Family Matters

Emergency-room patients benefit from having relatives with them

SATURDAY, May 12 (HealthScout) -- Emergency-room patients being treated for heart attacks or other life-threatening illnesses and injuries benefit from the comfort and support of having family members with them, says a new study.

"It's the first study of its type that we know of in the literature," says lead author Dezra J. Eichhorn, a trauma psychosocial clinical nurse specialist at Parkland Health and Hospital System in Dallas.

Because of the close bonds, family members know how to comfort a relative in ways impossible for any doctor or nurse.

"I really think that's what makes the big difference," Eichhorn says. "They can advocate for them or just be with them to make them feel less afraid or less alone, to hold their hand and talk with them."

The study, published in the May issue of the American Journal of Nursing, was based on interviews with nine emergency department patients. Eight had invasive procedures, such as open wound exploration or chest tube insertion, and one had cardiopulmonary resuscitation (CPR).

Several themes emerged from the interviews. The patients said they were comforted and received help from relatives, who were able to act as their advocates and provide information to the medical team.

The patients also felt the presence of family members reminded the medical team that the patient was a person, not just a medical case. This would prompt the doctors and nurses to try harder to save the patients. And all the patients said they felt it was their right to have their family with them during their struggle for life.

There are benefits for family members, too, says study co-author Theresa A. Meyers, director of the emergency department at Presbyterian Hospital of Dallas.

"If they're sitting in the waiting room by themselves, they often feel helpless. If they're in the [patient's] room, they do feel like they can help," Meyers says.

"I had one gentleman who told me that it meant so much to him that we offered for him to come in the room, that because we were concerned enough about him, that he knew we'd do everything we could for his wife."

But Meyers stresses that the presence of family members isn't suitable all the time; decisions should be made on a case-by-case basis.

"Some family members may feel like they can't be in the room. So we don't want to make them feel like it's an expectation. We want to make them feel comfortable with their decision," Meyers says.

Eichhorn adds that it isn't just a matter of throwing open the doors.

"We really believe it's important to have a controlled environment, that you assess the family members before they go in and before you offer them the option," she says.

For example, relatives who are extremely emotional, combative or under the influence of drugs or alcohol wouldn't be invited to visit the patient.

Both Parkland Memorial Hospital and Presbyterian Hospital have implemented policies to offer the option of family presence during invasive procedures and CPR. A follow-up study is under way to determine how many hospitals across the country have such policies.

But Eichhorn and Meyers say this is a controversial issue that raises the hackles of many medical professionals.

"It's a fear of the unknown. It's a fear of how the family members may react when they come in the room," Meyers says.

They both acknowledge that theirs is a small study, but say it's a first step in convincing other doctors and nurses.

"It's a concept that people are beginning to learn about and consider, but there's still a lot of emotionalism and controversy associated with the practice," Eichhorn says.

What To Do

Take a look at another study, published in February 2000, that examined this issue from the perspective of family members and medical staffers.

And for more HealthScout stories on patient issues, click here.

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