Families in the intensive care unit: their effect on staff

In summary, families in the ICU have had both a positive and a negative effect on staff. On the positive side there is an increased opportunity for staff to get feedback and appreciation. Goals can be realistically refocussed to help the family when a patient can no longer be helped, thus broadening the role of the staff. This also applies to the nurse advocacy role being enhanced by the increased patient data provided by the family. The opportunity to personalize the patient, to get to know him, is provided by the family's presence. And when a patient dies in the unit a family's grieving can help the staff with closure around its own grief. Families who express unrealistic demands of the ICU staff can be experienced as a stress. Staff who feel unsure of themselves or criticized by families have found the presence of families difficult. Staff who prefer to remain detached from patients also are uncomfortable with increased family presence. Feelings of rivalry with those nurses seen as "super nurses" has been a source of stress for a few in the unit. Discussions of how the staff feels about families and how certain families make the staff members feel about themselves have helped to maintain an objectivity on the part of the staff. Identifying the stress and providing support and understanding for staff have reduced the numbers of exacerbations and provided increased opportunities for staff and family to work together toward their common goal--the well-being of the patient.