Family-witnessed resuscitation: focus group inquiry into UK student nurse experiences of simulated resuscitation scenarios

David Pontin; Gerard Kenny; Issy Bray; John Albarran

doi:10.1136/bmjstel-2016-000115

Family-witnessed resuscitation: focus group inquiry into UK student nurse experiences of simulated resuscitation scenarios

BMJ Simul Technol Enhanc Learn. 2016 Jun 24;2(3):73-77. doi: 10.1136/bmjstel-2016-000115. eCollection 2016.

Authors

David Pontin¹, Gerard Kenny², Issy Bray³, John Albarran²

Affiliations

¹ Faculty of Life Sciences and Education, School of Care Sciences, University of South Wales, Pontypridd, UK.
² Department of Nursing and Midwifery, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
³ Department of Health and Social Sciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.

Abstract

Aims: To describe the impact of family members' presence on student nurse performance in a witnessed resuscitation scenario. To explore student nurses' attitudes to simulated family-witnessed resuscitation and their views about its place in clinical practice.

Background: Family-witnessed resuscitation remains controversial worldwide. Hospital implementation remains inconsistent despite professional organisation support. Systematic reviews of international literature indicate family members wish to be involved and consulted; healthcare professionals express concerns about being observed while resuscitating. Student nurse perspectives have not been addressed.

Design: Qualitative, focus groups.

Methods: Participants: UK university second-year student nurses (n=48) who participated in simulated resuscitation scenarios (family member absent, family member present but quiet or family member present but distressed). Data generation 2014: focus group interview schedule-five open-ended questions and probing techniques. Audio recordings transcribed, analysed thematically. Research ethics approval via University Research Ethics committee.

Findings: Overarching theme=students' sense making-making sense of situation (practically/professionally), of themselves (their skills/values) and of others (patients/family members). Students identify as important team leader allocating tasks, continuity of carer and number of nurses needed. Three orientations to practice are identified and explored-includes rule following, guidance from personal/proto-professional values and paternalistic protectionism.

Discussion: We explore issues of students' fluency of response and skills repertoire to support family-witnessed resuscitation; explanatory potential to account for the inconsistent uptake of family-witnessed resuscitation. Possible future lines of inquiry include family members' gaze as a motivational trigger, and management of guilt.

Keywords: family witnessed resuscitation; qualitative research; simulation; student nurses.

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