Question 1 (889 words without citations)
“Parental presence during resuscitation in the PICU: the parents’ experience. Sharing and surviving the resuscitation: a phenomenological study” was conducted by Fiona J. Maxton to provide a deeper understanding and significance of parents being either present or absent during resuscitation attempts on their children in the Pediatric Intensive Care Unit (PICU). This research was justified since parent presence during resuscitation attempts has been a widely debated topic, and there is a need to identify and understand its benefits and drawbacks so that nursing policy regarding the process can be designed to address the needs of parents (Maxton, 2009). Parents bear the ultimate responsibility for their children. It is therefore necessary that nurses give them the opportunity to participate in procedures involving their children if nursing care is to be holistic as it ought to be.
Fiona Maxton used a hermeneutic phenomenological approach to capture the experiences of parents whose children had undergone both successful and unsuccessful resuscitation procedures at a PICU within a tertiary pediatric hospital in a metropolitan area in Australia. She however fails to explain to readers who are not familiar with research methodologies on why she chose this methodology. However, it was an excellent approach for translating the significance of actual human experiences to real situations.
The setting of the study was a single 20-bed Pediatric Intensive Care Unit in a referral hospital. Since the nurses at the hospital served all respondents who were recruited for interviews, this might have been a flaw in the research. Different nursing teams at different PICUs might have responded differently under identical circumstances, radically changing the experiences the respondent went through. A very significant strength in her sampling was that respondents were identified and conducted approximately one week after their children had undergone resuscitation attempts. This timing was excellent since the memory of the experience was still fresh (van Manen, 1990), and the initial shock and depression of losing a child had subsidized for those parents who lost their child. However, her sample of eight parent couples was not large enough to be reflective of a conclusive derivation of the research topic (Maxton, 2009). Additionally, the research did not include parent couples who were absent and their child died during a resuscitation attempt.
The collection of data was objective and focused directly on the objective of this research. By using unstructured interviews, the researcher was able to extract the real feelings of parents concerning their experiences since too much formality would have induced tension. Holding interviews in quiet environments allowed respondents to reflect upon themselves and speak their hearts out. I would say that data collection was excellently executed and relevant.
This research was on a very sensitive subject. It was thoughtful that the researcher sought to establish relationships with her participants (van Manen, 1990) by first consulting the medical and nursing professionals who had handled respondent’s children at the PICU as well as the social worker before making contact. Parents had the choice to participate, withhold from participation and to withdraw from the study depending on their discretion. For anonymity, participants and their families chose or were accorded pseudonyms. This contributed to credibility of the study since participants had reason to trust the researcher.
Fiona Maxton liaised with the referral hospital as well its associate university’s Institutional Ethics committees for ethical approval of the procedures she was going to follow. Data collection therefore did not violate any ethical competencies recommended by the two institutions. Ethical approval is a very essential component in research (Flick, 2009) since it underlines authoritativeness in its findings. Any study that relegates ethics renders itself irrelevant and consequently inapplicable in professional service delivery, more so in nursing where emphasis is laid on the need to respect the culture, morals and beliefs of targeted communities as part of meeting emerging standards of care.
The data collected was recorded and transcribed. Field notes and transcripts were exhaustively read and throughout the report, actual quotes from participants are used to support the conclusions made and the significance they have. This is proof that data analysis was done extensively and research findings are a reflection of the collected information. The credibility and meaningfulness of the research is evident in the way it is presented and how it relies on participants’ actual feelings and interpretations of the experiences they went through, based on their responses.
At the end of the report, the researcher derives four themes capturing parent’s experience. The researcher then proceeds to give a detailed description for each, accompanied by supporting evidence from participants’ responses and an analysis of why and how the author derived these findings. It states that parents needed to be there for their child no matter the outcome of resuscitation and to appreciate the process. Physical presence gave parents hope and enabled them to establish relationships with staff in preparation for any eventuality (Maxton, 2009).
Finally, this research is valuable in that it is transferable to real nursing practice. It captures the feelings of parents whose children have to undergo resuscitation. It also emphasizes on the need to have parents have the choice of whether to be present during the procedure or not. This is a call for nurses to view circumstances from parents’ point of view and make the appropriate provisions to respect their wishes (Maxton, 2009). For parents, it outlines the importance of being present as their child goes through a procedure which could potentially result in death.
Question 2 (369 words without citations)
(a) This article found out that parents undergo much stress fearing separation from their children who are undergoing critical procedures like resuscitation. Parents have an urgent desire to be there to support their child as an exhibition of parental responsibility. Being present makes parents appreciate the effort made to save their child and prepares them to cope with the outcome (Maxton, 2008). Despite helping parents maintain hope amid the gravity of circumstances, presence also gives them the chance to say goodbye incase resuscitation fails. It is important therefore that nurses allow parents to witness resuscitation attempts as it does not harm them psychologically as thought.
(b) Qualitative research can contribute to improved clinical practice in a big way. First of all, it can alleviate the gap between theory and practice by changing the trend in which clinicians have to rely on their experience and intuition (Silverman, 1992). Scientific knowledge in its traditional context cannot always meet the unique requirements of specific situations (Seale, 1999). Research therefore must come in as the bridge that connects theory and actual practice by drawing the experience and intuition accumulated by clinical practitioners and specific situations to derive relations that help achieve holistic clinical practice.
Secondly, qualitative research exposes points of weaknesses that may have been unconsciously included in the formulation of clinical policy (Silverman, 1992). Sometimes, an aspect of clinical care might be overlooked or dismissed on the perception that it is unimportant or inconsequential. It is the role of research to identify misconceptions and neglected areas of clinical practice (Seale, 1999) so that the necessary changes in institutional policy can be implemented. For example, the research by Fiona Maxton emphasizes on the need for parents to be present while their children undergo resuscitation. The findings can be applied in health institutions where parent presence is disallowed or discouraged, and the benefits can be reaped by clinicians through their clients’ satisfaction.
For individual clinical practitioners, the findings of qualitative research can help instill a deeper insight and understanding of clinical practice. The healthcare practitioner will therefore be able to build better relationships with his patient and gain the knowledge of how best to act in specific circumstances (Silverman, 1992). Derivatives from qualitative research can also be instrumental in helping clinical practitioners understand the context of their profession.
List of References
Flick, U. (2009). An introduction in Qualitative Research. California: Sage.
Knott, A. and Kee, CC (2005) “Nurses’ beliefs about family presence during resuscitation.”
Applied Nursing Research,18, 192–198.
Maxton, JC F. (2008) “Parental Presence during Resuscitation in the PICU: the Parents’
Experience. Sharing and Surviving the Resuscitation: a Phenomenological Study.” Journal of Clinical Nursing 17, (23) 3168-3176
Seale C. (1999) The quality of qualitative research. London: Sage Publications.
Silverman, D. (1992). “Applying the qualitative method to clinical care.” In: Daly J, McDonald
I,Willis E, eds. Researching health care. Designs, dilemmas, disciplines. London: Tavistock/Routledge, 176–188
van Manen, M. (1990). Researching Lived Experience. Human Science for an Action Sensitive
Pedagogy. University of Western Ontario, London, Canada.