Abstract

The purpose of this study was to describe the reactions to stress in patients witnessing a cardio-pulmonary resuscitation, in order to determine if the witnessing patients' needs are being met adequately, and to determine the effect of a specific psychological stressor on patients.

All resuscitations ("STATS") done over a two-month period at Loma Linda University Medical Center, with oriented patients in the room, were observed and recorded on an Observation Guide. A Questionnaire was also solicited from medical-surgical nursing personnel who had observed "STATS" with witnessing patients in the last three months. The Guide and the Questionnaire were developed from a study of psychology, physiology, and nursing literature. The descriptive survey method was used.

Of the two patients observed directly during on-going "STATS," the following similar anxiety symptoms were observed: expressions of anxiousness and nervousness, verbally and specifically; rigid posture and muscle tenseness; overactivity and unusual restlessness; repetitive statements; and clenching of fists alone or around objects.

In both Patients A and B sedation, emotional support by listening and explaining, and physical contact (touch) seemed to help the patients. With Patient A nursing personnel on the unit did not support the patient during, but rather after the "STAT," although a Chaplain did give support during the procedure.

Vital sign changes were noted in both Patients A and B. Systolic blood pressure increased 14 to 35 points, respectively, but this was still within normal limits. Pulse and respiration rates also remained within normal limits.

The results of the Questionnaire verified the findings of the two direct observations. Of the 25 patients recalled by 42 respondents, all 25 manifested at least one anxiety reaction, and 21 had from two to eight different reactions. Nine personnel thought that the witnessing patient had been left alone during the "STAT," as the staff was so busy with the resuscitation. Thirty of the 42 respondents felt that patients were contacted at some time, and that their needs for reassurance were met to some degree.

No significance was found in the removal of 12 patients from the room and the non-removal of 13 patients (p >.05). Whether the arrest patient lived or died was not found to be a significant factor (p > .05) either, in the matter of increasing or decreasing anxiety reactions. Cardiac problems either increased or developed, in 8 of the 25 patients recalled, to a great enough degree to cause concern by the staff.

It was concluded that patients who witness cardio-pulmonary resuscitation do experience psychological stress and do develop observable anxiety reactions. It was also concluded that many nurses either do not appear to be aware of the need for communication, or they just do not take time to communicate with patients during this time of stress.

Recommendations included: (1) that resuscitation classes place an emphasis on the witnessing patient's reactions and needs, (2) that someone (nurse of Chaplain) be added to the "STAT" team to care for these patients, and (3) that ways be studied to improve the resuscitation team's effectiveness and the "STAT" environment.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Matilda Anabelle Mills

Second Advisor

Rachael Lee

Third Advisor

Marianne Underwood

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1972

Date (Title Page)

6-1972

Language

English

Library of Congress/MESH Subject Headings

Resuscitation

Type

Thesis

Page Count

vi; 64

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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