Does Family Presence in the ICU Help or Hinder?
By Kathleen Rose Umali
Senior Nursing Student
Dominican University of California
San Rafael, CA
I am writing in response to an article, "Does Family Presence in the ICU Help or Hinder?" by Beth Puliti, posted on Oct. 11, 2010 for Advance for Nurses. I found the article to be extremely enlightening as far as educating the nurse population on the different experiences in dealing with patient families. In school, we learn that the patients we care for come in with a variety of medical backgrounds, religious affiliations, and health beliefs so it should be no surprise that the family and friends that come to visit these patients are as diverse as the patients themselves.
In facilitating the best nursing practice, I completely agree that having family present in the ICU, and in generally any and all units, leads to improved quality of care, better patient outcomes, and more positive patient satisfaction scores. Having the patient's family there to witness the care can have all sorts of benefits. Patient family involvement coupled with dual patient/ family education can lead to shorter hospital stays and less re-admissions because families are aware of relevant information that some patients may not be able to retain due to high stress levels or for whatever reasons such as important medications and special precautions to take. I fully advocate for hospitals to allow reasonable visiting hours but also believe that nurses should reiterate to families the importance of rest and recuperation.
I am a big advocate of having the family learn how to help the patient so that when the patient goes home, he/she can better transition into post- acute care but I also understand that in my career I will come across difficult situations in which I will need to use my best judgement to decide how to provide the best holistic care for my patients. When I was 16, my niece was a patient at Oakland Kaiser's pediatric ICU and because of her parents' complicated familial situation, there was a lot of tension on the entire unit because of our family. The nurses and her physicians all knew of the situation and our family was given a case manager and we had weekly meetings with the case managers in order to get updates of her status.
My mom was appointed our family's liason between the medical team and the family because she herself is an ICU nurse. I understood exactly of which she pinpointed as the detrimental effect families may have on the ability for the medical staff, especially the nurses, to care a patient more effectively. I truly appreciate that, although at times we were difficult to deal with in that stressful situation, they were still able to give all their love and care to my niece and all other patients and families on the unit. Furthermore, as a nursing student, I have witnessed multiple cases in which family members caused a negative impact in the quality of care but still, again, advocate for allowing patients to have their loved one around when they need them the most.
Thank you so much for your contribution to nursing.