Nurses and Family Presence during Resuscitation - Assignment Example

Research Critique: Nurses and Family Presence during Resuscitation Knott, A., Kee, C.C. (2005), 'Nurses' beliefs about family presence during resuscitation', Applied Nursing Research, 18, 192-198. Introduction. This is a qualitative article that explores the experiences and feelings of nurses who have been present in acute situations where a patient was being given cardiopulmonary resuscitation while the patient’s family was in the room. The scope was broad in that nurses from ER, cardio units, ICU, neonatal as well as labor and delivery were included in the sample (Agard 2008). The reason this article was chosen is because it explores the personal side of nursing; as a qualitative study, it provides insight into the experiences, beliefs, and emotions of those nurses involved in the population sample, which was the stated aim of the article. [107] Purpose of Study. The study is investigating the feelings, experiences, and beliefs of nurses who have been involved in resuscitation activity where the family of the patient have been present. The conventional wisdom is that it is a bad idea for the family to be in the room during this event as it is stressful, traumatic, and some family members may become hysterical or try to interfere with the medical professionals (Demir 2008). New research, however, seems to be pointing to the possibility that family presence during resuscitation has both therapeutic and clinical value, showing positive effects regardless of patient outcome. [101] Literature Review. The literature review is constructed well, but the majority of sources are not what would be considered recent, even though the names of researchers cited in the article are known in the profession. The article appeared in the 2005 edition and there is one reference to a study performed in 2003; however, the vast majority of references in the literature review section have been written more than five years prior to the publication of this article. Nurses are writing the article under review, and so their credibility is strong; yet the reliance on what could be considered out-dated research is troubling (Moons & Norekval 2008). That said, there is a notation in the article that research on nurses’ opinions regarding these types of acute situations is minimal, and that may account for the “reaching back” to earlier years for the literature review. Nevertheless, I thought the authors could have found some more recent research to bolster their investigation. [160] Methods, Procedures and Ethics. In terms of the methodology, a descriptive qualitative model was chosen to maximize the variation of sampling while retaining a broader, more generalized inquiry in terms of the subject. It should be noted that the nature of qualitative research is such that it does not require conformation to explicit models or particularly grounded theory; the descriptive level of qualitative research allows it to summarize that data which closely resembles the events that participants in the sample present (Knott & Kee 2005). Thus, in this case, participants were given the opportunity to give voice to their feelings about the topic through a somewhat structured, open-ended interview schedule that encouraged the sharing of perceptions, opinions, and insights. As the scope of this research was the perspectives of family presence during cardiac resuscitation, the focus was upon nurses who had been employed in acute care settings who had also either personally observed or participated in resuscitation procedures where the patients’ families were either present or at least available. To broaden the group, researchers also looked to nurses who had experience in a multiplicity of hospital units so that the various work responsibilities of the sample group would provide the most variation possible in terms of the family presence at a resuscitation event. Accordingly, there was no other inclusion criteria used other than the experience and presence of the nurse at the seminal event. In terms of ethics, researchers’ obtained approval to conduct the study from the sponsoring university’s institutional review board, all respondents were professionally acquainted with the primary investigator, and each participant signed an informed consent including an agreement to have the interviews taped. For the sake of accuracy, all interviews were indeed recorded and transcribed verbatim to ensure accuracy and provide a foundation for any subsequent analysis. [300] Results and Discussion. The results are presented clearly and logically. The researchers established four general themes from the interviews; those conditions where family presence is an option, the utilization of the family presence at resuscitation to force a family decision regarding future resuscitation orders, the feeling of the nurses that they were under scrutiny during a very stressful procedure attempting to save a life, and the impact of actually seeing the resuscitation (or attempt at resuscitation) on the family members themselves. Obviously, the first natural concern of medical professionals is that family members do not interfere in the attempt to save a life (Marble & Hurst 2008). Many of the respondents commented on the importance of family members remaining calm, not interfering with any specific procedures, and particularly not creating conditions that required the nurse to divert attention from the patient to having to manage family members. Of all the comments recorded, perhaps the most important was the observation that if the family chose to remain in the room during a resuscitation effort, there should be one member of the staff specifically assigned to “family management” so that those nurses involved in the lifesaving procedures were free to concentrate their attention on that specific task. [205] Overall Concerns. Overall I found this study to be interesting regarding the personal experiences related by the nurses, but the nature of the qualitative collection of data leaves the reader simply feeling as an observer, rather than as a judge of scientific evidence. The authors made the article easy to read by using standard sub-headings and presenting their interview excerpts in a plain format. I think that the results of this study are helpful to the profession as a whole. The one concept I did find most interesting was the notion that some facilities encourage the staff to endure the family presence during a resuscitation attempt in an attempt to demonstrate to the family the traumatic efforts made and secure their agreement to not subject their relative to such extreme measures in the future, e.g., a Do Not Resuscitate (DNR) order. The idea is that if the families see what really happens, they will be less willing to subject their loved one (and the staff) to the rigors of such dramatic—and often unsuccessful—efforts. [175] References Agard, M. (2008) Creating advocates for family presence during resuscitation. Medsurg Nurs., 17, 3, 155-160 Cottle, E.M., & James, J.E. Role of the family support person during resuscitation. Nursing Standard, 23, 9, 43-47 Dalio, A.M. (2008) Family presence during cardiopulmonary resuscitation. American Journal of Critical Care, 17, 4, 310-311 Demir, F. (2008) Presence of patients' families during cardiopulmonary resuscitation: physicians' and nurses' opinions. Journal of Advanced Nursing, 63, 4, 409-416 Dudley, N.C., Hansen, K.W., Furnival, R.A., Donaldson, A.E., Wagenen, K.L., & Scaife, E.R. (2008) The Effect of Family Presence on the Efficiency of Pediatric Trauma Resuscitations. Annapolis Emergency Medicine, 11, 13, 215-230 Engelhardt, E. (2008) Family presence during resuscitation. Journal of Continuing Education Nursing, 39, 12, 530-531 Fallis, W.M., McClement, S., & Pereira, A. (2008) Family presence during resuscitation: a survey of Canadian critical care nurses' practices and perceptions. Dynamics, 19, 3, 22-28. Grudzen, C.R., Koenig, W.J., Hoffman, J.R., Boscardin, W.J., Lorenz, K.A., & Asch, S.M. (2009) Potential Impact of a Verbal Prehospital DNR Policy. Prehosp Emerg Care, 13, 2, 169-172 Hill, R., & Fuhrman, C. (2008) Presence of family members during resuscitation. Ann Emerg Med., 52, 3, 309-310 Knott, A., Kee, C.C. (2005), 'Nurses' beliefs about family presence during resuscitation', Applied Nursing Research, 18, 192-198 Marble, S.G., & Hurst, S. (2008) Innovative solutions: family presence at codes: a protocol for an oncology unit. Dimens Critical Care Nursing, 27, 5, 218-222 Maxton, F.J. (2008) Parental presence during resuscitation in the PICU: the parents' experience. Sharing and surviving the resuscitation: a phenomenological study. Journal of Clinical Nursing, 17, 23, 3168-3176 Moons, P., & Norekval, T.M. (2008) European nursing organizations stand up for family presence during cardiopulmonary resuscitation: a joint position statement. Progressive Cardiovascular Nursing, 23, 3, 136-139 Quest, T. (2008) Precious last moments: family presence during resuscitation. Medscape Journal of Medicine, 10, 10, 230 Tinsley, C., Hill, J.B., Shah, J., Zimmerman, G., Wilson, M., Freier, K., & Abd-Allah, S. (2008) Experience of families during cardiopulmonary resuscitation in a pediatric intensive care unit. Pediatrics, 122, 4, e799-804 Zakaria, M., & Siddique, M. (2008) Presence of family members during cardio-pulmonary resuscitation after necessary amendments. J Pak Med Assoc., 58, 11, 632-635 Read More