Attitudes of Community Hospital Critical Care Nurses Toward Family-Witnessed Resuscitation.

BACKGROUND: Family-witnessed resuscitation is not consistently practiced in critical care despite the fact that it is recommended and research shows that it supports the emotional needs of families and patients and improves decision-making, care, and communication. Nurses support the idea of family-witnessed resuscitation but may not believe it should be standard practice. OBJECTIVES: To examine the attitudes of American community hospital critical care nurses about family-witnessed resuscitation and to identify differences in attitudes between nurses who have and have not experienced it. METHODS: This cross-sectional, descriptive study of 40 critical care nurses was conducted at 2 community hospitals. Demographic data were collected and a previously developed questionnaire was used to survey participants on their attitudes about family-witnessed resuscitation factors including decision-making, process, and outcomes. RESULTS: Most participants (92%) had experienced family-witnessed resuscitation and most had positive attitudes about the benefits and outcomes of family-witnessed resuscitation. Participants did not believe that family presence is too distressing for families or that resuscitation team performance would be negatively affected. Participants indicated that fear of litigation, family disruption of resuscitation, and family misinterpretation of procedures would not increase with family presence. CONCLUSIONS: Findings show that community hospital critical care nurses support family-witnessed resuscitation. Prior experiences and cultural beliefs should be considered when developing family-witnessed resuscitation policies. Further research is needed on the influence of these factors on nurses' attitudes toward family presence to inform practice.

Stress among caregivers of chronically ill older adults: implications for nursing practice.

Caregiving is a dynamic process involving a series of decisions at different stages of a person's chronic illness trajectory. Research suggests the burdens of caregiving can lead to caregiver stress, the actual or perceived physical or emotional strain experienced by the caregiver. Nurses have a pivotal role in assessing for caregiver stress and providing interventions to assist caregivers. This article defines caregiver stress, discusses the impact that caregiving has on a caregiver, provides assessment principles to identify caregiver stress, and includes evidence-based interventions that can be tailored to individual caregivers to encourage health-promoting behaviors.