GOD!!! is this legal??? about family members???

  1. GUYSS I need help really bad because I think I am going crazy.
    Today I thought I was going to just turn in my badge and say goodbye to nursing. I work in a small 102 bed-long acute hospital, the ones where you will have patients for months.. well, There is this patient who has a daughter that got the nickname of the "beast". She wants only certain nurses to be the only ones to take care of her daddy, and certain CNA's and RT's and guess what?? the hospital mgte. lets her do it!!!!
    Can they do that??? say ok, such and such are going to take care of your dad all the time???? I got so mad because she did not want the CNA assigned today to take care of the patient. I am one the RN's in her "good list" and I told her over the phone that I will take care of her dad when I am ASSIGNED I will NOT take care of her dad IF she asked the charge nurse or whoever to PUT me in the assigment. I've been in that section for almost 3 weeks now and I think is getting out of hand. The lady is not even on her right mind, she is on antidepressants or something, but I was so upsed I ended up crying. My supervisor is the biggest idiot, she will NOT STAND UP for the nurses and that was the most frustrating part of the day. I will talk to the administrator because I don't believe of this system of family members requesting nurses. I am not a private duty nurse!!!
    thank you so much for letting me vent, I love this site
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  2. 22 Comments

  3. by   live4today
    Pamelita.....welcome to Allnurses!

    I use to work in a medical center where the same nurse stayed with the same patients until they were discharged from the hospital. I truly enjoyed it this way because it gave patient and nurse the opportunity to establish a better nurse/patient relationship and a better continuity of care for the patient. Many times, if a patient or their family member have trust issues where certain staff is concerned, I don't blame them for asking for the same nurse, CNA, or whomever they feel will best meet their loved ones needs.

    Yes....some long term patients...and their family members... become quite burdensome emotionally speaking. In cases like that, it is always best to request a change when you....the nurse.....feel yourself becoming "burnt out" to where you may end up short-fused and take it out on the patient and/or the patient's family members.

    This type of flexibility should always be alloted for by the floor supervisor......and understandably so. We may be nurses, but we are human beings first and foremost who are subject to having our "emotionally challenged" days just like our clients and/or patients. I hope you get this worked out to the betterment of ALL involved.
  4. by   Nurse Ratched
    We may be into something here - there is a sign at a haircut place in the mall - soemthing to the effect of "There will be an extra $2.00 charge to request a specific stylist." Management should love the idea...

    I've seen a couple of instances where family members or pt's request NOT to have a specific nurse (one who has been abrasive or otherwise ticked them off, usually there is a good reason.) But to have a list of "who I want to take care of me." Sorry - it's a hospital, and in a group setting, staffing assignments are made with the best interest of the unit as a whole, as well as specific patients.

    As cheerfuldoer suggests, continuity of care is nice, but therapeutic care can also be compromised if the same person is assigned day after day, or if the pt or family becomes dependent on certain staff members. In psych, this would be of particular concern and sometimes staff-splitting becomes an issue.

    I'm all for pt's advocating for themselves, but sometimes demands are unreasonable. The needs of the unit and other patients on a particular day are what dictates whether their requests are or not.
  5. by   sjoe
    So your supervisor is permitting patients' relatives to make staff assignments, in other words. If the supervisor supports this, there is nothing illegal about it, however that same supervisor thereby makes it clear that: 1) she is not in charge of this unit, 2) she cares little for her nurses, 3) she knows nothing about supervision, much less about leadership.

    The question is not whether this is legal, the question is whether you want to put up with working on this unit and for this supervisor. (Even if they promise you pizza.)
  6. by   pebbles
    Sometimes leting patients take so much control over certain aspects of their care makes their demanding controlling attitudes worse. There are other ways to let pt's have control over their care... than by having control over staff. This sounds like a difficult situation, but I can't see anything *illegal*....

    Do you have a union or some other group that represents the interests of nurses at your facility... Or perhaps this could be discussed at a staff meeting. If you all stand together and tell the manager the devastating effect this has on morale and your ability to give GOOD care, maybe together your words would have more weight?

    I also agree that this is part of the bigger picture of how this manager treats staff and you need to think about what kind of workplace you want to work in, as well as what type of pt care you enjoy. A happy workforce is a productive workforce....
    Last edit by pebbles on Sep 15, '02
  7. by   cactus wren
    Sooooo....Who takes care of this patient on your off days, or does the stupidviser expect you to work straight through until patient is dc`d?
    Nope, I spelled it like I pronounce it.........
  8. by   Texagain
    This happened to me one time- the family member did not like me for whatever reason (personality, not a quality issue)and called the charge nurse and house supervisor. The 2 bosses asked me what I wanted and I told them that I felt I could provide quality medical care to the patient. They told the patient and family that all the nurses on the unit were competant and that I was the nurse assigned and that I would complete the shift with them. I really felt good about that. I think your place should do that also.
  9. by   karenelizabeth
    we had a Dad of twins who made it blatently obvious when he aproved of who was looking after his twin daughters. Our manager is good and did tell him that it is the nurse incharges clinical judgement who cares for which baby and not his personal choice.

    He still made it very hard though and even obstructed one member of staff when one daughter went off and needed bagging.

    Now I can understand some of where he was coming from he was a manager and used to being in control and wasn't . You you want the best care for your children (god knows what sort of parent I would Be in those curcumstances) but the best way is not to make nurses feel uneasy thats when mistakes are made.

    Anyway he made life so dificult and himself so unpopular that nobody wanted to look after them. I was one of the chosen (don't quite know what I had done to deserve that) so just to make life easier I did look after them when I was on duty. but this was to the detrument of my own health in the end as one of the girls was extreemly sick and as a result ended up being bagged and retubed (cpr too on more than 1 occasion) nearly every night for a week. By the end I just couldn't face going to work so ended up off sick for 4 months in the end with stress.

    I will never let myself be put in that position again ever
  10. by   ktwlpn
    [QUOTE]Originally posted by Pamelita
    [. The lady is not even on her right mind, she is on antidepressants>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. .FYI-please see various threads dealing with the topic of depression.....Thank you (I agree that the admin needs to take a stand with this s.o.-)
  11. by   susanmary
    Originally posted by sjoe
    So your supervisor is permitting patients' relatives to make staff assignments, in other words. If the supervisor supports this, there is nothing illegal about it, however that same supervisor thereby makes it clear that: 1) she is not in charge of this unit, 2) she cares little for her nurses, 3) she knows nothing about supervision, much less about leadership.

    The question is not whether this is legal, the question is whether you want to put up with working on this unit and for this supervisor. (Even if they promise you pizza.)
    Perfect. Absolutely perfect. Sue
  12. by   Pamelita
    Hey guys...guess what.... today the daughter visited her daddy and she was FINE! like nothing happened, she even smiled and talked to me like we were best friends. I couldn't believe it!!!
    She asked who was the CNA and RT, but she was so happy I was the nurse. ANyways, I think she is totally "loony". I will speak with the administrator because this is an issue that needs to be stopped, sometimes, if a patient wants a private room we would move patients around just to give that patient a private room. I don't understand why admin. would do this.
    I understand family members are very concerned about their loved ones and they can ask all the questions they want. HOWEVER when they interfere with care, are extra demanding and take control of the nursing staff is totally out of hand. I appreciate all your replies
  13. by   CaliNurse
    Wow, this is also dealt with at my facility about once a year. The facility should not let any outside person control the staffing. This brings to mind a saying that we use..... If you are not part of the solution - you are part of the problem.

    Once the family learns they are in absolute control heaven forbid. You think you have strange request now.... it gets worse!

    and another one..... Passive acceptance is encouragement !

    When it is to the point when this is stressing you out you do have the right to ask to be removed from the care of the patient.
    We have this happen at my unit. We also have long term patients. Some are vent patients and as you know any vent patient comes with an extra nervous system ... lol...

    We try to stick with continuity of care but also do not want the nurses to become burnt out by something that is an easy fix.

    Good luck,

    Cali
  14. by   nimbex
    My guess is that a couple of things come into play, my experience is both sides of the staffing and management fence.

    We know what the family wants....

    What do the nurses want... If a nurse feels comfortable taking the assignment knowing that the family shows disfavor, the nurse should be encouraged and supported for taking the challenge. "I know you prefer I didn't care for your dad, but I am a competent nurse and enjoy taking care of him... tell me what turned you off about me..." This is a hard question to ask... even harder to listen to the answer but it helps identify WHY the family is choosing one over the other... it could be as simple as one nurse placing a cold washcloth on a forehead.. while the other removed the blanket when the patient was hot.... we never know what goes through their minds

    continuity of care is very important to the patient and family.

    So it the sanity of the nurse, I just changed assignments after 3 nights with a difficult patient and very difficult know it all EMS son. The family demanded I take care of mom and wanted to know why on night 4 I wasn't assigned.

    I replied that on night 4, I was very exhausted and couldn't give mom and family the care and nurturing that was required, they needed a nurse that was "fresh" who could meet mom's needs. Did this make me less of a nurse? some might say yes.... I feel that I'm human and should recognise and be supported when I'm burnt out. The family had no problem with this and I assured them that I would share my knowledge of their mom with the new nurse if it benefited in her care and spent time talking with them (even though I didn't want to ) to show that I was still supporting them.... in a different way.

    Long story short... consider yourself blessed that you have made a positive impact with this family.... Consider yourself a strong nurse for recognising and standing up to your limitations of meeting their needs day in and out....

    Any one, especially your supervisor, should see switching assignments when the nurse is burnt out as an asset to the patient and family. You may just need to help the supervisor see just how understanding she really is to the patients needs:roll

    good luck , stand your ground

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