Family Presence During Paediatric Resuscitation: Pros And Cons

Discuss About The Family Presence Resuscitation Paediatric.

Cardiopulmonary resuscitation also called CPR is mainly seen to be comprising of the use of chest compressions as well as artificial ventilation. This is mainly done to maintain circulatory flow as well as oxygenation during cardiac arrest. Researchers are of the opinion that survival rates and neurologic outcomes are found to be poor in most of the cases in patients with cardiac arrest (hill, Knafl &Santacroce, 2017). However, there are also studies which state that early appropriate resuscitation that involve early defibrillation as well as appropriate implementation of the post cardiac arrest result in improved survival as well as neurologic outcomes. Often there are many instances where professionals allow the family members to be present with their loved patients in their critical times. Often different types of negative consequences remain associated with the presence of the family members. management, there have been many debates about the allowance of the family members. It would be represented in the essay and would be supported by different evidence based articles to show whether such decisions are clinically correct or not.

The main database that I have used for the literature search is Medline and Cinhal. The search terms that I have used are “resuscitation presence of family”, “family presence in resuscitation of loved one”, “presence of family members in end moments of patients”,” should families be allowed during resuscitation” and others. The level of evidences used is the first level of evidences like systematic reviews and second level of evidences like randomized control trials. Hence, the evidences are high of quality and content. I have mainly used an argumentative approach proving the point.

Do family members present during resuscitation of their loved ones in acute settings are more affected in comparison to those who are not present with their loved ones?

Many articles have supported the presence of family members during the critical time of the patient during his cardiac resuscitation. It is seen that children are mostly seen to want their parents beside them during medical procedures. Majority of the adult patients are mainly seen to want their family members to be present during the times of the emergency procedures. They feel comforted as well as helped by the family members being present there. There is a similar view as well from the family member. Many of the family members believe that it is their right, duty as well as their obligation to be there with their loved ones during their emergency procedures in the cardiopulmonary resuscitation. Researchers are of the opinion that the presence of the members at the bedside helps the members to understand the severity of the condition of the loved ones and thereby helps in removing the doubt  that each of the healthcare professionals are doing the best that they can provide to the patient (Giles, 2017). Many of the researchers are of the opinion that when the members are present in the room beside the patient, it results in the decreasing of their anxiety as well as dear about what is happening with their loved ones. It is also seen that it helps the family members to pass on vital information about the patient to the healthcare providers. It helps in the facilitation of their needs to be together as well as their opportunity to be with their loved one, advocate for them, comfort them, protect, and support their loved ones (Olding et al., 2016). It has been also seen that the presence of the family members allows them to experience a sense of closure as well as help in facilitation of the grief procedure should death occur.

Pico question

However, a large number of negative aspects are highly associated about the presence of the family members in the room of resuscitation of the loved ones. In many of the cases, researchers have observed in their observational studies that the family members have interfered with the resuscitation efforts of the healthcare professionals. Different types of interruptions from the family members are thereby seen to increase the increase the risk of death for the patients. They are also seen to go through different types of physical, psychological as well as legal obligations for the members who are working in the resuscitation teams. Therefore, in order to allow the resuscitation team members to concentrate on their actions and helps the patient to overcome the situation, interruptions from family members cannot be tolerated and hence they should not be allowed in the rooms (Twibell et al., 2018). Many of the researchers have again concentrated on the psychological trauma that family members witness during the resuscitation efforts. Often many researchers have supported the presence of family members during resuscitation at home where there were no significant posttraumatic stress disorders noticed among the members. However this articles cannot be supported in the essay as cardiac arrests that occur at home are entirely different from the cardiac arrests that had taken place in the acute care emergency wards (Porter et al., 2017). This is mainly because the cardiac arrests that occur in the homes are different in the sense as the emergency resuscitation the family embers summon teams only where they have already noticed cardiac arrest situation of the patient. Many families were seen to conduct the resuscitations on their family members themselves. However, in case of the emergency rooms resuscitations, the nursing professionals only notice most of the cardiac arrests (Frivold et al., 2015). They then call for the resuscitation teams to immediately respond and the family members only learn about the vent after the resuscitation is being carried on. This sudden scenario of the professionals resuscitating their loved one result in many kinds of questions and concerns among the members that might affect their mental stability and for this the members should not be allowed in the rooms. In the inpatient cases of cardiac resuscitation, social supports are usually not available and therefore family members who are present can undergo severe psychological trauma when they are not given proper social support. Moreover, inpatient acute settings mainly contains cases of the interventions that include visible bleeding which may include insertion of central venous catheter and many others witnessing such interventions may prove to be traumatic to the family members (Powers & Candela, 2017). It should be kept in mind that not all members of the family have equal reaction to particular psychological trauma.  Many of the researchers have stated that many people who checked the resuscitation of their loved ones were 11% less likely than their controls to have developed symptoms of depression. However, there are also studies which have shown that 1% of the witnesses accounting to about 5 people have committed suicides after such situations. Therefore, it clearly states many individuals in a population are at a higher risk for the development for depression and posttraumatic stress disorders after watching resuscitations.  At the time of the event, it can never be possible for the professionals to find out how the members would react after watching their loved ones go through the critical phase (McLean, 2016). Therefore, by analyzing the cost benefit ratio, it can be stated that keeping the family members out of the rooms will not affect their mental stability to patient at which they can self harm themselves or develop PTSD as in cases where they may develop so when resuscitations are witnessed (Giles et al., 2018). Therefore, family members should not be allowed in the rooms of resuscitation of their loved ones.

Conclusion:

From the above discussion, it is clear that being present with loved one may be the duty and right of the family members and make the patient comfortable it is not the correct decision. It is important for the operations to be outside the rooms so that they do not interrupt the resuscitation process, do not develop depression and PTSD and do not lose mental stability. Therefore, nursing professionals should try to advise the members to be outside the rooms while such strategies are being carried on the patients.

References:

Frivold, G., Dale, B., & Slettebø, Å. (2015). Family members’ experiences of being cared for by nurses and physicians in Norwegian intensive care units: A phenomenological hermeneutical study. Intensive and Critical Care Nursing, 31(4), 232-240.

Giles, T., de Lacey, S., & Muir?Cochrane, E. (2018). How do clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation?. Journal of clinical nursing, 27(5-6), e1214-e1224.

Giles, T. (2017). Caring for people at deaths door during resuscitation events. Australian Nursing and Midwifery Journal, 25(6), 36-36.

Hill, C., Knafl, K. A., & Santacroce, S. J. (2017). Family-Centered Care From the Perspective of Parents of Children Cared for in a Pediatric Intensive Care Unit: An Integrative Review. Journal of pediatric nursing.

McLean, J., Gill, F. J., & Shields, L. (2016). Family presence during resuscitation in a paediatric hospital: health professionals’ confidence and perceptions. Journal of clinical nursing, 25(7-8), 1045-1052.

Olding, M., McMillan, S. E., Reeves, S., Schmitt, M. H., Puntillo, K., & Kitto, S. (2016). Patient and family involvement in adult critical and intensive care settings: a scoping review. Healthcare Expectations, 19(6), 1183-1202.

Powers, K. A., & Candela, L. (2017). Nursing Practices and Policies Related to Family Presence During Resuscitation. Dimensions of Critical Care Nursing, 36(1), 53-59.

Porter, J. E., Miller, N., Giannis, A., & Coombs, N. (2017). Family Presence During Resuscitation (FPDR): Observational case studies of emergency personnel in Victoria, Australia. International emergency nursing, 33, 37-42.

Twibell, R., Siela, D., Riwitis, C., Neal, A., & Waters, N. (2018). A qualitative study of factors in nurses' and physicians' decision?making related to family presence during resuscitation. Journal of clinical nursing, 27(1-2), e320-e334.