Parents in the recovery room: survey of parental and staff attitudes
BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6973.163 (Published 21 January 1995) Cite this as: BMJ 1995;310:163
- P A Hall, clinical fellowa,
- J F Payne, clinical fellowa,
- C G Stack, consultanta,
- M A Stokes, senior lecturerb
- a Department of Anaesthesia, Children's Hospital, Ladywood Middleway, Birmingham B16 8ET
- b Department of Anaesthesia, University of Birmingham, Edgbaston, Birmingham B15 2TH
- Correspondence to: Dr Stokes, Department of Anaesthesia, Children's Hospital, Ladywood Middleway, Birmingham B16 8ET.
- Accepted 19 October 1994
It is unusual in British hospitals for parents to be with their child while recovering from anaesthesia, although their presence during induction of anaesthesia is now common. Parents are encouraged to be with their child in other clinical areas,1 and American experience suggests many parents value being present in the recovery room.2 Before introducing this practice in our hospital we sought to determine the attitudes of parents and staff to parental presence during recovery from anaesthesia.
Subjects, methods, and results
We invited the parents of 150 consecutive children presenting for elective surgery to come to the recovery room as their child emerged from anaesthesia. Recovery staff decided when to call the parent, with the guidelines that the child should be awakening, maintaining his or her airway unsupported, and cardiovascularly stable, although not yet fully conscious. Parents completed one questionnaire before coming to the anaesthetic room and another on leaving the recovery area. Recovery staff completed a questionnaire after the family had left. Questions were asked as statements and responses indicated as strongly agree, agree, disagree, or strongly disagree. The study was approved by our ethics committee and parents gave informed consent.
The table gives the results. Only three parents initially did not want to accompany their child to the recovery room, although one mother changed her mind. A further 10 had left the ward to find refreshments when they were called to the recovery room and so were unable to attend.
Responses of parents and nurses to questionnaires on parental attendance at recovery room
After initial reservations, recovery staff felt that parental presence was worth while. Their attitude became more positive as the trial progressed; parental presence was judged a success in 29 (58%) of the first 50 cases but this increased to 49 (98%) of the last 50 cases, despite some parents who were distracting and “got in the way.”
Comment
Despite some anxieties parents wanted to be with their child during recovery from anaesthesia and surgery. Most felt that they could help and comfort their child. We do not know, however, if parental presence during recovery reduces children's stress in a similar way to that shown during induction of anaesthesia.3
Staff quickly learnt to cope with parents as observers. The worries of clinical staff about parents witnessing serious postoperative complications (for example, airway obstruction, haemorrhage) were unfounded. It is usually possible to predict which children are likely to have difficulties postoperatively, and parents were not summoned until the child's airway was secure. No parent was asked to leave the recovery room unexpectedly. Indeed, one parent was able to reassure a recovery nurse, telling her that “the bleeding was much worse last time.”
While a child is in hospital parents should not be considered as visitors and should be encouraged at all times to offer care and support for their child, unless the interests of the child preclude this.4 We believe that parents should be present during emergence from anaesthesia whenever possible. Unwilling parents, however, should not be pressurised. Bevan et al have shown that high anxiety levels in parents are associated with more behavioural disurbances in children.5 A similar pattern would be expected in the recovery room.
Some practical problems exist, however, ranging from the provision of extra chairs to the need for a liaison nurse to escort parents to and from the recovery room. Few operating suites have waiting areas for relatives, and ward areas are often inadequate. In summary, parents welcomed the opportunity to come to the recovery room at an early stage, few problems occurred, and there was staff support for continuing the practice.