Caring of patients placed to Intensive Care Units is a process that is both multifactorial and challenging. Therefore, it is wrong to limit the scope of nursing and medical care in ICU to the provision of adequate life support. Definitely, managing patients’ hemodynamic parameters and providing effective healthcare interventions are the vital ingredients of nursing and medical care within the ICU (Elliott, Aitken & Chaboyer, 2011). At the same time, the psychosocial and emotional wellbeing of patients greatly impacts their chances for fast recovery (Elliott et al., 2011). Not surprisingly, families are acquiring new roles and becoming more significant in achieving the desired patients’ outcomes.
Providing family-centered care and encouraging families to participate in the clinical decision-making processes is vital both for the patient and nurse. In today’s health care, family is usually regarded as a complex system of interdependent elements and relationships, which function collectively to achieve a common purpose. It is a separate ecosystem which, nonetheless, is continuously engaged in close interactions with the patient, a member of that family. Family provides resources that are vital for the patient’s survival. It transforms available resources into useful forms for the patient’s consumption (Bomar, 2004). In healthcare, families function as a caregiver during critical illness and a provider of vital resources during rehabilitation, health promotion, and prevention (Bomar, 2004). Families have a remarkable capacity to adjust to the conditions of illness and shift the scope of their formal and informal roles to meet the demands of quality medical care in the ICU (Bomar, 2004).
It is interesting to note that more nurses working in ICU come to realize the caregiving potential of families and the role they can play in the provision of critical care to patients-members of their family. Since the 1980s, the role of family in the ICU has become the centerpiece of professional discussions in nursing and medicine (Elliott et al., 2011). Today, it has become a worldwide trend to operationalize family as the major provider of continuous crisis and post-crisis support to members admitted to the ICU (Elliott et al., 2011). Professionally-centered models of nursing incorporate families into their philosophies, to let families help doctors and nurses choose the best for the ICU patient (Elliott et al., 2011). “Healthcare providers that value the family/patient partnership during a critical illness strive to facilitate relationship building and provide amenities and services that facilitate families being near their hospitalized relative” (Elliott et al., 2011, p.157). Today’s nurses working in ICUs are more likely to operationalize families as partners, who can provide relevant information and help adjust the physical and emotional environment that suits the unique needs of each patient. These shifts in the ICU care mentality further result in positive culture changes among the nursing staff (Elliott et al., 2011). Consequently, families not only benefit their members admitted to the ICU but extend their influence on the quality of nursing care and models of care used in the health care facility.
Certainly, one should not forget that families’ participation in care for critically ill patients is associated with numerous challenges. Family members of ICU patients are often confronted with a life-threatening crisis, and they may not have enough emotional and mental resources to overcome the problem independently (Davidson, 2009). They may experience anxiety, dissatisfaction, and even depression (Davidson, 2009). Thus, nurses will have to engage in compensatory efforts to facilitate families’ adaptation to the care conditions within the ICU. At the same time, and from the viewpoint of Roy’s adaptation model, nurses cannot view the patient as a holistic and adaptive system without including families in critical care provision. Roy’s adaptation model suggests that family is the fundamental element of every patient’s environment (Lopes, Pagliuca & Araujo, 2006). The model suggests that it is from the family or through it that the patient can receive stimuli to motivate enhanced physical and emotional recovery. It is family that can provide the most significant environmental modification and create a supportive environment for the critically ill patients (Browne & Talmi, 2005).