Abstract: Parental presence during resuscitation is a point of debate in the health care practice due to the stable beliefs and stereotypes, all of which finally point to the threats an incompetent and poorly prepared for such experiences person might bring. The present review addresses the “triangle” ( providers’, patients’, family members’) beliefs concerning and attitudes towards the introduction of this practice for the families.
The studies reviewed show that the role of family presence is high, especially when the patient is a minor, but the lack of agreement among the three parties involved points to the necessity of additional training for health care specialists. In the search, the basic combinations of keywords were “family presence during resuscitation” and “parental presence during resuscitation”, and the specifying words were “effect”, “impact”, “attitudes”, “failure of resuscitation” and “beliefs”.
Nowadays, the common time-honored practice of keeping family members away from the patient being resuscitated begins to disappear, as the role of families in the health and well-being of patients is crucial. On the other hand, with respect to the novelty of the issue of family presence and comparatively insignificant spread of this practice, there exists a number of doubtful issues to be clarified by the empirical studies. First of all, the patients’ and their relatives’ attitudes and beliefs concerning family presence during resuscitation are not actually clear.
In addition, it is also important to have information about nurses’ attitudes (possible prejudices) and the effects of family presence during resuscitation. The present literature review is designed to answer these questions. Speaking about pediatric resuscitation, it is necessary to point out that both parents and nurses view family presence as an important factor that positively determines the success of the regular emergency procedures (McGahey, 2002; Marrone and Fogg, 2003).
P. McGahey also writes that most experiences, associated with parental presence during the resuscitation of minors, are characterized by both parents and health care specialists as satisfactory. However, “the negative aspects included the lack of a support person for the family in 2 cases [out of 30] and the perception that the resuscitation had been prolonged unnecessarily in 1 case” (McGahey, 2002, p. 30).
The scholar therefore indicates that the health care team leadership model should be flexible enough to be adjusted to the situation of family presence during resuscitation, as the major parental prejudice as well as problem indicated after the presence is the poorly-established channel of communication between the staff and the parents (MCGahey, 2002), the lack of explanations and contact in general conditions parental “alienation” from the process so that they begin to feel redundant.
The article by Heckendorn et al (2005), based on the study, which sought to triangulate the views of patients, family members and health care specialists, points to the distinction between the patient profiles as predictors of the consent. For instance, only 50 per cent in cardiologic unit are willing to have their closest relatives present during resuscitation, whereas in the trauma unit this percentage reaches 95.
“We found no instances of conflict between the wishes of family members and patients such that in all cases where family members desired to be present, patients either expressed indifference or were supportive of this choice” (Heckendorn et al, 2005, p. 81).
As for the physician’s and nurse’s consent, the situation is a bit more complicated, as about 20% of health care specialists express concerns about the behavior of family member in the resuscitation room and have the belief that “further complications could arise if family members lose control” (Heckendorn et al, 2005, p. 82), i. e. the “visitors” might fall into panic or interfere into the procedures.