Involving the Family in Pre-hospital Care

[Sasha]

Do you make an effort to include the family in care of a patient, young or old? Or are you one of those who prefers them to just get out of the way so you can do your job?

Was reading an interesting article on including family in the care, which personally i think it's better for the patient, in my limited experience the patient seems to be calmer knowing that family is there and they are not alone in a truck with strangers.

Involving the Family in Pre-hospital Care
Full Article: http://www.ems1.com/columnists/robe...191-Involving-the-Family-in-Pre-hospital-Care

Simply stated, pre-hospital family-centered care is the art of treating patients as you would like to be treated — emotionally, physically, and medically. A more formal definition is "the systematic approach to building collaborative relationships among EMS providers, their patients, the patients' families, and other healthcare professionals, which in turn promotes quality EMS care, community health, and safety." It provides focus to ensure the patient and their family members are informed about their condition, the therapeutic pathways being taken, any prognosis, and options to care within the EMT's or paramedic's scope of practice.

There is also a strong emphasis on the EMS provider utilizing the patients' or their families' knowledge of relevant medical conditions, histories, and treatments, and knowing information about the other members of their health care team. This type of care encourages family members to be active guests during all procedures, including full resuscitation. This collaborative approach provides an environment that promotes higher quality care and ultimately makes the EMT's or paramedic's job easier and more rewarding.

While these ideals may seem simple and theoretically easy to execute, it is possible to overlook or neglect them in times of stress or as tasks become more routine. It is important to remind ourselves why holistic patient treatment is so important, and take a moment to consider the following advice to help us provide such treatment at the highest level.

 

[VentMedic]

We did just have a recent thread for the resuscitation issue. I believe in many circumstances the family should be present especially if they have has a difficult time letting go or to see everything was done.

Definitely a great idea for kids unless there is suspected child abuse. Then it is a judgement call on the situation as you want to get the child to the hospital and under protective custody but you don't want to make the suspicious and refuse care.

The other issue is with adults. They don't always tell their loved ones everything and often will not reveal anything in front of their family. Sometimes patient privacy must be observed and don't be surprised or get your feelings hurt/ruffled if much more is revealed to the hospital staff behind closed doors with the family out of hearing range.

Even for routine testing in a Pulmonary or Cardiac Lab, privacy issues puts us in a limited situation when it comes to interviewing or confirming information. With the family present I can not ask directly what the patient knows about his diagnosis of cancer or just about any disease unless given explicit permission. However, if I ask for permission with the family present I will be accused by the patient of stacking the deck against him/her by putting him into a stressful position of answering no in front of his family. But, if you ask the family to leave while you talk to the patient, they get suspicious and demand to know what one has to hide.

Granted it is a little different in an emergency but we have learned long ago in the ED, simple questions such as "can you be pregnant" can cause embarrassment when asked of a teenager in front of her parents. It is such a routine question asked of all women of child bearing years that we sometimes forget comfort zones. As well, that girl will not be honest even if there is a chance of pregnancy so the question is almost pointless and has just led to an uncomfortable situation.

 

[Ridryder911]

Alike any other call or patient each response is unique and should be treated individually. Each should be evaluated case by case. There are times that help from family is essential and other times could be an impedance.

In other health care professions they are taught in how to cope with family members and involve them in patient care, again the same old limerick .. we lack to educate our own.

R/r 911

 

[8jimi8]

I would like to say that I "want" to involve the family...but what I want is not necessarily what the patient wants/needs. Rid and Vent pretty much covered it all.

 

[usafmedic45]

I would like to say that I "want" to involve the family...but what I want is not necessarily what the patient wants/needs. Rid and Vent pretty much covered it all.

Once Rid and Vent get done posting, most threads should just be locked because pretty much everything that needs to be said has been said and the rest is usually just petty squabbling over details or exceptions to the rule.

 

[WuLabsWuTecH]

Yep! ocmpletely agreed. Always on a case by case. Almost ALWAYS with peds patients (where we'll even let 1 family member/caregiver ride in the back!).

 

[daedalus]

I am sure to make a big effort to create a positive first impression and respect parents of young children when I take care of their kids. If the parents are at ease, I feel they can better keep their kid at ease.

As far as adults, I feel that family sometimes gets in the way, but I am always respectful.

 

[HotelCo]

Depends on the call. As long as the patient doesn't mind their involvement, and they don't create problems, they're welcome to stay and be involved.

 

[mycrofft]

Case by case, and remember who the pt is.

We let a frat "brother" ride to an ER with his injured "little brother"/pledge who mysteriously tore his medial proximal thigh right by the groin while intoxicated. The elder kid was keeping the younger one shut up about, as it turned out, being chased after a drinking game with paddling (cricket bat style) if he was caught, and membership if he outran. Tried to climb a chain link fence with unbent tips wearing a jock strap. Cops finally got the story.

I like to eliminate the non-pt's for the length of the ride.