Overview of the Issue
The participation of the family in a resuscitation process is a contentious issue. Most health care organizations do not have policies that govern the involvement of family members in the process. Consequently, most nurses do not know how to handle relatives of a patient during the process. The guidelines help to streamline the process as health care providers understand their roles. It prevents the likelihood of code team making decisions based on personal experience or opinions.
Some nurses perceive the presence of family members as interference. They claim that the members make them anxious, thus not being able to execute their responsibilities efficiently. The American Nurses Association’s Code of Ethics for Nurses stipulates “the nurse’s primary commitment is to the patient, whether an individual, family, group or community” (Fell, 2009, p. 145). Thus, nurses have a moral duty to consider the interests of family members during a resuscitation process.
Understanding the concept of family presence in resuscitation is critical to the nursing profession. It helps the nurses to abide by the established code of ethics. Nurses have an obligation to foster justice and observe fidelity in their profession. Giving family members the liberty to partake in the resuscitation process is one way of promoting loyalty and fairness in the nursing profession. Fell (2009) claims that the presence of family members during a resuscitation process helps build a good relationship between the public and nurses. A lack of understanding of the efforts that nurses make in an attempt to save life results in people having a negative opinion regarding the profession. Thus, allowing the family to participate in the resuscitation process may help to change the view that people have towards the nursing profession.
Summary of the Articles
Fell (2009) relates a personal experience in the significance of the presence of family in the resuscitation process. The author uses a myriad of theories and the American Nurses Association’s Code of Ethics for Nurses to justify his argument. According to Fell (2009), the issue of family participation in resuscitation is significant to nursing as it is provided for in their code of ethics. The nurses have an obligation to take care of patients and anyone associated with them. The author holds that nurses promote autonomy, fidelity, justice, and nonmaleficence by allowing families to be present during the process. Fell (2009) outlines numerous reasons that lead to nurses and other medical staff opposing family participation.
They include interference of the process by family members, misconception of the actions the health care providers take in the course of resuscitation, possible litigation, and trauma, among others. Nonetheless, there is no evidence to substantiate these claims. Fell (2009) contends that the challenges can be mitigated by having a family support person. According to the author, family members can offer reassurance and support to the patient. Moreover, they understand the condition of the patient, thus not blaming nurses for negligence in the case the patient dies. They may offer information regarding the patient’s medical history that can facilitate the resuscitation course. Fell (2009) recommends the involvement of the family in the resuscitation process and designation of a family facilitator.
Bowden and Greenberg (2009) outline the significance of family members partaking in the resuscitation of their kid. They support their argument using data from health care facilities in the United States, Europe, and Canada. According to the authors, most health care providers are opposed to the idea of family presence. They believe that it compromises the entire resuscitation course. Health care providers claim that family presence contravenes the patient’s discretion and disrupts the process (Bowden & Greenberg, 2009). On the other hand, some health care providers assert that the presence of family members facilitates decision-making and enables parents to understand the health condition of their child. Family members believe that their presence makes health care providers act in a humane manner. The authors recommend collaboration among the medical staff and the family.
Blair (2004) evaluates the practicality of family participation in emergency resuscitation. The author uses a scenario of a patient who sustained a colossal head injury to assess the issue of family participation. According to Blair (2004), family members have the right to witness the resuscitation procedure. The nursing organizations “view family presence as a right, obligation, and natural event” (Blair, 2004, p. 20).
According to Blair (2004), the American Heart Association policies for tragedy cardiovascular care encourage the participation of the family in the resuscitation process. Besides, the Emergency Nurses Association favors the presence of family. The Code of Ethics for Nurses demands that they respect the interests of patients and their families. Blair (2004) holds that the presence of family members minimizes psychological harm in the event of death. Health care providers use false evidence to prevent family members from witnessing resuscitation course.
Twedell (2008) claims that a lack of guidelines on family presence contributes to the challenges observed during the resuscitation process. The author contends that policies help to enhance the relationship between family members and medical staff. The health care providers do not make resolutions based on personal opinion or experience. Twedell (2008) advocates the availability of support person during resuscitation. The support person offers psychological assistance to family members. The support person ought to be a nurse. Nurses understand the resuscitation process. Besides, they quickly identify the spiritual and emotional needs of the family members. Twedell (2008) recommends transparency when formulating guidelines for family participation. The attitude of health care providers would determine the success of the implementation of the guidelines.
Jabre et al. (2013) carried out research to identify impacts of family presence on resuscitation process. The study involved 570 relatives of patients who suffered from cardiac arrest. The study aimed at determining if family members had post-traumatic stress disorder (PTSD) or anxiety and depression after the process. The study found that individuals who did not witness the resuscitation processes showed higher levels of PTSD than those who participated in the procedure. Besides, they exhibited elevated levels of anxiety and depression. The study revealed that family presence does not compromise medical efforts. Additionally, it prevents possible psychological distress amid the family members.
Pros and Cons
Family presence in a resuscitation process is associated with various pros and cons. One of the benefits of family presence is that it helps members to understand the gravity of the patient’s condition. The family members witness first-hand the effort that the nurses make to save the patient. Family presence helps members to cope with the situation in the event of death (Blair, 2004). Witnessing the resuscitation process helps family members to appreciate that there is no alternative way of saving the patient. Thus, they use the opportunity to bid the patient farewell. They do not have problems in the grieving process. Family members may facilitate resuscitation process. They may furnish the code team with information that can go a long way towards facilitating the resuscitation process.
One of the demerits of family presence is that it may interfere with the resuscitation process. The code team may be unable to discharge its duties due to anxiety. Besides, family presence may increase the possibility of lawsuits (Blair, 2004). Family members may misconstrue an action, thus filing a lawsuit against the code team. Resuscitation processes are harrowing. Hence, family members may suffer from psychological trauma upon witnessing the process.
Personal Stance
Family members should be allowed to partake in a resuscitation process. It is decent to allow relatives to be there for their loved ones during difficult moments. Family members feel obliged to assist their loved ones in times of needs. Thus, they might seem to have abdicated their responsibilities if not allowed to partake in resuscitation course. It would be difficult for the members to cope with the situation if the patient does not make it. In other words, allowing patients to partake in resuscitation eases closure and healing. Nurses may not have vital information regarding the patient. For instance, they cannot tell the duration that a patient has been unconscious. Moreover, they may not have the medical history of the patient. Allowing family to partake in the resuscitation process would enable the code team to gather information about the patient. The information would go a long way towards saving the life of the patient.
Recommendation
Nursing can enhance the participation of family members in resuscitation process by formulating and implementing guidelines. Besides, equipping designated nurses with skills in family support can go a long way towards ensuring that the process runs smoothly. Thus, the nursing should ensure that some personnel are trained in how to assist family members go through the resuscitation course.
References
Blair, P. (2004). Is family presence practical during emergency resuscitation? Nursing Management, 35(6), 20-23.
Bowden, V., & Greenberg, C. (2009). Should family members be present when their child is being resuscitated? Pediatric Nursing, 35(4), 254-256.
Fell, O. (2009). Family presence during resuscitation efforts. Nursing Forum, 44(2), 144-150.
Jabre, P., Belpomme, V., Azoulay, E., Jacob, L., Bertrand, L., Lapostolle, F., … Vicaut, E. (2013). Family presence during cardiopulmonary resuscitation. The New England Journal of Medicine, 368(11), 1008-1018.
Twedell, D. (2008). Family presence during resuscitation. The Journal of Continuing Education in Nursing, 39(12), 530-531.