Journal of Postgraduate Medicine
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LETTER
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Year : 2015  |  Volume : 61  |  Issue : 2  |  Page : 146-147  

Relatives' experiences in acute care settings: Barriers and remedial measures

S Senthilkumaran1, F Benita2, R Manikam3, P Thirumalaikolundusubramanian4,  
1 Department of Emergency and Critical Care Medicine, Sri Gokulam Hospital, Salem, Tamil Nadu, India
2 Department of Emergency Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
3 Department of Emergency Medicine, University of Malaya, Kuala Lumpur, Malaysia
4 Department of Internal Medicine, Chennai Medical College and Research Centre, Trichy, Tamil Nadu, India

Correspondence Address:
S Senthilkumaran
Department of Emergency and Critical Care Medicine, Sri Gokulam Hospital, Salem, Tamil Nadu
India




How to cite this article:
Senthilkumaran S, Benita F, Manikam R, Thirumalaikolundusubramanian P. Relatives' experiences in acute care settings: Barriers and remedial measures.J Postgrad Med 2015;61:146-147


How to cite this URL:
Senthilkumaran S, Benita F, Manikam R, Thirumalaikolundusubramanian P. Relatives' experiences in acute care settings: Barriers and remedial measures. J Postgrad Med [serial online] 2015 [cited 2020 Jun 4 ];61:146-147
Available from: http://www.jpgmonline.com/text.asp?2015/61/2/146/153122


Full Text

Sir,

We read the article by Bhalla et al. [1] and the related commentary [2] with keen interest. These articles depict the positive experiences of relatives in acute health-care settings and emphasize a relationship-centered approach in health care. However, we would like to point out a few gray areas, based on our experiences in emergency departments and discuss the barriers to the said approach as well as remedial measures. With the increasing acceptance of family-centered care, health-care providers have relaxed visitation policies, allowing family members/caregivers at the bedside even during invasive procedures and resuscitation, and included them in health-care decisions.

However, there are a few drawbacks. For instance, when they happen to witness the cries and agony of the patients, see the bleeding and suffering, or watch the procedures (intervention, resuscitation, suturing, etc.), they get upset or faint and fall. Sometimes they are likely to sustain injuries and require medical assistance and care included themselves. A few misunderstand and misinterpret the services and/or complications of an emergency as medical errors and become furious with the care providers, and use abusive language or react violently and physically assault the care providers. At times, the caregivers damage hospital properties in an emergency room and disrupt care to other patients. All these problems occur globally, due to the misconstrued ideas of an unprepared mind and the adverse media publicity of hospitals and health-care services. In our locality, women in particular express their grief physically by beating on their chests, or by wailing and fainting. The emotional responses of the caregiver/family member add to the anxiety and stress of care providers, and interfere with the delivery of health care. [3] Moreover, witnessing therapeutic events in an emergency setting definitely disturbs the peace of family members. [4] Unfortunately, these traumatized family members have sued hospitals and health-care providers, stating that they witnessed their actions and described them as suboptimal. Additional challenges in academic institutions are interferences by relatives for education and discussion during while handling emergencies by care providers, and the management of such clinical problems by junior faculty. Various social, psychological, cognitive, and economic factors push the caregivers/family members towards such behavior. Furthermore, the relatives or the caregivers are often unaware of how to safely handle infected body fluids and health wastes, which may contribute to serious hazards to the care providers in a health-care setting.

 Remedial Measures



Good communication skills and empathy among care providers win the confidence of caregivers and lead them to accept the care provided to their loved ones at the hospital; they also have positive effects on adherence to medication, behavior modification, follow-up, and long-term care.

Medical and nursing students, doctors, and nurses are taught and trained more about diseases, diagnostics, drugs, devices, and demands of the disease; and less about the delivery of holistic health care, which includes the needs and expectations of the patients and the caregivers. To bridge the gap between care providers and caregivers, there is a need for well-planned training using simulation models.

References

1Bhalla A, Suri V, Kaur P, Kaur S. Involvement of the family members in caring of patients an acute care setting. J Postgrad Med 2014;60:382-5.
2Jagannathan A. Family caregiving in India: Importance of need-based support and intervention in acute care settings. J Postgrad Med 2014;60:355-6.
3Boyd R. Witnessed resuscitation by relatives. Resuscitation 2000;43:171-6.
4Kramer DB, Mitchell SL. Weighing the benefits and burdens of witnessed resuscitation. N Engl J Med 2013;368:1058-9.

 
Thursday, June 4, 2020
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