What is your policy of telling the family the pt's disease progress

  1. Is it allowed to share some details such as increased PTT, decrease creatinine with the family?

    if the family is a ACNP herself, worrying her mother to death, what would you do? Especially, after her mother being treated badly and now the pt is getting worse and incubated.
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  2. 13 Comments

  3. by   Biffbradford
    I don't know what the policy is, but if a family member knows enough medical to ask about BUN/Creat, then I'll tell 'em. I've seen worse (MUCH WORSE) things held from family, this is no big deal in my book.
  4. by   icuRNmaggie
    On admission I ask who is the family spokesperson and I hand them a business card for our unit. I say we can only have one family contact who can share information with the rest of the family to prevent any misunderstandings.

    I tell the family that your family spokesperson can ask for those test results from the MD.

    I do not give any info to the nurses, nurse wannabees, nursing students NPs etc. No way. It snowballs into having multiple family members making constant phone calls demanding to know every test result. I do not have time for that. Most of all, the pt and his spokesperson have a right to privacy with protected health information.



    I had two physicians and a med student as family members at the bedside. I was very sorry that I shared an ABG result , HUGE mistake, they then wanted to take over and manage the pt and even tried to give me orders even though they were not on staff and were from out of state.

    In the am the intensivist transferred that unfortunate pt to a Level one hospital at 0705 mainly because they family was so out of control with their attempts to run the show.

    I have learned the hard way to have "medical professionals" write down their questions and present them to the intensivist.
    Last edit by icuRNmaggie on Aug 31, '14
  5. by   MunoRN
    Quote from icuRNmaggie
    I had two physicians and a med student as family members at the bedside. I was very sorry that I shared an ABG result , HUGE mistake, they then wanted to take over and manage the pt and even tried to give me orders even though they were not on staff and were from out of state.

    In the am the intensivist transferred that unfortunate pt to a Level one hospital at 0705 mainly because they family was so out of control with their attempts to run the show.

    I have learned the hard way to have "medical professionals" write down their questions and present them to the intensivist.
    Was the patient able to make their own decisions?
  6. by   icuRNmaggie
    No. Young woman with severe neurologic damage, intubated, in cooling phase of therapeutic hypothermia.
  7. by   MunoRN
    Were any of these family members the decision maker for the patient?
  8. by   icuRNmaggie
    no. Mother and Father were not fluent in English.
  9. by   MunoRN
    Who was the decision maker?
  10. by   icuRNmaggie
    the parents.
  11. by   MunoRN
    It sounds like the patient was transferred based on the wishes of the three family members with medical backgrounds, so it would seem the parents were deferring at least some decision making involvement to those three?
  12. by   icuRNmaggie
    Exactly. One ER physician, one was an Internist, one a medical student. I see where you are going with this. As surrogate decision makers they had a legal standing to request protected health information.

    I had the intensivist speak to them two or three times during the night for various reasons. They were understandably very emotional. I can not say more in a public forum. In retrospect I should have put them in contact with the physician for all of their questions.
    Last edit by icuRNmaggie on Sep 3, '14
  13. by   MunoRN
    If the official decision makers, the parents, want to include those three in the decision making process, then why would information be withheld from them?
  14. by   icuRNmaggie
    It was not withheld, in fact I volunteered an ABG result showing improvement and answered every question completely and truthfully. After that, they wanted to give orders. It was an awkward situation as they wanted to apply their expertise in desperation to save their loved one. The MDs were reluctant to talk with them and I don't know why.

    I would handle it differently now. I would let the intensivist provide all of the test results, answer their questions and order what they suggested rather than being the messenger and middle man.
    Last edit by icuRNmaggie on Sep 3, '14

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