Parental presence during resuscitation in the PICU: the parents’ experience

Abstract

Recognition of the parents' compelling need to stay will improve nurses' understanding of how witnessing this event may assist family coping and functioning. Ways in which parents may be better supported in making the decision to stay or leave during resuscitation are identified.

Family Presence During Resuscitation and Invasive Procedures in Pediatric Critical Care: A Systematic Review

“…Parents also commented that being present was beneficial for them, 14,15,17 specifically noting that physical contact with their child was valuable. 9,16,17 Additionally, 81% of parents felt that their presence was beneficial to the medical staff.…”

“…16 Parents who had not been present felt as though they had failed in their role as the child's protector. 15 Support for parents during and after resuscitation was noted to be crucial, and it was apparent that support was best left to experienced staff, most often nurses. 15 Parent presence gave parents a new positive perspective of the nurses' role.…”

“…15 Support for parents during and after resuscitation was noted to be crucial, and it was apparent that support was best left to experienced staff, most often nurses. 15 Parent presence gave parents a new positive perspective of the nurses' role. 15 Family members reported that they served as the link between the child and the rest of the family and indicated that if they thought their presence would be detrimental to their child, they would leave the bedside.…”

“…15 Parent presence gave parents a new positive perspective of the nurses' role. 15 Family members reported that they served as the link between the child and the rest of the family and indicated that if they thought their presence would be detrimental to their child, they would leave the bedside. …”

“…Respondents discussed an inherent need to make the decision for themselves as to whether or not they chose to be present. 9,15 In 5 of the 6 studies, 9,14-17 researchers noted that parents felt that their presence was helpful to their child. There is an inherent need for the choice to be present Parents did not report additional trauma by being present Memories of resuscitation were not long-lasting Support for parents during and after resuscitation was crucial Parents who did not witness the resuscitation were more distressed Not being present made coping more difficult Managing coping was more effective for some if they were able to leave and return All families of previously healthy children wished they had been present Of those not present, most wished they had been present and believed that their presence would have been a comfort to the child and would have helped in coping with the child's death The resuscitation was not traumatic Parents would recommend being present to others 76% of those present would not change anything compared with only 25% who were not present All families expressed the importance of the option to be present Presence provided strength to the child and gave family the opportunity to give the child permission to die Physical connections facilitated healing for family members Presence reassured families that all possible options were exhausted, doubts were dispelled, and closure was provided If not present, parents wondered if outcomes could have been different Family members began the process of accepting the child's death while present for the resuscitation All parents said it was important to be at the bedside and believed their presence was helpful to the child 95% felt that being present helped them personally and assisted them in understanding their child's condition 86% believed they had a right to be there, and 82% did not think their presence made a difference in the providers' care All would be present again All agreed or strongly agreed that presence gave them peace of mind, was the right thing to do, gave them the chance to let their child know that they loved him/her, and helped them know everything possible was done for their child…”