Nursing Assignment: Should Family Be Present During Resuscitation?

This nursing assignment delves into the contentious issue of family presence during resuscitation within the acute care setting. The paper begins by providing a historical context, highlighting the initial adoption of this practice and its subsequent spread. It then presents a detailed analysis of the arguments for and against allowing family members to be present during resuscitations. The assignment explores concerns about disrupting medical procedures, potential legal liabilities, patient privacy, and the emotional impact on family members. Conversely, it acknowledges the families' desire to be present and the potential for traumatic memories. The author concludes that family members should not be allowed during resuscitation because their presence can interfere with medical efforts, increase the risk of litigation, violate patient privacy, and cause panic. The paper advocates for alternative support systems, such as counseling rooms for families, and suggests that a dedicated healthcare professional should provide support and guidance. The assignment uses various sources to support the arguments and presents a well-structured discussion of this complex topic.

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Nursing Assignment
Student’s Name
Institutional Affiliation
Professor’s Name
City
Date

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Introduction
The Foote Hospital in Michigan in the USA is where the concept of permitting relatives
to a patient to be present at the time of resuscitation began (Al Mutair, 2017). It happened when
two of the family members to a patient refused to leave at the time of resuscitation and requested
a few minutes to offer what they could during that time of crisis. The initial licensed institution
to develop evidence-based written specifications upholding this practice of family attendance at
the time of resuscitation in 1993 was the American Emergency Nurses Association (O’Connell et
al., 2017). Moreover, through the years the option of family members being present during
resuscitation has significantly been endorsed by several medical institutions throughout the
world.
Family presence at the time of resuscitation is an important topic and of current debate
amidst clinical health care providers. Consequently, the attitudes of physicians, nurses along
with families towards this topic are significantly different (Ferrara, Ramponi and Cline, 2016). A
few of the clinical health care professionals have the fear that relatives to the patient may end up
having traumatic memories of the practice, but the relatives prefer to remain with their patient
(Twibell, Siela, Riwitis, Neal and Waters, 2018). Professionals of various health care institutions
have issued statements that relatives to a patient should be provided with the opportunity to
remain during the operation (Moss, Good, Gozal, Kleinpell and Sessler, 2016). These
organizations include the Emergency Nurses Association, Royal College of Nursing along with
the Canadian Association of Critical Care Nurses.
Should family members be allowed to be present during the resuscitation of a loved one in
the acute care setting? Why, or why not?

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Resuscitations are a sudden and traumatic clinical event which regularly leads to a
patient's death or change in health status. For instance, the moment a patient has a cardiac arrest,
the relatives are asked to hold in a waiting room while saving actions are instituted. However,
this technique has sparked an argument since recently; relatives want to witness the actions taken
by the health professionals in saving the lives of their loved ones. As per the American Journal of
Critical Care, team members have enunciated more limitations than advantages affiliated with
family presence during resuscitation (Leske, McAndrew, Brasel and Feetham, 2017). Families
should not be permitted during resuscitation since it hampers with the efforts of the procedure
and escalates the peril of liability and litigation. Also, the family breaches the privacy together
with the confidentiality of the patient along with creating panic and fear.
In interfering with the efforts of the procedure, the attendance of loved ones disrupts and
impedes the resuscitation procedure through impairing the performance of the coding staff
(Hassankhani, Zamanzadeh, Rahmani, Haririan and Porter, 2017). The attempts of resuscitation
in such instances get unnecessarily prolonged due to the presence of family members and their
emotional behavior such as prying again and again on the situation of the patient, crying and
standing at the bedside. Families go out of control and distract the health care professionals from
doing their job as pointed by clinical providers at an international meeting of the American
College of Chest Physicians.
Furthermore, the anxiety to performance escalates, and there is a lack of accessibility of a
sufficient team to wholly aid the family of the patient due to the main focus on resuscitation
attention. Also, often nurses along with physicians hesitate to discuss the situation of the patient
openly in the presence of his family. Hence, this action causes hindrance in the care of the

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patient along with deferment in decision making in defiance of the need for punctuality at such a
critical period.
Family members to the patient escalate the peril of liability and litigation (Johnson,
2017). The code room might be very excruciating for the patient’s relatives, and at that period
the staff's effort may be elucidated as inhuman by the family members. For instance, delivering
shocks along with doing chest compressions to the patient may be viewed as a cruel operation in
case the patient dies. Moreover, during this critical condition, there may be chances for mistakes
to happen, indecorous remarks to be made and actions misapprehended by the patient’s relatives.
Thus, a mediator is vital to observe the family members' responses, transcribe medical
jargon and explain whatever is going on. However, this is not relevant since at that period,
saving the life of the patient is the key accountability of the clinical health care professionals
(Oczkowski, Mazzetti, Cupido and Fox-Robichaud, 2015). Also, the entire situation during this
procedure is too traumatic for the family members and a monitored action, or remark might
easily offend the loved ones resulting in a complaint. During these instances, the accountability
of the staff elevates. Investigators also accentuate that family observing resuscitation would
distress loved ones and result in a rise in lawsuits.
The attendance of relatives at the time of resuscitation breaches the privacy together with
the confidentiality of the patient (Zibrowski, Shepherd, Booth, Sedig and Gibson 2019). At this
crucial moment, it is possible that medical data formerly not familiar by the family be exposed in
the disarray of the code. Honesty along with nobility is the vital components of ethics, and the
patient’s dignity might be put in jeopardy as it is the moral duty to safeguard the privacy of the
patient. Since the patient is insentient, it is not viable to get his accord to alleged resuscitation.

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Also, it is immoral to authorize the presence of loved ones without knowing the agreement of the
patient to the authenticated resuscitation.
The nursing and midwifery council (2008) states that no one is sanctioned to data that the
patient does not want them to access (Coyne et al., 2016). Insufficient screening during this time
could lead to unassociated visitors gaining retrieval to data which could alternatively be
protected. This possible breach of secrecy can have more full ramifications affiliating with the
public's trust in the medical profession.
Lastly, with no doubts observing a patient at the time of operation generates panic and
fear among the loved ones as they are not perpetual to deal with such conditions (Fiori, Latour,
and Los, 2017). This could result in mental distress and the probability for the relatives to react
impulsively. Family members may keep reiterating on doing everything feasible even in
ineffectual resuscitation. Correspondingly, at times relatives to patients request for a code to be
stopped of which sometimes may be premature. Moreover, the staff’s stress levels might
involuntarily rise to impede their efficiency and destroy the attentiveness required to run the
code.
Conclusion
Although relatives want to view the actions undertaken by the health professionals in
saving the lives of their loved ones, the family members to a patient should not be allowed
during resuscitation. This is because their presence generates hindrance in resuscitation operation
together with escalating the peril of responsibility and litigation. Moreover, their existence
contravenes the right of solitude and privacy of the patient along with creating panic and fear
among the family members hence affecting the performance of health care providers. It would be
more useful for the patient and code staff if family members are not available during

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resuscitation as staff can focus wholly on the patient’s condition without any pressure. For this
reason, there should be a technical physician or nurse who could counsel the family of the patient
at the time of resuscitation in a counseling room instead of doing it in front of the patient.

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Bibliography
Al Mutair, A., 2017. Should Family be Allowed During Resuscitation? In Resuscitation Aspects.
InTechOpen.
Coyne, I., Comiskey, C.M., Lalor, J.G., Higgins, A., Elliott, N. and Begley, C., 2016. An
exploration of clinical practice in sites with and without a clinical nurse or midwife specialists or
advanced nurse practitioners, in Ireland. BMC health services research, 16(1), p.151.
Ferrara, G., Ramponi, D., and Cline, T.W., 2016. Evaluation of physicians' and nurses'
knowledge, attitudes, and compliance with family presence during resuscitation in an emergency
department setting after an educational intervention. Advanced emergency nursing
journal, 38(1), pp.32-42.
Fiori, M., Latour, J.M. and Los, F., 2017. “Am I also going to die, doctor?” A systematic review
of the impact of in-hospital patients witnessing a resuscitation of another patient. European
Journal of Cardiovascular Nursing, 16(7), pp.585-594.
Hassankhani, H., Zamanzadeh, V., Rahmani, A., Haririan, H. and Porter, J.E., 2017. Family
Presence During Resuscitation: A Double‐Edged Sword. Journal of Nursing Scholarship, 49(2),
pp.127-134.
Johnson, C., 2017. A literature review examining the barriers to the implementation of family
witnessed resuscitation in the Emergency Department. International emergency nursing, 30,
pp.31-35.

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Leske, J.S., McAndrew, N.S., Brasel, K.J. and Feetham, S., 2017. Family presence during
resuscitation after trauma. Journal of trauma nursing: the official journal of the Society of
Trauma Nurses, 24(2), p.85.
Moss, M., Good, V.S., Gozal, D., Kleinpell, R. and Sessler, C.N., 2016. An official critical care
societies collaborative statement: Burnout syndrome in critical care health care professionals: a
call for action. American Journal of Critical Care, 25(4), pp.368-376.
O’Connell, K., Fritzeen, J., Guzzetta, C.E., Clark, A.P., Lloyd, C., Scott, S.H., Aldridge, M.D.
and Kreling, B., 2017. Family presence during trauma resuscitation: family members’ attitudes,
behaviors, and experiences. American Journal of Critical Care, 26(3), pp.229-239.
Oczkowski, S.J., Mazzetti, I., Cupido, C. and Fox-Robichaud, A.E., 2015. Family presence
during resuscitation: a Canadian critical care society position paper. Canadian respiratory
journal, 22(4), pp.201-205.
Twibell, R., Siela, D., Riwitis, C., Neal, A. and Waters, N., 2018. A qualitative study of factors
in nurses' and physicians' decision‐making related to family presence during
resuscitation. Journal of clinical nursing, 27(1-2), pp.e320-e334.
Zibrowski, E., Shepherd, L., Booth, R., Sedig, K. and Gibson, C., 2019. A Qualitative Study of
the Theory Behind the Chairs: Balancing Lean-Accelerated Patient Flow With the Need for
Privacy and Confidentiality in an Emergency Medicine Setting. JMIR human factors, 6(1),
p.e11714.

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