Case Study A 40-year-old man lost control of his vehicle and struck a guardrail in a single-car collision. He was not wearing a seat belt and was thrown through the windshield, sustaining a traumatic, closed-head injury. He was brought to the trauma center via helicopter and was admitted to the surgical intensive care unit. The […]
A 40-year-old man lost control of his vehicle and struck a guardrail in a single-car collision. He was not wearing a seat belt and was thrown through the windshield, sustaining a traumatic, closed-head injury. He was
brought to the trauma center via helicopter and was admitted to the surgical intensive care unit. The night staff
supported the patient’s wife during her first visit to see her husband, who was receiving mechanical ventilation and was unresponsive and surrounded by multiple invasive catheters and equipment. The trauma team briefly met with her soon after admission to explain her husband’s grave prognosis.
The next day, a senior student in an undergraduate critical care nursing course assisted the nurse preceptor in managing the patient’s complex care. The patient’s wife came into the unit for her second visit just as the nurse preceptor and the student prepared the patient for the morning visit. As the patient’s wife approached the bedside, the monitors' alarms for the cardiac and arterial catheters sounded, indicating a cardiac arrest, and CPR was initiated. The healthcare personnel handling the code situation pulled the privacy curtains around the bed in an attempt to screen the situation from the view of the patient’s wife and the other patients and their visitors within the unit. At that moment, the student took the stunned wife into the hallway, and a nursing supervisor arrived to lead the woman into a private waiting room. The student later reported the morning events to her peers at a clinical conference, including the fact that the patient’s wife had arrived just as the code started. The student explained that the patient did not survive despite the team’s efforts and that the patient’s wife did not have the opportunity to see him again before he died. The student’s statement caused the instructor to question the policy in almost all adult critical care units that family members’ access to loved ones during CPR should be restricted. The ethical dilemma that arose in this situation involved the conflict between the desire of the patient’s wife to be present during CPR and the desire of the trauma team to exclude her.
Please discuss the following questions in your discussion board post.
An ethical dilemma surrounds the caregivers’ decision to restrict a patient’s family member’s access to her loved one during cardiopulmonary resuscitation. As the patient’s wife arrived in the emergency unit, the patient experienced a cardiac arrest, and CPR was initiated. However, the clinician pulled the privacy curtains around the bed to screen the situation from the patient’s wife’s view. Eventually, the patient’s wife was not allowed to watch CPR being performed on her husband, which led to a loss of the opportunity to see him again before he died. Although there does not exist an overriding to honor the family’s desire to be present during CPR, allowing them to stay with their loved ones helps safeguard their mental and emotional health. According to Toronto and LaRocco (2019), being present during CPR allows family members to understand that everything possible to revert the patient’s condition has been implemented and that there is nothing else that clinicians can do to help them improve. Family members also gain an opportunity to remain with their loved ones during the resuscitation and see them for the last time in case of death, which helps to avoid post-traumatic stress and its associated health implications. Therefore, it was necessary for the healthcare personnel handling the code situation to allow the patient’s wife to stay in the room as CPR was performed.
Allowing family members in the room during CPR does not invade the patient’s confidentiality. According to de Mingo-Fernández et al. (2021), offering family members the option to be present during CPR brings about positive results on psychological variables among both the patient and their loved ones. Although it may constitute a distraction to the clinicians, most patients are observed to respond positively to such an undertaking. Most patients, therefore, do not feel that their privacy is invaded. However, the family presence of CPR may impact the ethical principle of futility as clinicians’ capacity to deliver the required services to the patient is distracted. I, therefore, believe that family members should be present during resuscitations.
Toronto, C. E., & LaRocco, S. A. (2019). An integrative review is a family’s perception of and experience with family presence during cardiopulmonary resuscitation. Journal of clinical nursing, 28(1-2), 32-46. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14649
de Mingo-Fernández, E., Belzunegui-Eraso, Á., & Jiménez-Herrera, M. (2021). Family presence during resuscitation: adaptation and validation into Spanish of the Family Presence Risk-Benefit scale and the Self-Confidence scale instrument. BMC health services research, 21(1), 1-12. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06180-2
Customer's Feedback Review
Published On: 01-01-1970
Access to the order has been disabled by the author