Position Statement: Family-PSU Presence During Resuscitation

ISSUE

In most cases, the family is the patient's primary support system.  Family members are frequently not given the opportunity to remain with the patient during invasive procedures, including resuscitation efforts.  Families/primary social units and patients may be separated for reasons such as the perception of being overwhelmed and/or intimidated with the situation and concern on the part of the individuals performing the procedure in the presence of non-medically oriented individuals.   Families/ primary social units may be separated from patients because of the perception that observing such events may be distressing and/or may impede medical activities. 

POSITION

NENA supports the option of family or primary social unit presence during invasive procedures and/or resuscitation efforts.

NENA acknowledges that a support system, (i.e.) Social Worker and/or Pastoral Care, must be in place for the family member(s) during invasive procedures and/or resuscitation efforts.

RATIONALE

Every emergency patient is a member of a family or valued social unit with the family/primary social unit being defined as a person(s) who has an established mutual relationship with the patient.

The family/primary social unit is the major source of support for the individual during times of stress and crisis.

Studies have indicated that the most important needs identified by family/primary social unit members of critically ill patients are: 

• To be with the patient
• To be helpful to the patient
• To be informed of the patient's condition
• To be comforted and supported by family
• To be accepted, comforted, and supported by health care personnel
• To feel that the patient was receiving the best possible care

Family/primary social unit presence during resuscitation efforts allows the patient and the family to support each other and facilitate the grieving process by bringing a sense of reality to the treatment efforts and the patient's clinical status.

References

Emergency Nurses Association. (2005).  Position Statement: Family presence at the bedside during invasive procedures and/or resuscitation.

Eppich, W. J., Arnold, L.D. (2003) Family member presence in the pediatric emergency department. Current Opinion in Pediatrics. 15(3):294-298.

Madden, E., Condon, C. (2007). Emergency nurses' current practices and understanding of family presence during CPR. Journal of Emergency Nursing. 33(5):433-440.

Mangurten, J.A.  et al. (2005 Family Presence: Making room. American Journal of Nursing, 105(5):40-48.

Marrone, L., Fogg, C. (2003) Should the family be present during resuscitation. Nursing, 33(10):32cc1-32cc2.

Thomas, T. (2007) Family presence: To stay or not to stay.  Nursing Critical Care. 2(2):19-24.