Presence of Family Members in the Resuscitation

¶ … presence of family members in the resuscitation room, various factors must be taken into account. In regards to such events leading to traumatic repercussions, if the patient does not respond to the measures, it is likely that the next of kin would be affected by the experience. Moreover, by allowing family members to be present, staff is expected to ensure a minimum of support. However, given that resuscitation measures require concentration of forces and efforts on the patient, there may be no staff available to provide support for the family. This is specifically relevant when there are no trained facilitators to have been delegated such responsibilities. Some hospitals may lack resources in attending the issue. This is why family presence during resuscitation is not always recommended because it can affect relatives on a negative scale. On the other hand, it has been acknowledged for a long time now that family being present in the resuscitation room has its benefits. This indeed should be an option, which is to say that families should be given the right to choose whether or not they want to be present during cardiopulmonary resuscitation. However, hospitals should reserve the right to ask relatives to leave the room in cases of emotional interference that could disrupt or affect the resuscitation process. In relation to this, it is necessary, if not imperious, that hospitals design specific guidelines and policies that address the issue. However, many have no defined strategies or theoretical statements that comply with this. Consequently, it is often one's or another's decision if family presence is permitted.

A survey conducted in 1985, when family presence programs started to be considered a valuable option, revealed that many of the respondents who had been present during resuscitation were willing to recommend participation following the experience (Doyle et al., 1987, p. 108/674). It has been acknowledged ever since that participation allows family members to experience closure in cases when their next of kin does not survive despite the interventions. From this perspective, whenever the patient in cause has not delegated otherwise, there would be no reason family members should not be permitted attendance. There is also positive feedback from attendees to support this which is in regards to medical staff having done all possible for the patients. This is to say that, family members having witnessed the process, medical staff avoid being subjected to various concerns as to the implementation of resuscitation measures. By allowing relatives to observe the process, the former are reinsured that the best of efforts were implemented to save their loved ones and concerns of incorrect procedures are likely to be avoided. Thus, allowing the presence of family members reflects upon the interrelationship of staff and the former. While it has been suggested by various healthcare providers that this is an issue of breaking patient confidentiality, it does not necessarily come to that if appropriate measures are considered. In this respect, time allocation should be reserved toward offering informative prospects to the patients, where possible, as well as to family members. Both positive and undesired outcomes should be considered when providing information so that patients and family members alike are aware of the implications. Educational programs would provide basic training and theoretical knowledge in this respect. Facilitators would usually address the protocol with families in cause, answering whatever questions the latter may have and thus, reduce the anxiety that is subject to cardiopulmonary resuscitation and sudden death situations overall. What has commonly influenced perception of family presence in resuscitation rooms is the behavioral response of the former in relation to the process at hand. While most family members respond positively to the option of being present during cardiopulmonary resuscitation, healthcare providers have split opinions in regards to implementing the program. There are concerns as to their presence causing distractions that can affect and interfere with the process and thus jeopardize its procedural implementation. There are also opinions that include the risk of increased responsibility that falls upon staff. This is why there is an extended interrelationship that is subject to trauma-room interventions and it includes patient and family, as well as medical staff. This trilateral circle of interactions must reflect the basic of mutual understanding and accordance for family presence programs to be effective and indeed avoid negative connotation and follow ups. There are cases of staff when, having been informed of the benefits following family presence, there was a change in perception that extended the practice. For example, following a study by Robinson et al., a ?clinical team was so impressed with the benefits of the study that, after 18 families had been observed, the study was terminated to provide all families access to this opportunity. (as quoted in Mian et al., 2007, p. 53) This goes to show that information about positive outcomes needs to be made available to medical circles as well in order to change their perception about family presence and to allow for a vast understanding of its beneficial influence upon the family. However, practicing resuscitation when family is present can be subject to constraints as medical staff may be neither prepared nor accustomed to deal with having them in the room. Thus, it is also their ability to embrace family presence that needs to be taken into account when considering the issue because it is first and foremost the patient that falls under their responsibility. Having said this, it is acknowledged that, while family members should be allowed in the trauma-intervention room, this is subject to various factors that enable a positive outcome of the experience. It is also acknowledged that allowance does not assume that all experiences would be subject to beneficial follow ups. However, insomuch as the number of outcomes which reflect family and staff benefits prevails over experiences that result in family members presenting negative conditions, family presence during resuscitation measures should remain persistent. So long as family behavior during the process remains tempered, this is an option all families should be presented with.