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Hospital to allow relatives in A&E rooms

Chris Blackhurst
Monday 04 March 1996 19:02 EST
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Relatives and next of kin are to be allowed into a hospital's resuscitation rooms to watch doctors and nurses frantically using the techniques with which many people are now familiar thanks to the huge popularity of television medical dramas such as Casualty and ER.

In a pilot study, the Accident and Emergency Department of Queen Mary's University Hospital, at Roehampton in south-west London, will allow relatives, if they wish, into the previously barred "crash" rooms.

But staff opinion is divided over the plan. Senior doctors hope it will make relatives appreciate how hard they tried to save a deceased person's life and may cut down on subsequent costly litigation. Juniors, though, are not so sure. They fear relatives will become distressed and will impede the medical team's desperate work.

They are also concerned about relatives' reaction when the final decision is taken to stop attempted resuscitation, to switch the equipment off and stand back. At that point, they argue, those watching may press for them to continue and a row may develop. Instead of reducing the risks of litigation, allowing relatives to observe the rushed, highly pressured, often disorganised and ill-tempered business may increase the chances of legal action.

The split emerged in a poll of Roehampton's 80 doctors. The majority, who tended to be drawn from the more junior, inexperienced ranks, was firmly opposed, while a minority was in favour. However, as the minority comprised mainly of the hospital's most senior staff and included many consultants, the decision was taken to launch a test experiment.

On average, three or four patients a week at Roehampton suffer cardiac arrest and undergo resuscitation. In two months' time, once staff have been trained to cope, patients' relatives and next of kin will be allowed to be present.

Dr Michael Mitchell, a consultant in the A&E department, favours the proposal. "There is a growing feeling among doctors that the grieving process of relatives would be helped if they witness resuscitation," he said yesterday.

With the success of Casualty and ER, "people are much more aware and more sophisticated as to what to expect", he said but warned that it was "still a very traumatic sight, no matter how often someone has seen it on TV", and said the main priority was that relatives' wishes must be obeyed.

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