How do the attitudes and beliefs of critical care nurses influence the process for family presence resuscitation
Understanding critical care nurses' attitudes and beliefs regarding FPR can help identify what interventions can be used to promote and support the family presence during resuscitation in the ICU setting. The purpose of this research study was to describe the attitudes and beliefs of the critical care nurse and develop a beginning theory describing the process and practice critical care nurses use regarding family presence during resuscitation. Grounded theory methodology (Glaser, 1992) based on symbolic interactionism was used. The conceptual orientation influencing this project is the Patient Family Centered Care model. Results: Nurses' use constructs of attitude and beliefs as their basis to support their understanding that FPR is "the right thing to do" and "putting the patient first". The first priority at the initiation of the resuscitation is for the patient; that the resuscitation begins in a timely manner, and that all members of the team are present. During this crucial time, the nurses ask family members to leave the room for the resuscitation. When the resuscitation outcomes are expected to end with the demise of the patient, the staff then begins to address the needs of the family and the need for a FPR event. In this study participants identified that family facilitator availability is crucial in making a decision to allow a FPR event to occur. This study also identified a new phenomenon of allowing or involving family members input in regard to the decision to end resuscitation. Participants expressed this practice as common in critical care settings. It is unclear as to the benefit to the family or the efficacy of this practice based on evidence. Data from the conceptual model themes were used to develop the beginning theoretical model for FPR in critical care the "Justice Model". Central to this model that critical care nurses are guided by the ethical principles of "Justice" their right to be there, and beneficence to first do no harm to the patient first (resuscitation attempt) and family second for closure.
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