Comments on: Q: Parental presence and lumbar punctures http://blogs.bmj.com/adc-archimedes/2009/04/04/q-parental-presence-and-lumbar-punctures/ Just another blogs.bmj.com weblog Tue, 24 Nov 2009 05:36:32 +0000 http://wordpress.org/?v=2.5.1 By: Adrian Sie http://blogs.bmj.com/adc-archimedes/2009/04/04/q-parental-presence-and-lumbar-punctures/#comment-374 Adrian Sie Mon, 10 Aug 2009 14:47:52 +0000 http://blogs.bmj.com/adc-archimedes/?p=53#comment-374 Doctors may feel under more pressure, but a child may be calmer if a parent is present. I interviewed parents of babies in our neonatal unit to ask how they felt about being present or being excluded from procedures. I then asked doctors the same question. In general - Parents hate being excluded from procedures, unless they themselves find it frightening or stressful, in which case they leave. Doctors on the other hand think they're doing parents a favour. Parents don't want to be present because they want to spectate on the procedure, they want to be able to comfort the child, and they don't want something bad to happen while they're not there. Doctors on the other hand worry that parents will be looking over their shoulder. Doctors worry that their performance will be impaired by parents being present. Parents understand that a doctor may feel under pressure, and will willingly stay outside if that makes it easier. My conclusion is that doctors have a poor understanding of what parents would prefer and how they act; I would encourage doctors (and nurses too, who often express non-verbally to parents that their presence is not welcome) to allow parents to be present if they so wish, and not to worry too much about their abilities being somehow judged. On the other hand, if a doctor feels stressed, they should politely ask the parents to step outside for 10 minutes - to help the doctor relax, though, not the parent. Doctors may feel under more pressure, but a child may be calmer if a parent is present. I interviewed parents of babies in our neonatal unit to ask how they felt about being present or being excluded from procedures. I then asked doctors the same question.

In general -

Parents hate being excluded from procedures, unless they themselves find it frightening or stressful, in which case they leave. Doctors on the other hand think they’re doing parents a favour.

Parents don’t want to be present because they want to spectate on the procedure, they want to be able to comfort the child, and they don’t want something bad to happen while they’re not there. Doctors on the other hand worry that parents will be looking over their shoulder.

Doctors worry that their performance will be impaired by parents being present. Parents understand that a doctor may feel under pressure, and will willingly stay outside if that makes it easier.

My conclusion is that doctors have a poor understanding of what parents would prefer and how they act; I would encourage doctors (and nurses too, who often express non-verbally to parents that their presence is not welcome) to allow parents to be present if they so wish, and not to worry too much about their abilities being somehow judged. On the other hand, if a doctor feels stressed, they should politely ask the parents to step outside for 10 minutes - to help the doctor relax, though, not the parent.

]]> By: Victoria Hemming http://blogs.bmj.com/adc-archimedes/2009/04/04/q-parental-presence-and-lumbar-punctures/#comment-366 Victoria Hemming Tue, 12 May 2009 17:25:09 +0000 http://blogs.bmj.com/adc-archimedes/?p=53#comment-366 I asked this question as well during my first year of training and decided to look for an article about it to discuss in the journal club at the hospital where I was working. The reference is Nigrovic, L.E. Lumbar Puncture Success Rate Is Not Influenced by Family-Member Presence, Pediatrics, 120 (4) 777-782. The conclusion of the article is obvious from it's title! There are limitations to the study as there was no randomisation to observation or no observation and numbers were not equal between the groups. I asked this question as well during my first year of training and decided to look for an article about it to discuss in the journal club at the hospital where I was working. The reference is Nigrovic, L.E. Lumbar Puncture Success Rate Is Not Influenced by Family-Member Presence, Pediatrics, 120 (4) 777-782. The conclusion of the article is obvious from it’s title! There are limitations to the study as there was no randomisation to observation or no observation and numbers were not equal between the groups.

]]> By: vipin tyagi http://blogs.bmj.com/adc-archimedes/2009/04/04/q-parental-presence-and-lumbar-punctures/#comment-365 vipin tyagi Thu, 07 May 2009 18:50:39 +0000 http://blogs.bmj.com/adc-archimedes/?p=53#comment-365 More often than not, Junior doctors feel under pressure while performing L.P. in prescence of parents and it does affect the success of procedure negatively. Its not a good site for parents as well to see their young one in that awkward posture. More often than not, Junior doctors feel under pressure while performing L.P. in prescence of parents and it does affect the success of procedure negatively. Its not a good site for parents as well to see their young one in that awkward posture.

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