Introduction
Permission of family members in a trauma bay is one of the controversial issues in contemporary medicine. Both supporters of family presence and their opponents provide evidence for their positions and reveal benefits as well as negative aspects of every point of view. On the one hand, family presence is expected to have a positive impact on a patient providing a higher level of comfort (Traylor, 2018). Also, being present in a trauma bay or during resuscitation contributes to lower rates of posttraumatic stress disorder and stimulates acceptance of a patient’s death in case resuscitation is not successful (Traylor, 2018). On the other hand, family presence can distract the attention of the trauma bay team, thus decreasing the quality of care. Another ethical argument against family presence is the protection of the patient’s privacy. Moreover, relatives can be shocked by the patient’s condition, which can be traumatic. My ethical position is that the family should not be allowed in a trauma bay during resuscitation interventions. I believe that the fear of interference by a patient’s family as well as the lack of space for necessary interventions and fear of family members’ trauma are the arguments against the family’s presence in a trauma bay.
Impact of the Scenario on a Nurse Practitioner
The scenario when the family is allowed in a trauma bay can have a negative impact on nurse practitioners and the way they perform their functions. Thus, the study by Tudor, Berger, Polivka, Chlebowy, and Thomas (2014) provides evidence that the majority of nurses involved in the survey believe that family members are likely to panic in case they witness resuscitation efforts or will get a negative emotional impact. Consequently, nurse practitioners will be distracted from their direct duties and will have to take care of the patient’s relatives. Family presence during resuscitation interventions, unless allowed by a patient, involves a legal argument in addition to ethical. Thus, it is a violation of the patient’s privacy.
Family permission in a trauma bay contributes to some potential professional code conflicts. For example, the Code of Ethics for Nurses (American Nursing Association, 2015) demands the primacy of the patient’s interests, which may not be achieved in case a relative interferes with the process of care. Also, Provision 3 of the Code presupposes protection of the rights of privacy and confidentiality of patients, which becomes impossible when the family is present. Finally, nurses are expected to demonstrate accountability and responsibility for nursing judgments, decisions, and actions, and family permission can negatively influence these issues.
Since there are no definite federal guidelines concerning the issue, it is regulated by a healthcare facility. Still, it is important to consider the fact that healthcare staff takes legal responsibility for a patient’s well-being and thus should be empowered to decide on family permission. Thus, the legal evidence in support of not allowing relatives to be present during care procedures is the obligation of nurse practitioners and physicians to be responsible for the patient’s condition.
Strategies and Solutions to Address the Issue
Nevertheless, family presence during resuscitation is the right of patients and their relatives. The major strategy that can be implemented to avoid the negative influence is making a common decision about the family permission in a trauma bay. This decision should be made by the patient, family, the responsible physician, and a nurse practitioner. Consequently, the solution is to obtain the patient’s consent to the family’s presence and assess the safety of this permission by the physician. Still, the family should be educated about safety measures and not interfere with the resuscitation process. The case under analysis also involves the ethical issue of responsibility for the healthcare environment.
Conclusion
On the whole, the issue of family presence in a trauma bay is still controversial. Thus, taking into account the right of patients to have relatives near them during the process of care, the family can be allowed to be present in case the patient agrees, and the supposed benefits are greater than the possible risks. Still, when resuscitation interventions are provided for patients in acute conditions who cannot make decisions, the family should not be allowed not to interfere with the process of care.
References
American Nursing Association. (2015). Code of ethics for nurses with interpretive statements (View only for members and non-members). Web.
Traylor, M. (2018). Should family be permitted in a trauma bay? AMA Journal of Ethics, 20(5), 455-463.
Tudor, K., Berger, J., Polivka, B., Chlebowy, R., & Thomas, B. (2014). Nurses’ perceptions of family presence during resuscitation. American Journal of Critical Care, 23(6), e88-e96.