NTI 2016: Family Presence During Resuscitation?!

Family presence during resuscitation is a hot topic. We are all faced with a better-informed public then ever before. allnurses recently discussed this topic with the expert: Dr Cathie Guzzetta. Nurses General Nursing Event

You are reading page 3 of NTI 2016: Family Presence During Resuscitation?!

Editorial Team / Moderator

Lunah, MSN, RN

14 Articles; 13,766 Posts

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I have always offered family the option to be present during codes in the ED, but it must be done properly — with a clinical person who can stay with family members and interpret events and provide support. I wrote a paper on this topic in grad school, and I was surprised to find in my research that despite healthcare personnel's fears that family presence would increase lawsuits, it actually did not have that effect at all. Family members have reported feelings of improved closure because they had the opportunity to be there at the very end. I think family presence is so important.

Btherese

7 Posts

I was faced with the situation my junior year of nursing school, only I was the family member. I was staying with my dad in the icu overnight (the previous night he had suffered a heart attack at home- my first CPR unfortunately). It was about 2am when he coded. The nurses asked if I wanted to leave and I refused. One lovely nurse stood next to me and walked me through everything they were doing. Telling me what rhythm he was in, everything. I'm sure I only heard maybe half of what she said but it made me feel better knowing what was happening and, God forbid they didn't get him back, at least he had someone that loves him right there. Note: they did get him back and he's doing better than ever!

I can respect the nurse's concern about having family there but from my personal experience seeing first hand how quickly they reacted and how hard they worked made me feel better about his care. Even if they hadn't gotten him back I would know that everything possible was done for him. And that's all I can ask for as a family member.

edmst

30 Posts

To me, this is one of the MANY issues with healthcare. Healthcare is so focused on "patient/family satisfaction" as if it is a hotel or restaurant. In an emergency, I don't want family members hovering around me with no clue to whats going on or being in the way while I'm trying to maneuver around them while they stand there and wail. An example, the other day a daughter in her 50's brought her mother in her 80's to the ED with a chief complaint of of being weak, dizzy, and not being herself for the past 5 hrs. EKG showed her HR was 27. Surprisingly her BP was around 110/70. This case could've gone bad realllll quick. As I'm trying to connect the pt to the pacer pads and crash cart and then try to start a large bore IV in the AC, the daughter was refusing me to start a line in the AC because "its uncomfortable when she bends her arm". I snapped at her because we need a large IV. She was also in the way because she was trying to find an outlet to plug in her cellphone. I was able to get a line and give glucagon and eventually the HR came up. But guess what, nothing I did will matter. The fact that I snapped at the family is what is gonna matter to administartion. Any nurse with years of experience knows this is always the case.

Boomer MS, RN

511 Posts

Specializes in Med Surg/ICU/Psych/Emergency/CEN/retired.
To me, this is one of the MANY issues with healthcare. Healthcare is so focused on "patient/family satisfaction" as if it is a hotel or restaurant. In an emergency, I don't want family members hovering around me with no clue to whats going on or being in the way while I'm trying to maneuver around them while they stand there and wail. An example, the other day a daughter in her 50's brought her mother in her 80's to the ED with a chief complaint of of being weak, dizzy, and not being herself for the past 5 hrs. EKG showed her HR was 27. Surprisingly her BP was around 110/70. This case could've gone bad realllll quick. As I'm trying to connect the pt to the pacer pads and crash cart and then try to start a large bore IV in the AC, the daughter was refusing me to start a line in the AC because "its uncomfortable when she bends her arm". I snapped at her because we need a large IV. She was also in the way because she was trying to find an outlet to plug in her cellphone. I was able to get a line and give glucagon and eventually the HR came up. But guess what, nothing I did will matter. The fact that I snapped at the family is what is gonna matter to administartion. Any nurse with years of experience knows this is always the case.

There is no one on this planet more frustrated than I am about "patient satisfaction scores" and Press Ganey, which I despise. From your story above, the daughter was in the way and interfering with your job. The Position Statement from ENA regarding "Family Presence During Resuscitation" was and is not advocating a disruptive scene as you described. I sense your frustration, and it is appropriate and understandable. I would have hoped another person (supervisor?) would have stepped in to facilitate the situation, but we all know that is not always possible. I've been there too. What I also see is that you gave outstanding care to a patient. I know administration can be very short sighted in these situations. I say, "Well, done EDMST." Do you know about Terry Foster, an educator and ENA leader? He showed me where to get the T-shirts that say, "I'm here to save your a**, not kiss it!"