FIVE family members in a crowded ICU rm all night long! - page 2
Last night I took care of a very young adult patient who is basically donor material now because of a rather unfortunate combination of cocaine and a heart condition. The family was approached in ER about the big "D" word... Read More
- 3Nov 18, '08 by janfrn Asst. AdminQuote from scarymaryHey don't laugh! I HAVE one of those!! It's so much better than holding the penlight between my teeth...Perhaps what you need is this
Quote from PlaneFlyerRNIt wasn't my intent to one-up you, just to commiserate.I most humbly retract my complaint. You have me beat by far. I think I would be pretty sour about having to nurse in the dark while under stealth mode.
- 5Nov 18, '08 by heartnurseinvaI feel your pain planeflyer...I would definitely bring your concern up in your next staff meeting. That is absolutely ridiculous and should not have be allowed. It is one thing if your patient was stable. Or, if the family had come to some agreement on code status or heroic measures...that was not the case, and as far as I am concerned, they prevented you from doing your job proficiently.
I am sorry...I am one of those nurses who do not sugar coat anything. I tell the family exactly how I see it. Giving a family false hopes is never a good thing. I do think it is necessary for the family to see how unstable their loved one is and how much care I am delivering to the patient. However, not if it is preventing me from doing my job.
I work in a CVICU and we have limited visiting hours.. 4x/day, 30 mins in length. If the patient is unstable or if we are in a middle of a procedure--during the visiting time--they family does not come back and can not make the visiting time up.
I remember when I was a new nurse and felt that my charge nurse made all the decisions, including the care of my patient. I soon developed a backbone and questioned anyone who wanted to tell me how to do my job.
There would have been nothing wrong if you decided to ask your family to leave or to limit the numbers.
You have the final say...it is your license.
- 2Nov 18, '08 by tryingtohaveitallI'm like JanRN, working in a PICU with a tragic situation like that, we tend to let anyone and everyone in to say good-bye and spend their last hours together. I sympathize with you, I can imagine how busy you were trying to provide excellent care around the feet and bodies in your path.
Your lead nurse? It is ludicrous for her to say such a thing. Good grief, I agree the better response from her should have been to say that you look taxed and how can she help? Good grief.
- 5Nov 19, '08 by CreamsodaIf the person was a possible brain death/donor candidate, I feel the family should be allowed to stay. Normally im with you on limiting visitation if its disruptive and the pt is fine/stable, but if the person in dying/going to die, the family needs to be able to spend time. What you could have done is asked the family to switch off 2 at a time only in the room, and keep switching off. Provide chairs and ask them to stay out of the way if your very busy and explain why you need quick and easy access to the pt. How would you feel if you had a loved one who was going to die, and the nurses told you you could visit for 30 minutes 4 times a day and this was the last time you would see your family member. Overnight stays I feel are fine in this situation. 5 at one time is excessive. It should have been limited to 2 at a time.
- 7Nov 19, '08 by heartnurseinvaQuote from CreamsodaIf I understand planeflyer correctly, the issue is that the family had not come to grips with the gravity of the situation, and all heroic measures were being made. If that is the case, stepping over 5 family members is ridiculous.How would you feel if you had a loved one who was going to die, and the nurses told you you could visit for 30 minutes 4 times a day and this was the last time you would see your family member.
If, however, the family had come to some kind of decision, and I don't have to run my tail off to keep your loved one alive...then I don't care if the entire family is in the room.
There is nothing a family member can do or help the patient while he/she is in the ICU.
Me personally, being on both sides, I have no problem letting the nurse do her work--there is nothing I can do to help...especially if my loved one is unstable. I would want my father/mother's nurse to have her entire focus on my parent..not jumping over my brother to do her job.
And, if this was the last time I would see my family member, I would have made the end of life decision for my parent and planeflyer would have not been put in the situation she was forced into. :wink2:
- 3Nov 19, '08 by ŽNursethank you all for your insight. i feel so much better now with your help.
update: just to let you know....a nurse with more 'gravity-prone ovaries' (read - testes) than myself nipped the family reunion around the icu bed in the bud during the day shift yesterday. a family conference had been held and they decided to make the patient an organ donor after the docs declared the patient officially brain dead. they now come in pairs around the clock in shifts so that family ( which is really massive ) can be with the patient and each can say good bye. i was still really busy with my patient, (donor patients are really intense!) but the smaller numbers were much more manageable and i was able to 'do my thing' without having to wait for three or four people to move away from hovering over the patient.
i just hafta add - please don't think that i'm against having family there especially when death is so imminent. my only fear is patient impact related - as when something goes south because i'm more distracted by the family than i should be. kinda like when you're trying to make that really complicated favorite receipe for a special occasion and you keep getting interruptions while you're measuring out the ingredients and mixing stuff together.....except that when your dish flops, nobody dies.
i think that family should be with the patient as much as possible in such a case as the patient being a donor. keeping the numbers down to two, no more, and not expecting to keep the nurse involved in an 8 hour lecture of "icu 101" would be helpful too.:trc::heartbeat
- 1Nov 21, '08 by criticalcarenurse93I Do Agree 5 Extra Folks In The Room Is Too Much..... It's Very Hard To Do Your Job With The Extra Distraction Of Family. It Would Be Wonderful If They Could Realize Our Jobs Are Not Easy And Manuevering Around Them Just Makes It Even Harder!
A Little Cooperation From The Visitors Would Be Welsome!
The Only Time I Allow That Many People In The Room Is When I Am Certain The Patient Is Going To Die And Die Soon. I Don't Want Their Last Memories To Be That "the Mean Nurse Did Not Let Me Be With My Family Member"....
Our Unit Has Scheduled Visiting Times And Limits On Number Of People At One Time. We Usually Follow Our Own Rules And Veer When The Primary Nurse (not The Charge Nurse) Decides To! Our Charge Nurse And Manager Is Supportive Of The Idea That The Nurse Caring For The Patient Has The Final Say!
- 2Dec 21, '08 by pH7.40Quote from scarymaryactually thought of wearing one myself.Perhaps what you need is this
I don't think the family realizes how they exhaust the pt. as well
as themselves. And no I can't brush her hair now because I need to
hang some fluids and a pressor to keep her alive!