs and put it by the bedside and let her say goodbye to the little one in her own way. She was so very upset, but with tears streaming down her face, she hugged me and told me how much it meant to her to at least rock the baby one last time.

Just breaks your heart.
Anne, RNC

Thanks for this. Very interesting.

Once upon a time I was that patient having the lifesaving invasive procedures in the ER and my brother insisted on staying with me. He kept saying "I won't have her alone for this". They let him stay when the were doing chest tubes and everything on me. Of course, I don't remember it and clearly I am OK now. It is comforting for me to know that a family member was there and it must have been terrible to see what they were doing to me (he is a management consultant after all and a big sissy).

I hope if a member of my family is ever in a similar situation the hospital will let me do the same.