Seeing for themselves – healthcare professionals views about the presence of family members during brainstem death testing

Majella Doran, Pauline Black

Research output: Contribution to journalArticle

2 Citations (Scopus)
12 Downloads (Pure)


Aims and objectives: This paper provides an insight into the views of healthcareprofessionals on the presence of family members during brainstem death testing.Background: Brainstem death (BSD) presents families with a paradoxical death thatcan be difficult to define. International research suggests families should be giventhe choice to be present at BSD testing, yet it appears few units offer families thechoice to be present and little attention has been paid to developing practice toenable effective facilitation of choice.Design: A qualitative, exploratory design was adopted to understand the perceptionsof healthcare professionals. Individual semi-structured interviews were audio-tapedand carried out over two months.Methods: A purposive sample of 10 nurses and 10 doctors from two tertiaryintensive care units in the United Kingdom were interviewed and transcripts wereanalysed using content analysis to identify emergent categories and themes.Results: Healthcare professionals indicated different perceptions of death in thecontext of catastrophic brainstem injury. The majority of participants favouredoffering families the choice to be present while acknowledging the influence oforganisation culture. Identified benefits included acceptance, closure and better understanding. Suggested challenges involved the assumption of trauma ordisruption and sense of obligation for families to accept if choice was offered. Keyissues involved improving knowledge and communication skills in order toindividually tailor support for families involved.Conclusions: If families are to be offered the choice of witnessing BSD testing,considering that needs and conventions will differ according to global culturalbackgrounds, then key needs must be met to ensure that effective care and supportis provided to families and clinicians.Relevance to clinical practice: A proactive approach to facilitating family choice tobe present at testing requires the development of guidelines that accommodatecultural and professional variations to provide excellence in end-of-life care.
Original languageEnglish
Pages (from-to)1597-1607
JournalJournal of Clinical Nursing
Issue number11-12
Early online date3 Aug 2016
Publication statusE-pub ahead of print - 3 Aug 2016


  • nurses
  • nursing
  • intensive care
  • critical care
  • brainstem death
  • brainstem
  • death testing
  • choice
  • families
  • end-of-life care

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