Rich, Ann (2007) "I’ll call you when we are ready" (One family’s experience of critical care and end of life decision making). In: 8th International Family Nursing Conference: Healing Families, Healing Communities: New Innovations in Practice, Education, and Research, 04-07 June 2007, Bangkok, Thailand. (Unpublished)

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Abstract

The purpose of this paper is to explore through narrative accounts one family's expérience of critical care, after the admission of a family member to an Intensive Care Unit (ICU) and their subséquent death five weeks later. Numerous studies support the need for effective communication and clear information to be given to the family. In this instance it was évident from their stories that there were numerous barriers to communication, including language and a lack of insight into the needs of the family. Many families do not understand the complexities of nursing care in an ICU so lack of communication by nursing staff was identified as uncaring behavior and encounters. Facilitating a family's proximity to a dying patient and encouraging them to participate in care helps to maintain some sensé of personal control. Despite a commitment to involving family members in care, which was enshrined in the Unit Philosophy, relatives were banished to the waiting room for hours. They experienced feelings of powerlessness and helplessness as they waited with other relatives for news following investigations or until 'the doctor had completed his rounds'. Explanations of "we must make 'the patient' comfortable" was no consolation for those who wished to be involved in care. The words "I'il call you when we are ready" became a mantra to the forgotten families who waited patiently for those with power to admit them to the ICU. Implications are this family felt they were left alone to cope with the traumatic expériences leading up to and surrounding the death. They felt mainly supported by the priest, who not only administered the last rites but provided spiritual support to the family and dealt sensitively with many issues. Paternalism in décision making when there is a moral obligation to ensure that discussions on end of life dilemmas are an inclusive process with families, doctors, nurses was not understood, therefore it caused conflict within the family over EOL décision making. The family felt that the opportunity to share expériences through telling and retelling their stories would enable them to reconfigure the past and create purpose in the future.

Item Type:	Conference or Conference Paper (Poster)
Additional Information:	Highlights of the 8th International Family Nursing Conference, Bangkok, Thailand, June 4-7, 2007 published in the Journal of Family Nursing 2008 Nov;14(4):391-3. doi:10.1177/1074840708327975
Uncontrolled Keywords:	critical care, end of life, decision making, family, experience
Subjects:	H Social Sciences > HQ The family. Marriage. Woman R Medicine > RT Nursing
Pre-2014 Departments:	School of Health & Social Care School of Health & Social Care > Family Care & Mental Health Department
Related URLs:	Organisation Organisation
Last Modified:	14 Oct 2016 09:07
URI:	http://gala.gre.ac.uk/id/eprint/2596

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