Home Page Feature Details

Left Content Area

Right Content Area

Kathy Quirk
414-229-3144

Center Content Area

Helping families of loved ones in critical care

The Family Critical Care Needs Inventory that Leske co-developed is used in intensive care units around the world.

Anxious families waiting in intensive care units all over the world have benefited from the life work of a UWM nursing professor. Jane Leske’s research on families with loved ones in critical care has helped make these areas more open, accessible and comforting environments.

Leske and colleague Nancy C. Molter of the Institute of Surgical Research at Brooke Army Medical Center in San Antonio, Texas, are co-developers of the Family Critical Care Needs Inventory – a survey tool that has been translated into more than 20 languages and is used in critical care nursing from Amman, Jordan, to Beijing, China.

“In critical situations, we need information and we need to vent,” Leske says. “We wanted to develop guidelines that offer the optimal way to practice and advocate that critical care nurses deal with families in the best way possible.”

Leske’s research shows that families have five basic needs when a loved one is in intensive care: “They want to visit or at least be close; they want assurance; they want information; they want a comfortable place to wait; and they need support.” That support may range from posting family pictures in a patient’s room to helping with financial issues.

Finding better ways to support families is vital because the intensive care experience touches millions annually. Estimates are, says Leske, that more than 80 percent of American families will someday find themselves waiting anxiously at a bedside in a critical care unit.

Research based in experience
Leske’s work as an advocate for families grew out of her own experience as a staff nurse in an intensive care unit more than 30 years ago.

At that time, medical staff either wouldn’t allow families into the unit or severely restricted visiting time. Waiting rooms were institutional and uncomfortable. Families often couldn’t get information about the patient; there was no one to comfort them. Sometimes, they weren’t even told where to find restrooms or food.

After entering the academic world in 1982, Leske began researching family needs in critical care units. This research provided critical care nurses with research-based findings and recommendations that have helped drive changes in the way families are treated.

For example, Leske’s work showed that supportive medical staff could help alleviate family stress by providing information and opportunities to talk about the situation. She also found that medical staff could allow families more time with patients without negatively impacting the patient’s medical care.

Today, families can stay in intensive care units most of the time. In some hospitals, nurses furnish them with pagers or cell phones so they can be immediately contacted if they need to step out for food, go to work or get some sleep.

In addition, critical care patients are routinely surrounded by family photos, cards and letters. Waiting areas offer comfortable chairs and private areas for conferring with medical staff. Families get practical information on where to find food and other necessities, and are offered opportunities for counseling.

Pioneers recognized
Patients and families are not the only ones to notice the impact of these changes, both large and small. Last year, the American Association of Critical Care Nurses (AACN) honored Leske and Molter for their work as patient advocates with the 2007 Pioneering Spirit Award, the association’s highest honor for significant contributions to critical care nursing.

In recognizing their work, the AACN cited Leske and Molter’s “pioneering contributions in bringing the importance of family needs to the forefront of critical care and developing the body of evidence to support the need for change in critical care.”

Leske admits she got a little teary when she received the AACN award last summer. But she says it wasn’t so much the award itself as the thought of what her research has done to impact nursing practice through the years, improving communication and sensitivity to family needs.

“It’s important that everyone working with the patient knows that someone loves this person,” says Leske.

Next Steps
Leske’s work continues to challenge her. Currently, she’s doing research at a local hospital, working with families of victims of gun violence and auto accidents. She talks to families who are in their first two days in intensive care. “I just go up to them and ask if they’d be willing to talk about their experience.” More than 90 percent say yes.

These patients, often just barely into adulthood, illustrate the continuing complexity of providing families with comfort and information. In a children’s hospital, a parent would have a bed in the child’s room, but that’s not the case for these young adults. And new privacy restrictions can limit parents’ access to information, though most intensive care staff are able to find ways to help parents in these situations.

Leske’s research has already shown that families who are well-cared-for in intensive care units do better in dealing with their loved one’s condition. Her next step is to show the possible link between a good family experience and better outcomes for patients.

“It’s still a theory, but it’s a theory that guides my research,” says Leske.

UWM News

Home Page Feature Details