Family support liaison in the witnessed resuscitation: A phenomenology study

Abstract

BackgroundFamily-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. ObjectiveTo explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. DesignThe hermeneutic phenomenology. SettingsThe emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran. ParticipantsThere were potentially 380 nurses and physicians working in the emergency departments and acute care settings of 6 tertiary hospitals in Tabriz. A purposive sample of these nurses and physicians was used to recruit participants who had at least 2 years of experience, had experienced an actual family witnessed resuscitation event, and wanted to participate. The sample size was determined according to data saturation. Data collection ended when the data were considered rich and varied enough to illuminate the phenomenon, and no new themes emerged following the interview of 12 nurses and 8 physicians. MethodsSemi-structured, face- to- face interviews were held with the participants over a period of 6 months (April 2015 to September 2015), and Van Manen’s method of data analysis was adopted. ResultsThree main themes emerged from the data analysis, including ‘Futile resuscitation’, ‘Family support liaison’, and ‘Influence on team’s performance’. A further 9 sub-themes emerged under the 3 main themes, which included ‘futile resuscitation in end-stage cancer patients’, ‘when a patient dies’, ‘young patients’, ‘care of the elderly’, ‘accountable person’, ‘family supporter’, ‘no influence’, ‘positive influence’, and ‘negative influence’. ConclusionsParticipants noted both positive and negative experiences of having family members present during cardiopulmonary resuscitation. Welltrained and expert resuscitation team members are less likely to be stressed in the presence of family. A family support liaison would act to decrease family anxiety levels and to de-escalate any potentially aggressive person during the resuscitation. It is recommended that an experienced health care professional be designated to be responsible for explaining the process of resuscitation to the patient’s family.