family presence at bedside during resuscitation and or invasive procedures

Julie, RN · May 18, 2000

While I was working over this past summer as a student nurse extern in a VA hospital, we had a very unexpected code one night. The family was in the room when the cl started to code. Subsequently, the daughter, who was a nurse insisted on staying during CPR. The MD's were resistant to the idea, but she insisted. Although it was very emotional for her (and I-this was my first code), I think (in the end)it gave her peace of mind to know that everything possible was done to resuscitate her father. She did not physically interfere in the room, but did cry and yell alot. As a student, I did not know what to make out of the entire situation, so I just held her hand quietly. Sometimes words are better left unsaid....

Maggie LI · May 18, 2000

In my working hospital, we do not let relatives presence at bedside while doing resucitation or invasive procedures. We think those procedures will make the relatives sad and fear. We will ask the relatives wait at the waiting area a movement. After the procedures, we will let them come in again.

Trauma Columnist · May 21, 2000

I work in a large midwest level one trauma center and I do let pts families' at the bedside during resuscitation. I have had good experiences. It is necessary to have a nurse or social worker assigned just to the family so that everything can be explained. The physicians, residents and med students have varying degrees of comfort with this. I also did this in a VA hospital in Indpls several times, several years ago with good results also. It gives the family a sense that everything is being done. We don't do this all the time. I don't think it helps the families to see us repeatedly sticking their loved one, especially a child. Also CPR is aggressive, its a legitimate action in a code and one most lay people are familiar with. I don't allow families in during central line placement or a procedure where sterility is important. However, if there is time, I always explain to the pt and family what is going to happen and what they will see. Good luck.

mesue · May 24, 2000

Originally posted by JWV:
What is your feelings abbout this and what is your hospital policy. Have any of you read any articles on this subject.
JWV

I have had more famlies call a code than a doctor. They see all what we do and are able to let go of their loved one. I sometimes cry with them.. and I've been in ER for 10yrs and nursing for 20+ years...I'm still not done

hilary · May 25, 2000

Hi there I work in a general intensive care and although we let relatives be present when they are dying ie if treatment has been withdrawn we do not let them stay whilst there are invasive procedures going on and if the patient has a cardiac arrest than they are asked to leave alon with other relatives in to visit other patients.

How ever I don't think there is anything wrong in allowing relatives to stay during resuscitation aslong as there is a member of staff to stay with the relative as it can be a very frightening sight - Can you remember your first cardiac arrest???

good luck

Hilary.

Julie, RN · May 30, 2000

I just found this article on this topic and thought some of you may be interested: http://www2.nurses.com/content/news/article.asp?DocID={107FE39A-2DAD-11D4-8C3D-009027DE0829}&Bucket=Feature+Articles

Toots · Jun 1, 2000

Originally posted by JWV:
What is your feelings abbout this and what is your hospital policy. Have any of you read any articles on this subject.
JWV

ER nurse l5+ years, find the "new" family present during codes very stressful on the staff. The last two = one who claimed to be a "nurse" (but had little knowledge of ACLS procedures) watched, took notes, and critiqued the code; the second the family member took turns standing, sitting, pacing and sobbing the entire time and there was nobody on staff available to help her. The staff stress comes from having to mind your manners and NOT be able to fall into the "gallows humor" ERs are famous for - as unprofessional as it may seem to non-er people, the off the wall comment, is really a tension breaker and helps to keep the code team going during a long effort. Personal opinion is that family present is not a good trend and should be the exception rather then the usual practice.

maruko_t · Jun 2, 2000

I am totally agree to do so!!

countessvonH · Jun 8, 2000

I did a presentation on this topic for a graduate class. It is definately a double edged sword. I think it really depends on the sitation and the availablity of support personnel.

CEN35 · Jun 24, 2000

In most cases I think the family present during a code, is NOT a good idea. However, it does vary. Some families can be totaly out of control, and should not be present. Others, they are very well controlled and may be appropriate. In the ER the family is usally not prsent when FA's arrive by squad. If I had to vote one way or another, I would say NO.

Pediatrics, are different though. I feel it is in the parents best intrest to be present, so that they can see we are doing everything and anything possible, to help their child.

If it was my decision, I would say no, except for the parents of peds. If I was given a choice to be or not be present, with one of my own family members, I think I would feel the same.

CEN35

CEN35 · Jun 24, 2000

Invasive Procedures - I don't agree with any famaily members otyher than peds parents present. Past situations have proved to me that family members can be more of a nuisance than a benefit. My past experiences have shown, that the family members like to tell you where and how to do procedures, that they know nothing about. There have been times when they have been explained in detail, why certain things must be done in a certain way. Yet they insist on things their way? I alwyas ask the family members to leave the room for a procedure. If they refuse, I wait a while, until they leave. OR I come back and explain tothem that I need them to stay to the side of the room (which is a big issue, d/t small roomes here), and ask them not to interfere.

CEN35