Family Presence During

that no one be present, the absence of a written policy, a patient’s family member being violent, patients ’ families disagreeing about who should be present, a patient’s family member being under the influence of drugs or alcohol, and a patient’s fam-ily member being a perpetrator of a crime against the patient. All of these factors should be explored in nursing research. We are far from having a complete model to explain why nurses do or do not invite family pres-ence during resuscitation. Certainly, as you men-tion, the availability of resources for family support is essential to consider. Several professional organi-zations and experts have recommended that a spe-cific member of the health care team, often labeled the “family facilitator, ” be designated to support patients ’ families when they choose to be present for a resuscitation event.2-6 The facilitator is usually a nurse but sometimes is a chaplain or a social worker. The Emergency Nurses Association7 has described the family facilitator role in detail and has provided guidelines for educating facilitators. We agree with your implied point, as does David-son,8 that if family facilitators were prepared and available, more nurses and physicians might view family presence favorably. You seem to wonder how a family facilitator can be appointed when nurses have other patients who require care at the same time. Family facilita-tion cannot be accomplished adequately while nurses are caring for other patients. Effective facili-tation requires the nurse to stay with the family at all times while they are present in the patient’s room.9 Two or 3 hours of facilitation time may be required for a resuscitation effort that is unsuccess-ful, depending on how long the family stays with the patient after death. Less time would be required for a patient who survives, however, because the nurse assigned to the patient incorporates care of the family into ongoing care of the patient. Hospitals that fully support family presence during resuscitation will explore options for ensur-ing that a facilitator is present with the patient’s family. For example, a policy may state that a desig-nated individual who is on call will serve as facilita-tor. The on-call person may be a manager, a retired nurse volunteer, or a nurse from a nearby unit who volunteers to serve because of the recognized valu