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

fotografe · Mar 11, 2005

Excellent idea on the parent lying down during suturing. I was helping to calm my daughter during suturing and never thought I would go down, and when it was all over I was desperately looking for a place to sit when the doc said boy are you white. More nurses came running in to keep me from hitting the ground than were treating my daughter.

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.

Jay Levan · Mar 11, 2005

:stone Im sorry but I've read all the posts here, and I see none that mention evaluation of a particular situation. Yes there are examples of generalities, but no mention of specifics. So I will ask a specific question, "Do any of you allow parents/significant others in with psych. (O.D.'s) even if it has been determined by someone, E.R. Doc, E.R. Nurse, etc. that this was only an attempt to gain attention?" Another question, "do any of the posters here evaluate their patient's parents ability to withstand the procedures they are about to witness?" Of course I believe that all medically oriented persons be allowed to stay, in an out of the way place if there is one, but my experience with non-medically oriented parents varies to widely to be sure of anyone's capbilities to a) allow me to do my job without interfearence. and b) not pass out during said procedures, there by splitting my attention to them when I should only be concentrating on the child I am responsible for. I have witnessed situations created by Doctors that believe they know everything about people, and allow entire families 8 - 10 - even more people at the bedside when a young girl went through her windshield, we hadn't even been allowed time to clean her wounds, (Her face appeared as shredded wheat, with ketchup!!) I begged the Doc. not to do this, and when he insisted, I politely excused myself from the room, alerting him that more than one would probably fall, they did and I wound up helping them up from floor, writing three incident reports and gained three more patients to take care of. These are only a few of the rediculous situations I have found myself in. I'm sure there are those of you who will critisize my lack of positive action in this case, but I did make my point, didn't I? :uhoh3:

barefootlady, ADN, RN · Mar 11, 2005

Parents of children (under 18) have a right and a duty to be present at the bedside of their sick and/or injured child until or unless they prove themselves to be a hinderance. They can then be asked to wait outside or, in some cases, be removed by security or city police to an approiate waiting area.

That is the premise I work under. The doctors here support parental involvement.

fergus51 · Mar 11, 2005

I think it always depends on what procedure is being done. I do think parents usually have the right to make that decision for themselves, but not always. Few people would argue that a parent has a right to watch their child's surgery for instance. The most important thing is that the child is treated, and if that is best accomplished with a parent in the room or outside, it doesn't matter.

needsmore$ · Mar 11, 2005

i think if the patient is under 18 and not an emancipated minor then parents should be allowed to be with their child. as a nurse, it is my responsibility to explain to the parent (legal guardian) what is going on, how it will be accomplished, side effects, etc. parents (legal guardians) have the right to refuse certain aspcts of care (as long as this refusal does not hint at abuse, neglect by it's omission). if after receiving this information, i often give the parent the opportunity to decide to stay and comfort or leave and "rescue". regarding ods.: i know the teenage drama crowd can make these decisions tough. again, the parent needs to know what is being done to their child and why. if the parental presence causes problems in giving care to the child, then the parent may be asked to leave temporarily so the care can be done. if parent refuses to leave, and their presence is detrimental to the child, then you have a whole risk management issue going on--- usually ods may involve involuntary commitment papers being filled out--a whole other subject for a thread we should start!

remember also that at a certain age we need the minor child to consent as well-i know that i will not hold down a 16 yr old for a blood test to be taken-if they refuse, i refer this refusal and all medical concerns to the parent. unless there is some underlying mental/psychological condition- after a certain age, children should be able to verbalize displeasure over the idea of certain procedures, but despite this, still be able to hold still and not need to be papoosed like a 2 yr old ( imo)

anne

Beachbum · Mar 11, 2005

Every situation should be evaluated. Sometimes the parents create more anxiety for the child. The parents should be told everything that is going to happen and to expect if need be they may be asked to step out of the room if needed. THe parents should not restrain or hold the child, there only job should be loving and comforting.

mcmike55 · Mar 11, 2005

Family in or out??? It poses a good question, that you can see, has many good view points.

There are several schools of thought. Many situational. It depends on where it is taking place, ED or OR for example, and who is involved as well.

Allowing a family member or two in a code does have some merit. I have heard that it allows closure, and shows the family that the staff, did indeed, do everything they could to save their loved one. I have heard some places have one nurse that stays with the family, explaining things, supporting them, and allowing them to leave if needed.

In the OR, I have heard of family being in the room during induction, and then leaving.

We have all heard the horror stories as well. Several here, people passing out, getting in the way of the staff, etc. One doc told me of a parent scooping their child off the OR table, partially under, and running down the hall!!

Parents need to be a source of comfort and support, they cannot be associated with a painful procedure, etc. I'm sure all agree here. I'm not in peds, so I'm sure someone could add insite.

The bottom line, in my mind, allowing family in during resuscitation and treatments should not be a spur of the moment idea. It should be organized and proper staff and training be available.

Mike