Dealing with patient's families - page 2

Hi, Does anyone have suggestions for dealing with patient's families in life and death situations? Especially now in the 'customer service' atmosphere hospitals are trying to create- (at least in my... Read More

  1. by   canna42
    No offense meant to greenville or anyone else who works icu but lets face it...if you have a max of 4 pts..lot less family to deal with..more time to deal with those you have. I had 14 pts one night when every visitor had reasonable requests for my time. One visitor complained that she had been requesting a pillow for herself since 7pm...I brought it to her at 8:30pm. Mustering all the patience I had by then..I explained my patient load..lack of staff..and same time agreeing that none was the fault of her..I simply stated I had to take care of patients needs first but got to her needs asap.It is a difficult transition for patients just coming out of icu to the floor. In our icu it is 1-1 or 1-2 ..we have no step down unit..so they go from that to 1-12 ratio nursing. A lot of difficulty later is avoided if when admitted patients and family receive adequate information. Most have never been to a hospital and only know what they see on tv..good or bad. Our biggest problem is intoxicated visitors and visitors with no branches to their trees.
  2. by   ktwlpn
    Originally posted by VAC
    Glad to hear I'm not the only nurse going into the 'hotel business'. I have no problem being courteous and going out of my way to help people. At my hospital we are instructed to say before we leave a patients room, "Is there anything else I can get for you, I have the time" We have stufffed teddy bears from the gift shop that we give out to families who have been offended to smooth things over, if we are unable to do so by apologizing for whatever upset them. We also can give them a meal tray form the cafeteria to smooth things over. Visiting hours are history, it's open visitation. We aren't really backed up enforcing only 2 visitors at a time in ICU. It seems customer service is the priority instead of patient care. Now there is a similar crusade in place to increase physician satisfaction. I really do think my hospital is a great place to work otherwise, and I'm really glad I found this website and all of you who keep writing.
    Thanks
    >>>>>>>>>>>>A crusade to increase PHYSICIAN satisfaction? Pray tell-what will that entail? I can just imagine (but am trying not to)
  3. by   VAC
    Physician satisfaction...
    We are told to greet them as soon as they walk onto the unit, and ask how we can help. We are not to initiate any phone calls without gathering all pertinent info (common sense, I think) We are to have charts, labs, vitals, assessment, all pertinent info together before calling along with being aware of any consults on the case. We have to keep a log of calls and make sure everyone else knows when we place a call to a doctor, so the person answering the phone doesn't have to make the doc wait while they search for who called. We are instructed to say things to the patient like, " I'm calling Dr Smith about your pain, he really is concerned about you and your pain." These are all the examples I can think of. During this meeting when this plan was unveiled I asked 'What if the doc doesn't want to address the patient's pain" I was told first to tell the patient about any valid reasons why pain meds weren't being given, and then go to the superviser if the pain issue isn't resolved. If the really back us up, this can work, but I don't see how we keep the docs, patients, families and everyone else happy at the same time.
  4. by   debbyed
    I know that families and visitors can get on everybodies nerves but sometimes it is just do to the fear of the unknown.

    I have found that over the years if I stay open to the families I have less problems. From minute one involve them in the care or at least make them feel involved. There are so many things the patient and the families have no control over, find something they can control. For example ask a daughter "Do you think I should use powder or hand lotion on your mom's bottom after I wash her." Ask a son "could you help me fill out this menu, you know your fathers likes and dislikes so much better than me." When you have to do a procedure , explain it as simply as possible that ask if one family member would like to stay. The family rather than feeling like you are chasing them away, feel like you are involving them and you will find all but maybe one will leave you alone to do what you must do. Try using their energy and strength rather than fighting it.

    Little things like these take only a very few minutes but frequently they will make your life easier in the long haul. By giving the family some little control they will begin to trust you and respect what you do. You will become "their favorite nurse" because you involved them and made them feel needed. And by making them feel confortable you will find their demands of you will dramatically decrease.
  5. by   thisnurse
    its funny...i actually ENJOY working with the families and i am very good at it.
    you have to give them a feeling that they are doing SOMETHING..it might be something insignificant but still something.
    i try very hard to remember what it was like when my mom was in the hospital or my brother, or when we lost my nana. i try to keep the family informed about the patients condition. and i always make myself available to them.
    if its a family who has been there for days like if their family member is critical or dying...i will offer to get them juice or something to drink if im not busy.and i will bring them in blankets and pillows if they are staying overnight. i guess i prepetuate the hotel thing but i can relate to staying at the hospital for days.
    and if i see a family member in the hall and i am not assigned to the family i will stop and ask about them.
    i dunno...i like people and i enjoy the interaction.

    of course some families are just idiots. nothing you do is good enough and nothing you do is enough. i hate when there is a room FILLED with people and i can tell my patient is nervous and uncomfortable. sometimes the patients feel like they have to entertain and they are just not up to it. i will call the family into the hall and ask them if they would mind taking turns. so far ive not had any problems. if i get a minute alone with the patient i will ask them if they are enjoying all the company. (i was in the hospital in traction for two months once. i did NOT enjoy the company. if the patient wants the visitors to leave i will tactfully ask them if they would mind coming back a little later when the patient is up to it. usually the patient will then take over saying that they are very tired or whatever.

    and yes ive been burned by family. i had one report me for telling them that their mom had a brain tumor. lol...i never told them that i told them she did NOT have a brain tumor.
    dummasses.
  6. by   willie2001
    Originally posted by VAC
    Glad to hear I'm not the only nurse going into the 'hotel business'. I have no problem being courteous and going out of my way to help people. At my hospital we are instructed to say before we leave a patients room, "Is there anything else I can get for you, I have the time" We have stufffed teddy bears from the gift shop that we give out to families who have been offended to smooth things over, if we are unable to do so by apologizing for whatever upset them. We also can give them a meal tray form the cafeteria to smooth things over. Visiting hours are history, it's open visitation. We aren't really backed up enforcing only 2 visitors at a time in ICU. It seems customer service is the priority instead of patient care. Now there is a similar crusade in place to increase physician satisfaction. I really do think my hospital is a great place to work otherwise, and I'm really glad I found this website and all of you who keep writing.
    Thanks
    VAC, are you from Pensacola? We had a required inservice where we had to watch a video of some CEO from a Hospital in Pensacola on the subject of patient satisfaction. As a result, we are incorporating some of the strategies; one of them being "is there anything else I can get for you,I have the time". I have always as a rule, said the first part, but somehow I have a hard time spitting out the "I have time" and sound sincere. I have a real hard time comparing the operation of a medical facility with that of a hotel. Oh well, the customer is always right.
  7. by   deespoohbear
    Physician satisfication???? I can deal with patient and family satisfication-these people are sick and need attention and care. But the physicians? Give me a break!! I always try to be courteous to the doctors and have all my info together before I call a physician, but sometimes things just don't work out that way. How about nurses' satisfication? How about the times we page a physician for a true emergency and it takes 30 minutes for them to return the call? How about the doctors who still think nurses are maidservants for them? Fortunately, I work at a small hospital and most of the family practice docs are pretty easy get along with. Some of the consulting docs we get from the bigger hospitals can be rather difficult but our dealings with them are usually pretty limited. I saw something the other day that just blew me away. One of our family practice docs was seeing his elderly patient who had just been admitted. The patient was alert and oriented, but deaf and had a hard time seeing. She was trying to set up her lunch tray and was having a difficult time doing it. (Granted, the CNA should have set the tray up, but that is a whole other thread). Anyway, this patient asked the doctor if he would put the salt and pepper on her food. I was sitting outside of the room charting, and I was going to see if this doctor did it, or if he came and got one of us. And, low and behold, he did put the salt and pepper on the patient's food and asked her if there was anything else she needed. I about fell off my chair!!

    I always try to be helpful to my patients and their families. I know education is one way to diminsh their fears, but sometimes that doesn't work. There are some people who are just nasty, period. They like to be in control no matter what. Those families, I just do the best I can and provide the best care I can.
  8. by   VAC
    Hi, willie2001,

    No Im not from Pensacola, though I grew up around that area. I live all the way down south at the other end of the state. I think these customer service trends are popping up everywhere.
  9. by   Mijourney
    Hi. dees, if it's any consolation to you, I just recently heard on one of the media channels that managed care companies are going to grade doctors and their practices. If the doctor or the practice doesn't give quality service, then he/she either will not become credentialed or lose their credentialing with an insurance company.

    Looks to me like we're going to have a similar checks and balance as the government does. The insurance company will check and balance us, we'll check and balance them, the patient and families will check and balance insurance and health/medical professionals. For the patients and families, well, we'll have some laws and policies in place to check and balance them but probably won't enforce them to any particular degree.

    As far as comfort measures for families, you have to take them where they are. In home health, usually it's possible, although that means more time spent with paperwork, to assess and evaluate how patients and families cope with certain things. I think that grnville hit on an important point that you want your families actively involved. They must understand that they are to rely primarily on their own inner and outer strengths to get through a tough situation.

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