Family Members of our Patients ....

  1. I mean no disrespect, but there are times when I get so frustrated by family members. Sometimes I really wonder if some of these people really understand what they are doing when they take up the time of the nurse asking us to do things that are really not a priority. Here is an excellent example:

    Nurse: I will be hanging this TPN, changing the tubing and assessing the patient.

    Family: Can you get my husband a box of tissues .... oh he needs these right now because his nose is running.

    Nurse: certainly, I will be right back.

    Nurse: Here are the tissues and assist the patient with the nose running.

    Family: I am sorry, but he also needs some ice as he has a very dry mouth because the doctor will not let him eat anything.

    Nurse: I can only give him a few pieces of ice dear as the physician has made it known that he does not want him taking anything by mouth. I will be right back.

    Nurse: Here are a few ice chips. Now I really need to hang this TPN.

    Family: Ok, I know, I have been such a pain today, I am sorry. But, he needs to use the bedpan, he says it is urgent.

    The TPN is still not hanging.

    Sometimes I think that families as well as patient's do not understand the thinking and the time that goes into providing care. When I am caring a patient, I am not just worrying about getting their bed made or about their ice water .... I am focused on what their labs are, why are they in a tachy rhythm .... and thinking (critical thinking) my way through their care all the time. When I enter the room to perform a procedure or complete a task, it drives me crazy that families take so much of my time. Perhaps it would not be so bad if I am not rushed at every minute of the day trying to get all that needs to get done, done!

    I need some counsel here .... is it me or do the rest of you feel the same way?

    Oh, here is another thing .... just as you are getting ready to do something important, the phone rings and the patient has to take the call. Guess who it is? Yup, usually his wife, who just left 5 minutes ago. :angryfire
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  2. 24 Comments

  3. by   Katnip
    You're right. Families DON'T understand what we do behind the scenes. Most are still hung up on the old image of the nurse's job, that of hand maiden, pillow-fluffer.

    I had a patient a couple of weeks ago. His wife was a retired nurse. She said nurses today do what doctors did back then. Nurses didn't so much as take blood pressures; only docs did that, much less interpret lab results.


    Unfortunately, I can't think of a good, efficient way to educate the general public on what we really do. No television producer in their right minds would make a show like that. Catching a med error made by the pharmacy, hearing those first railes indication possible infiltrates, being the first to see that low potassium value...these are not as exciting as watching docs run codes.
  4. by   Stitchie
    I learned this the hard way:

    Techs are your friends. The hospital pays them.

    You job is to:
    Delegate, delegate, delegate.
    If you are hanging TPN you can let everything else wait. It has a short shelf-life. It gets nasty when left in the tubing too long. The techs are there to get those "comfort items" for patients -- use your techs.

    Even if it's uncomfortable, you cannot hang TPN and get all those little items that patients need. The family will have you running your butt off.

    If the phone rings, I just keep doing what I'm doing. (Of course that doesn't apply now that I'm in ED so much anymore, but boy that used to bug me). The wife can call back, but nursing care is delivered on your schedule.
  5. by   RNPATL
    We do not have techs on my floor ... trust me, if I could, I would certainly delegate! But, I love your statement that nursing care is delivered on my schedule ... that is one I will certainly remember.
  6. by   Stitchie
    If you don't have techs (oh the horrors, I couldn't do my job without them) then you prioritize. TPN is more important than tissues, ice, etc. You could make "rounds" like HS care to make sure that patients are set for the night.

    You didn't say what kind of floor you work on or how many patients you have. But no help? The hospital would have to pay me really, really well, because I could not survive without the help of someone I could delegate small things to.
  7. by   RNPATL
    I work on a very busy surgical step down floor ... we get all the post surgical patients ... and it is a VERY busy floor. Today, I was charge and had a patient assignment of 6 patients ... all primary care. I was beside myself today. This is when the families really fry my last nerve. We are trying to get techs and hopefully that will be a reality. We sure do need them.

    As far as rounds, I do this now .... in an attempt to ensure that my patient's basic needs are met. I really think the family just wants attention and to feel some sense of control over what is happneing. Whatever the reason, it can be frustrating to constantly deal with them when you have work that must be done.
  8. by   Spidey's mom
    Quote from Stitchie
    I learned this the hard way:

    Techs are your friends. The hospital pays them.

    You job is to:
    Delegate, delegate, delegate.
    If you are hanging TPN you can let everything else wait. It has a short shelf-life. It gets nasty when left in the tubing too long. The techs are there to get those "comfort items" for patients -- use your techs.

    Even if it's uncomfortable, you cannot hang TPN and get all those little items that patients need. The family will have you running your butt off.

    If the phone rings, I just keep doing what I'm doing. (Of course that doesn't apply now that I'm in ED so much anymore, but boy that used to bug me). The wife can call back, but nursing care is delivered on your schedule.
    This is good advice . . . . we have CNA's and I don't know what I would do without them.

    steph
  9. by   suzanne4
    When working on a step-down unit, ER, or anywhere else, always made meds, treatments, and IVs the priority. Loved it one time in the OR when a surgeon wanted me to stop counting sponges so that I could change his CD.
    Guess who waited...................him, none of his assistants would help him close as I told him that I was still looking for a sponge. You should have seen the look on his face..............................Priorites are priorities!
  10. by   chaosRN
    This is one of the many reasons I love ICU. See families 3-4 times a day for 30 minutes at a time. (We of course have exceptions) I just love it when your pt has a b/p of 60/30 or worse & the family (if they are even in the room) insists on you, the nurse, adjusting their pillow . We don't have techs all the time, so pillow fluffing isn't my priority right now!! :spin:
  11. by   Loribabble
    I think the reason I don't want to switch to days is that I can count on visiting hours being OVER!

    I was taking care of a 17yr old boy who was just placed in halo traction - his spinal cord was having a reaction so they admitted him overnight for observation. He was in a lot of pain and had lots of N/V. His 16yr old GF was with him. They were from out of town.... several hours away and he lived with her in her mother's home. She couldn't stay, being a minor and all, and he wanted to leave AMA.... but he was a minor. Both stated there wasn't a parent to take responsibility... none that they wanted contacted. Supervisor notified along with social work... girl could NOT stay on unit - had to stay in either ICU or ER waiting room as there was a police officer on duty all night long. At that the girl suddenly "Remembers" that dear old dad lives in city. By now I have WASTED 4 hours trying to resolve this....

    He comes in and starts yelling at ME regarding the safety of his daughter. I gladly handed over the supervisor, administrator's, my manager's number for him to clear up in the am. I could not believe it.... sure it is ok for her to have a boyfriend live with her... have her go several hours to spend the day at a major trauma center/county hospital in a BAD part of the city, etc.... but becuase I wouldn't babysit - I was the bad guy! Thank heavens my manager backed me up 100%

    I had another pt who wanted her 6 year old son to stay with her... she had lots of family - she really wanted us to baby sit while she was in surgery and during her recovery.

    I guess some people just don't understand limits!
  12. by   Marie_LPN, RN
    (Delegate lol, i needed a good laugh at that word. Unfortunately i worked for a lot of companies that thought the word 'delegate' meant 'boss around and always take for granted'. Not all places and people are like that, but there are a few that are. Which is why that word has always griped me everytime i've read it in my Nursing Skills book.) Sorry for the rant, anyway:

    Thing is, if you're hanging TPN and the FAMILY member is asking for something, you say "right now it is time to set up this scheduled prescribed nutrition, also called TPN that Mr. Patient needs since he isn't eating. As soon as i get this set up, i will go and (inserted whatever here). Is there anything else they need" (if the pt. cannot speak for themselves). I've seen several nurses make a statement like this while in the process of hanging the bags, priming the tubing (if it wasn't primed prior to getting in the room), and setting up the pump. It's not dismissing what a person requested, but it makes it clear that you are thinking and doing what's best for the pt.
  13. by   Marie_LPN, RN
    Another example:

    A pt. had a BM, which was pretty messy, and had been admitted with pneumonia, but also had 2 pressure sores. So the nurse and i go into the room, and the daughter wouldn't be quiet about the eye crust that the pt. had in her eyes. And the nurse simply said "we want to get this BM off of her backside to keep those sores clean, and to rebandage them. I will clean her eyes again when we're finished getting her clean and dry and the sores recovered". And i cleaned her eyes again, but the daughter was kinda huffy about it. But after explaining why you'e doing what and why in a certain order, there's nothing you can do after that, because you did try to explain it to them. It's up to the individual if they're going to believe you or not.
  14. by   dphrn
    Quote from LPN2Be2004
    (Delegate lol, i needed a good laugh at that word. Unfortunately i worked for a lot of companies that thought the word 'delegate' meant 'boss around and always take for granted'. Not all places and people are like that, but there are a few that are. Which is why that word has always griped me everytime i've read it in my Nursing Skills book.) Sorry for the rant, anyway:

    Thing is, if you're hanging TPN and the FAMILY member is asking for something, you say "right now it is time to set up this scheduled prescribed nutrition, also called TPN that Mr. Patient needs since he isn't eating. As soon as i get this set up, i will go and (inserted whatever here). Is there anything else they need" (if the pt. cannot speak for themselves). I've seen several nurses make a statement like this while in the process of hanging the bags, priming the tubing (if it wasn't primed prior to getting in the room), and setting up the pump. It's not dismissing what a person requested, but it makes it clear that you are thinking and doing what's best for the pt.

    Exactly! What is more important for your patient...TPN or tissues? Please find a way to explain the TPN is to be hung and then you will gather the other items the wife is asking for! I have to ask...did you set the TPN down to go get tissues?

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