Proposal to allow relatives into casualty is rejected

Letting relatives watch attempts to bring their loved ones back to life in hospital accident and emergency departments could cause deep psychological trauma and do more harm than good, nurses decided yesterday.

The Royal College of Nursing, meeting at Harrogate for their annual conference, rejected a proposal that hospitals should operate an open door policy for relatives who wanted to be present when resuscitation was attempted.

In an emotional speech to the college's annual conference in Harrogate, Betty Woodland, an A&E nurse with 30 years' experience, described how witnessing efforts to revive her 18-month-old grandson after he fell into a lake added to the family's distress.

"The loss of a precious child devastated the family. But efforts by police, ambulance, paramedics and A&E staff left us traumatised so much so that I will live with it for the rest of my life. No amount of training in A&E prepared me to watch it from the other side."

She said the accident left no mark on her grandson's body, but after the resuscitation attempt he was bruised and battered.

"For ever I will wonder did they carry on for longer than they would have if we had not been watching. There is no doubt in my mind that I and my family were, and still are, damaged by watching that attempted resuscitation."

Going against advice from a working party of the college and from doctors on the UK Resuscitation Council, that relatives should be allowed into resuscitation rooms to aid the grieving process when attempts failed, nurses decided by a margin of two to one that the dangers were too great.

The spectacle of a close relative being subjected to a medically-sanctioned assault - having their chest pounded, their windpipe intubated and their heart given an electric shock - in an often doomed attempt to bring them back to life, could add to the distress of those left behind, the meeting heard.

Hospitals did not have the resources to counsel relatives during a resuscitation attempt.

Helen Whyley, a staff nurse from Wales, who proposed the motion, said it was important relatives were present when a family member died. "This may be their last chance to say I love you, I'm sorry or goodbye," she said.

A 1995 survey showed a quarter of accident and emergency departments allowed relatives to witness resuscitation and there was no evidence that relatives who did so got in the way. Fears of litigation were unfounded as the experience tended to reassure the family that everything possible had been done, she said.

"It is said that relatives will not want to remember loved ones with people jumping up and down on their chests and giving electric shocks. But how do we know if we don't ask them?"

Brian Dolan, a research fellow in A&E at King's College Hospital, London, said he had been excluded from the resuscitation room when his own mother suffered a cardiac arrest. "Witnessing something is painful, but ignorance is far worse," he said.