Should parents be allowed to watch all procedure being done to their child in the ER?

CHUBBY · Nov 13, 1998

As a general rule, most ER nurses allow parents to stay with their child during treatment, depending on the treatment. I usually ask parents if they want to stay during suturing (as an example) because I can't tell ya how many times I've picked parents up off the floor because they got vagal. Its hard enough to hold onto a fighting 2 year-old who getting his head lac sewn without having to worry about picking up dad off the floor (never mind the incident report involved).

belle16 · Nov 14, 1998

In our ED we have found that suturing children is best accomplished by having the parent lie on the cart next to the child wrapped in a hug. They seem to feel secure that way. However, in procedures such as LP's usually the children are extremely ill and probably will only vaguely remember the procedure itself -- but the parents are terribly traumatized and will always remember. Children are also affected by parental anxiety, whether from a prior hospital visit or just generally. How many times have you heard a parent threaten a child with "They're going to give you a shot if you don't behave!"?? Treating the child as an individual with explanations and answering questions usually produces the best result, cooperation and less trauma, both for them and the parents.

mommatrauma, RN · Mar 6, 2005

I always give the parents the choice...but I always paint a picture for them, so they know what to expect...no surprises makes for a smoother procedure...parents as I am one, know what you are doing is supposed to be helpful, but its their baby..and maybe you've done this procedure a thousand times and little Johnnie's screaming doesn't faze you anymore...It is still traumatic to the parent...usually more so than the child...I have this little trick w/parents that I do...say for instance its IV time...I tell them what I am going to do...I warn them ahead of time it will be difficult b/c small veins, sick child blah..blah..blah...but then I paint a hero picture....I always say, you can certainly stay...but what may be more helpful is if you step out and let us do what we need to do and then when it is all done you can come back in a rescue susie because she'll need a big hug...and that way she won't associate parents w/pain and may make for a better post-procedure recovery....However, if the parents are adament about staying...they stay...but are instructed the same way, and told how they can be there and helpful without interfering in the procedure...

unknown99, BSN, RN · Mar 6, 2005

Absolutely, the parents should be involved in every aspect of their child's care.

Owensaunt · Mar 6, 2005

No Way. Parents can usually come in with kids to keep them from completely freaking out if the anesthesia attending did not write an order for versed- but as soon as their eyes are closed the parents need to be removed so that pt can get ET tube or positioned properly without parent thinking that we're hurting their child.

mattsmom81 · Mar 6, 2005

My son was in the ER as an infant and they were worried about meningitis...did an LP. I held him during the procedure. I was a nurse he knew however and I doubt the ER doc would have allowed all parents to hold. Quite a risk all around IMO.

I don't insist on staying during family member's procedures. A few years later my child needed an EGD. In these procedures the docs were uncomfortable with me in attendance so I did not insist. If the staff is not comfortable with me present, I leave...I want them comfortble and focused on my loved one.

Too many times I've been stressed by overbearing family who take me and my energy away from my patients. I would never do that to other nurses/docs. I give them space so they can do their job.

ktwlpn, LPN · Mar 6, 2005

[quote name=mattsmom81 If the staff is not comfortable with me present, I leave...I want them comfortble and focused on my loved one.

.[/quote] Can I quote you? We don't have this problem as often in LTC but try getting an Alzheimer's patient to focus in on you and co-operate while 2 or 3 family members are yelling "Dad! Stand up" or "Mom Take your pills" Simply getting a mod. assist resident from bed to chair can be dangerous for all involved when you have the interfering wife darting around trying to starighten clothing and give directions...no matter if she was a nurse 50 yrs ago-these people have to try to maintain control...they are the bain of our exisitence in LTC...

Trauma Columnist · Mar 7, 2005

We allow parents in the room if they want to be. Like one poster said - we paint a graphic picture of what they will see and we provide them with a chair and instruct them to stay there (we move it right next to the bed). We've had good luck.

Speculating · Mar 7, 2005

I am a nursing student and I was wondering
people feelings on allowing parents, if they choose to be, in the room at all times when their child is being treated in the emergency department. Should there be any
procedure that the parents should not be allowed to watch? I feel that the parents should be allowed in the room the whole time if they so choose to be. If the parent is
interfering 0with the treatment of the child then they should not be allowed to stay. I feel allowing the parent to stay would benefit both the child and the parent.

There are a couple theories involved here, but yes they should be given the choice to stay in the room. If it's painful the parents can come in after the fact and be the saving grace. Saving the patient from the mean people. It helps create a stronger child parent bond. However if they stay in the room they must remain seated at all times with a guestamation I've assisted a dozen or so parents up off the floor. Then you end up sewing them up too. There's no one big enough to keep me out of the room. I'm also an advocate for letting a couple close relative/decision makers in during a code as long as the stay in the corner and out of the way.

needsmore$ · Mar 10, 2005

we also allow parents at the bedside. they do not hold or immobilize their child for any procedure-they are there to support, hug, comfort. parents should not be used to help restrain a child for a procedure-

all parents must sit if staying for suturing ( i've had a few hit the floor that would not sit)

we allow parents at resuscitations as well-as long as they do not interfere with the care being provided. they are with a knowledgeable staff member who is explaining all aspects as it goes along. we get them right next to their child as soon as possible if that is their wish.

anne

ScarlettRN · Mar 11, 2005

Along these same lines, when it is a newborn that they are working on in the nursery and the whole thing is going on right in front of the window, do you think the curtain should be closed if it was left open? I came across this situation and really struggled with the right thing to do. I was the supervisor at the time, and opted to close the curtain.

When I work ER, I always tell the parent that their job is to be the hero and don't let them restrain their child. Whether they stay or not is up to them.