Family‐Centered Care

Abstract

S pring marks the annual decline of the respiratory syncytial virus (RSV) and influenza season. This is always a relief for the employees of the emergency department of any hospital, but even more so for that of a children’s hospital. With this lull, however, comes the sure knowledge that following spring is summer and trauma season. After 13 years of nursing, 8 of those years in the emergency department and 5 in a pediatric facility, I am all too familiar with trauma season and its affect on the pediatric population. This article is not about trauma statistics or even prevention, but rather it is sharing a personal experience that has had a profound and positive effect on me. It is about family presence during a failed resuscitation of a pediatric trauma patient. The presence of family during invasive procedures and cardiopulmonary resuscitation (CPR) is a controversial topic that is gaining some popularity with research to support its positive effects. This case study regarding my experience is further evidence for the positive impact family presence can have for parents. Family presence during CPR or traumas has been felt by healthcare professionals to distract the staff or cause too much pain for loved ones to witness. The reasons to exclude family vary, but in the last 10 years, research has not supported any of the reasons given for denying family presence during CPR. The Emergency Nurses Association (ENA), after 10 years of research, has developed a procedure for emergency departments to include family presence at the unexpected death of a loved one (Eckle, 2001). The ENA document on family presence states that emergency care requires assessment and intervention to meet not only the patient’s physiologic needs but also the psychosocial and emotional needs. An interdisciplinary approach that supports and integrates the family into the emergency care process is vital to identifying and meeting the full spectrum of patient and family needs (Eckle). A family-centered approach to care requires that the needs of the patient and family dictate practice, not the needs of the healthcare provider (Gill, 1993; Johnson, Thomas, & Williams, 1997). Parental presence during failed resuscitation is consistent with the core principles of family-centered care, i.e., treating patients and families with dignity and respect, communicating unbiased information, encouraging patient and family participation by building on their strengths, enhancing family control, and collaboration in the delivery of care. Literature Review