Department: ask an expert
A: Family presence during resuscitation first came to light in 1982 at Foote Hospital in Jackson, Mich., when a wife demanded to be present at the bedside of her husband during resuscitation procedures. In 1994, the Emergency Nurses Association published a position statement that encouraged family members to be present during invasive procedures and CPR. This was supported by a 2004 practice alert by the American Association of Critical-Care Nurses. Since then, numerous other nursing organizations have shown support for this initiative, and hospitals across the country have established policies to support the practice.
Knowledge of your facility's resuscitation or crisis management policy is essential. If there's nothing in it to address the issue of family presence, establishing a policy should be considered. But what can you do in the meantime? There are several steps that can be taken:
- Remember that medical care of the patient is always the priority.
- Members of the resuscitation team must be in agreement that family members may be present. If family members are already present at the initiation of resuscitation, all members of the resuscitation team should be advised they're there.
- A family presence facilitator should be assigned to remain with the family. The facilitator can be a staff nurse, charge nurse, medical resident, social worker, or clergy member. The facilitator's role is to explain the medical treatment taking place and to answer any questions. It's also the facilitator's responsibility to assess the family's physical and emotional response to what's going on.
- The number of family members may be restricted due to lack of space. Any family member who becomes disruptive, feels faint, or interferes with patient care may be asked to leave.
- The family may need to be provided with personal protective equipment and instructed where to stand and what they may or may not touch. Instruct them not to use cell phones or cameras.
- After the resuscitation, the family may be escorted to a private area to address any concerns or needs.
At many institutions, there's an increasing focus on patient/family-centered care. Although many staff members are uncomfortable with the concept of family presence as an option, research shows that it's often a positive experience for family and staff.
Assessing barriers to family presence during resuscitation may be the first step in changing the long-standing tradition of excluding family members from a crucial aspect in the care of a loved one. Consider being an advocate in creating a policy at your facility that supports this change.
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Learn more about it
. American Association of Critical-Care Nurses. Family presence during resuscitation and invasive procedures.
. Emergency Nurses Association. Emergency nursing resource: Family presence during invasive procedures and resuscitation in the emergency department.
. Groopman J. Being there.
Guzzetta CE, Clark AP, Halm MA, eds. Presenting the Option for Family Presence
. 3rd ed. Des Plaines, IL: Emergency Nurses Association; 2007.