Family presence can help parents grieve
Knowledge that providers did everything possible to save a child’s life can be a great comfort to family
Advocates of family presence argue that the practice helps family members to grieve after a loved one’s death, says Nancy Eckle, RN, MSN, CEN, clinical nurse specialist in the ED at Children’s Hospital in Columbus, OH. "When parents see ten people around the bed working really hard to save their child’s life, it helps them realize that everything possible was done," she emphasizes.
Parents are now involved when a resuscitation needs to be stopped, which helps them to accept their child’s death, Eckle says. "Before, they were isolated in a waiting area, waiting for us to come and give them the bad news, which was our first interaction with the parents," she recalls.
Even caregivers who resist the practice often acknowledge that family members should be allowed to be present as their loved one dies. "It may be appropriate if the patient is in critical condition and it looks like they’re going to die," says Rashmi Kothari, MD, FACEP, assistant professor in the department of emergency medicine at University of Cincinnati Medical Center (OH). "After things have settled down and I’ve gotten an assessment of where the patient is, I’ll go out and bring the family in so they can be with them."
When family members do not observe resuscitation efforts firsthand, it’s harder for them to accept the death of a loved one, argues Janet Williams, RN, MSN, CCRN, flight nurse at University Air Care, University Hospital in Cincinnati. After an auto accident, efforts to resuscitate an injured woman were unsuccessful. After the woman was pronounced dead, her daughter refused to believe it.
"It was my feeling that her response would have been much different if she had the opportunity to view the resuscitation," Williams says. "I couldn’t help but think that if she saw how hard we worked to save her mother’s life, she would have known that everything possible was done."
Family presence evokes emotional responses from staff, which are traditionally kept under tight wraps. "With families present, you overhear some very intimate conversations. It hits home that this isn’t just something that came in that we’re working on, it’s somebody’s wife or husband," says Mary Anne Belanger, RN, CEN, an emergency nurse at Wooster Community Hospital (OH). "There are sometimes tears during codes now, whereas there weren’t before, but it in no way impairs the level of care patients receive."
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