1. Miracle, Vickie A. EdD, RN, CCRN, CCNS, CCRC

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Meeting the needs of family members, significant others, extended family members, or others is of particular interest to many. Having been a critical care nurse, a patient in a critical care unit, and the family member of a patient in a critical care unit, I have had the opportunity to see this issue from all sides.


I believe that critical care nurses are fantastic at meeting the needs of families and doing whatever they can to help them through this difficult time. Believe me, it is just as hard (if not even harder) on the family as on the patient during this period. The patients are extremely well cared for by the nurses. But are we doing enough to take care of the families?


So as a tribute to critical care nurses, I would like to describe actions I have seen taken by nurses to help meet the needs of families of our patients. These are as follows:


1. Providing coffee and other beverages (legal, of course) in the waiting area.


2. Allowing flexible visiting whenever possible.


3. Meeting with the family members at least once a shift to discuss the patient's condition in terms they can understand.


4. Providing blankets and pillows for those who choose to spend the night in the waiting area or at the bedside, if appropriate.


5. Be instrumental in the placement of lounge chairs in the patient's room and in the lounge.


6. Having the courage to deliver bad news.


7. Having the courage to refuse some requests of the family in the best interests of the patient.


8. Knowing when to stay quiet.


9. Realizing the value of silence at certain times.


10. Allowing family members to remain at the bedside of a patient with a "do not resuscitate" (DNR) order even though the unit has a strict visitation policy and realize you will accept the consequence of your actions


11. Allowing a husband to remain with a very anxious wife to help her cough with pursed lip breathing during a severe asthmatic episode, thus decreasing the amount of medication needed.


12. Allowing a wife to bring a radio to her comatose husband so that he might hear his favorite station. This was before music therapy was generally accepted.


13. Providing as much privacy as possible.


14. Standing up to a physician and strongly emphasizing the need for he or she to speak with the family. Some critical care units have back doors that allow physicians to enter and leave the unit without walking past the waiting room. The family needs to talk with the physician.


15. Working to have a volunteer staff the waiting room as much as possible.


16. Allowing the family members to help in the patient's care if they so desire.


17. Telling family members that it is important for them to take care of themselves at this crucial time. Sometimes they need your permission to leave because they feel they should be at the hospital 24/7.


18. Providing beepers to family members.


19. Giving the phone number of the unit to the family members so that they can call for update on their loved one's condition.


20. Providing a certain time each day or week, in some cases, to meet with the family for a conference meeting to inform the family and answer their questions.


21. Serving as a patient advocate.


22. Allowing children to visit, if appropriate. Once, there was a patient dying from an ischemic bowel. His first grandchild had just been born in the same hospital. The nursing staff arranged to have the granddaughter brought to the patient's room for a short visit. His smile was unforgettable. Later, the nurse pinned a picture of his granddaughter to his hospital gown and it stayed there until he died.


23. Allowing a favorite pet to visit. The benefits of pet therapy have been documented. Before this became a more popular procedure, I allowed a family member to bring in a "seeing eye" dog. Thank goodness, the dog was a German shepherd.


24. Having the courage to break the rules when it is in the best interest of the patient and then be willing to accept the consequences.


25. Remaining with a family once life support has been removed until the patient dies.



So are we doing enough for the families of our patients? Who is to say what is enough? It varies from patient to patient and family to family. Yes, we could probably do more but I believe we are doing the best we can in every situation and we are still life-long learners. So we will keep doing what we are already doing and strive to do more. It is in our nature as critical care nurses.


Dimensions of Critical Care Nursing would like to issue a call for abstracts from undergraduate and graduate nursing students for a new section called, "Student Abstracts." Both undergraduate and graduate nursing students in the area of critical care conduct much good research and I would like to share the results of this research with our readers. So many times the results of this research are presented in the classroom setting and not disseminated to others. Here is an opportunity for those students to publish their abstracts.


If you would like to submit your research abstract, you must be either an undergraduate nursing student or a graduate nursing student. Your research must be related to the area of critical care nursing. Please submit the following:


1. Title of the Abstract


2. Your name and address


3. School of Nursing


4. No more than 2 paragraphs summarizing the research and its findings


5. Please submit the abstract to:Dimensions of Critical Care NursingVickie Miracle, EdD, RN424 Eastgate Village WyndeLouisville, KY 40223You could also fax it to 502-253-5560You could also e-mail it to [email protected]



Please submit your research and discover the pleasure of publishing.