Needs of family members of patients with severe traumatic brain injury. Implications for evidence-based practice.

Michael Donnelly is manager of the neurological intensive care unit and a neurological intermediate care unit at the University of Utah Health Science Center, Salt Lake City, Utah. intracranial pressure monitoring, hyperosmolar agents to control increasing pressures, and ventilator support. Although ICU nurses become accustomed to working in such crisis situations, the families of patients with severe traumatic brain injury may be overwhelmed by the patients’ critical, constantly changing status. While the families experience the whirlwind of care, often without understanding what is happening, they must also address the possibility of their relatives’ future dysfunction or untimely death. This time can be extremely stressful for these families. Indeed, all admissions to an ICU are stressful for patients’ families, but the sudden unexpected onset of severe traumatic brain injury, coupled with its unstable nature and strong probability of death, makes the families of patients with such injuries especially vulnerable. As Landsman et al reported, the severity of the injury may place demands on patients’ families beyond the families’ ability to cope. By following the vision of the American Association of CriticalCare Nurses (AACN) of advocacy for patients and patients’ families (see shaded box), compassionate ICU nurses can alleviate the anxiety and concern of these families. Even though research findings indicate that staffing and time restrictions A. Elaine Bond, DNSc, APRN, CCRN Christy Rae Lee Draeger, RN, BSN Barbara Mandleco, RN, PhD Michael Donnelly, RN, BSN, CCRN