How to deal with those family members who are "nurses"?

I usually don't have a chance to tell people I'm a nurse- my friend/family member does it for me! In the rare event I've not already been outed, I usually don't mention it unless I can do it offhand. I hate when pts/family announce 'I'm a nurse' as if I should hustle hustle and do nursey tricks for them.

On the other hand- I've taken care of all manner of healthcare professionals. I have found that most healthcare professionals I see on 'the other side' have always been very polite and helpful. I usually chit-chat and have no problems. A few though- wow, they can be monsters!

I refuse to play the game w/ the worst. You know, the ones who refuse to outright say they're a nurse, but keep their arms crossed, watch you like a hawk, and drop impressive medical terms left and right. I won't ask if they are a nurse. I refuse to. I just raise an eyebrow at some of the more obvious stuff- and go about my business. Honestly- if you're going to play passive-agressive Blues Clues, get a handy dandy notebook and get out of my way. Why are they always in the way??? These are also the ones that usually cannot so much as fix the bed so their loved one will be more comfortable- but hit silence (or turn of!!) the IV pump. Guess you fooled me- I am the horrible nurse who didn't know by telepathy that there was a teeny bubble in the tubing.

The ones who feel guilty because 'did I miss something?', or feel helpless or that they have no control- I can deal w/ that. The ones whose family member has a complex case or rare disease- I appreciate their insight. My kids on peds w/ rare genetic syndromes- Mom usually knew tons more then any of the staff, even better if she was a nurse.
I understand how it is to have a critically ill family member, a terminal loved one, or a child no one can diagnose. I know that in healthcare I'm not seeing people at their best. I've been there. I try to ask their opnions, thoughts, concerns when I can. It's no biggie to me to start an IV on someone w/ cruddy veins in the L. FA if family says it's my best bet. If they make a reasonable request and I can't comply, I don't mind explaining the rationale. If I'm told something that really doesn't matter, I just thank them for the info and go on. I'll even note it for future use. It may not matter to me at that particular time that Dad w/ STEMI is lactose intolerant- no milk in the protocol, lol- but it's nice to say "I'll put in on his history so when he's recovering they'll know". It implies that I expect him to recover. ((When my hubby was crashing they asked about allergies as he was septic- I went into a ramble about how "his Mom said he was allergic to sulfa because he got a rash but it ended up he really had mono and not strep so I don't think it was sulfa to begin with and don't you get a rash to 'cillins if you really have mono, but I don't think he's allergic to those either, and he's really probably not allergic to anything". I'm sure after the "I don't think he's really allergic to sulfa" they just tuned the rest out. They looked interested, though. Made me feel better and realize I needed to get a grip on myself. It's not easy to watch your loved one circle the drain- even worse, I think, when you realize excatly how critically ill they are.))

The twits, on the other hand, I just won't play. If it really gets nasty- innuendos and veiled threats- I refuse to apologize if nothing's been done wrong. I am, however, extremely polite and matter-of-fact. May I get you the supervisor? Shall I call the Doc? If you don't feel comfortable/safe/whatever, we cannot hold you here against your will. You have the right to request a second opinion/transfer/etc. You have the right to refuse this med/lab/IV/whatever. I have found that usually, when you put some of the responsibility back on them they settle down a bit. You give them the choice- in a very pt-advocate manner, and there's nothing left to argue with. The simple 'You have the right to refuse....' can make things pretty clear at times.

I'm ALL for involving family in care - many a time in the ED confused/combative patients often calm down/co-operate when family is around.

BUT, you cross a line when you step in and do stuff like throw away body secretions/excretions, label items in the room, suctioning (!) etc. Now you're no longer a family member - you're interfering in patient care and if you continue to do it despite my requests to cease and desist; you'll be asked to leave (and escorted out if need be).


My $0.02 worth.

cheers,

It is a lil anal...just admit that it's anal. there are more important things like a patient desating with SOB and only 10cc's of urine output in 20hrs!!! Now why that would of gone 20 hours without being noticed is beyond me...those are the battles you should fight...

As far as recapping the needles...how do you know that was the only time that nurse did so???? Telling a nurses supervisor that you just saw a nurse recap a needle is so beyond being anal that if i was the super i would of looked at you like you had three eyes...c'mon man...we are saving lives...and your gonna get hung up on the ONE time you saw a needle recapped...really???? thats only gonna buy you ill will...and your complaint will not be taken as YOU want it to be...

Reality Check,

Mex

Absolutely!! if they stay while i'm changing a diaper or a bed [the diaper not so much...especially if its a little one, but often times i have the family interject and say i'll do it, I LOVE PEDS ;-)] they most definately will be asked to do something...i dont allow family members to just stand there and not participate in the care of THEIR family member...and I work in pediatrics where its rare to see a family member not take charge in those things but it happens and i "handle" it. The great thing about peds is that it looks really bad if your asked point blank to help do "something" for YOUR child and you say no...i love it! ...and you better believe that i use it! I've even caught the unsuspecting dad off guard, sitting their with his crackberry (i can relate, i have a crackberry, lol) while me and his wife are handling a "difficult" situation but instead of calling for another nurse (because the task is so trivial, anyone can do it) i get him involved. I only had one time when the guy said no it's ok and stepped out...the funny things is you should seen the look his wife gave him...it was priceless...i bet you a million dollars he will never say no again...LMAO!!! In my area of practice parents need to feel as if they have some sort of control in the care of their child and they welcome it...if you use it to your advantage...it can be a very helpful thing...


Mex

Or the exact opposite - I've shut people down in the same exact way. "Oh, you're a nurse!" Then I turn my attention back to the patient, "Well aren't you lucky to have them here?!?" Then I immediately redirect my focus to the patient and conduct what I need to to. I'm not there to make friends with family members, I'm there to provide care. I don't have all day to chitchat about why dad is still on NS 2 days after the surgery and I don't care that he had a horrible reaction to Morphine one time yet is tolerating Dilaudid just fine (Everyone from the Doctor to the Pharmacist to me knows so drop it!). The ones that kill me are the ones that have a little bit of knowledge in a certain area but then turn around and try to apply it to mine. One of the most annoying was an ICU nurse at the hospital I worked at whose sister had surgery and she was trying to micromanage every detail. She was flipping over everything, asking me to call the doctor literally every hour over EVERYTHING. "My sister is getting a cough." I'd acknowledge it. Just, all sorts of stuff like that (and her sister, the one who actually had surgery, would be like, "It's no big deal seriously I'm fine"). Then an hour later she'd approach me and ask if I called the doctor about it yet. THIS WENT ON ALL DAY LONG. I took her aside and told her how awesome it must be to have an intensivist available 24/7 over on the unit, to only have 2 patients, and the HGB may be 8.5 but to trust me we see it all the time and the surgeon won't care nor do anything about it! Aghhhh. I don't even really care what she thinks or thought, bottom line it threw me off, hindered me rather than helped, and interfered with the care.

Trust me, I've done that. It's easier to give the boot in ER or ICU at times, because mgmt seems more inclined to back you up. I try to not boot the simply annoying ones- it ends up being more of a pain and hassle in the long run.
The really bad ones hang themselves. Eventually, they try to confiscate HIPPA material, throw a fit at the nurses station, follow you into another pts room- it never fails. They always cross the line. I'll catch them messing w/ the IV, 'shopping' in the cabinets, whatever. Out they go. It usually ends up that this type of 'nurse' family are no longer employed in the medical field.
I have to give my docs credit as well- they will openly confront someone who is hassling the nurses. They've stood up for us many times.

The harm is that she does not work there, she is a visitor. Nurse or not, she has no business "taking care" of some one else's patient.

I must say that this is the type of family member that irritated me the most until recently.... when I became one. I have always been the first to try to help out, to change linens, clean someone up, turn someone, etc as I know well how stressful nursing can be at times.

Let me preface this by saying that my main background is in ICU. I do not announce I am a nurse or anything when I see a family member in the hospital because really, it isn't usually relevant. I think most of us are reluctant to do so, because we don't want to be "that relative." There are some things that there are ways we prefer to do things, and others that endanger a patient's life. I try to be conscious of that. The care my family and friends in the past have received had never warranted any objection as any differences I saw were simply a matter of preference. Unfortunately, this time was different.

I watched a post-surgical relative drop her mean arterial pressures and she was barely producing any urine at all After quite some time of nicely asking the nurse, then insisting on speaking to the physician I became really angry. I went to the front desk only to find that the nurse, instead of calling the physician as I had insisted, was laughing and taking cell phone pictures of her coworkers, with her feet up at the desk. I kid you not. I know I never even have time to pee at work, let alone prop my feet up when someone is not doing well.

This nurse had not even assessed my relative properly.... her entire assessment consisted of taking a quick peep under the gown to "check" the dressing. That's it. After insisting again on speaking to the physician and her supervisor, she finally called in her supervisor. I demanded to speak with the physician again, or the house officer. The supervisor realized what was happening to my relative, saw that things were serious, and got the house officer who over the next several hours, gave her several fluid boluses to correct it. The nurse did not seem to think prior to that that pressures in the 60s were cause for concern. The only way I got her to do anything was to keep insisting that if she didn't call rapid response/physician/house officer that I would do it myself. During the several liters of fluid she received, the nurse did not once check her pressures again, assess in any manner, or seem remotely concerned. In fact, she incorrectly set up a liter of fluids with potassium in it as the bolus, which I had to discuss with her. I told her supervisor I wanted a different nurse, anyone else. I would have preferred the tech who at least seemed to realize something had changed.

I ended up doing assessments on my own as I did not trust that nurse, until a new nurse was assigned. I reported that nurse to risk management needless to say. I will not go into much more detail, except to say that you never know what has prompted someone to behave in the way they do. I was without sleep for nearly 48 hours at this time, and after dealing with this nurse, if you could call her that, for quite some time, I was much less polite than I ordinarily would be. I don't feel poor care excuses bad behavior, but at a certain point, things get ridiculous. You never know what people have gone through by the time they get to you. My relative's surgeon said that had I not have insisted on calling and getting help, it is quite likely that things would have not gone so well. He also has asked that the nurse be fired.

Seems to be a whole lot of drama over this one comment, and I think it has been misinterpreted by some. I don't think she was calling the previous poster "anal" for pointing out that recapping is wrong, because she even admits that it is the wrong way to do it. I think the problem she had, and I as well, is that someone in the facilty as a patient would even consider calling a supervisor about it. (If I am wrong, KeechieSan, please feel free to correct me)

Yep, agreed, the action is dangerous for the nurse, and not something I personally practice. BUT, it did not directly affect the poster as a patient, and did not place her in any danger what-so-ever. If she were truley concerned for the nurse's well-being, then why not mention it to the nurse in question? Why try to get the powers-that-be involved, unless she was annoyed at before mentioned situations and grasping at straws trying to find some way to get the nurse "in trouble" with the higher ups. And I am sure she has never strayed from the text book in her own nursing career, so she is in a perfect position to get on a high horse and criticize others.

Kudos to you for doing such a great job in handling the situation! Your story made me reminisce about the many patients that I have taken care of whose family member was a "nurse". Some are great and sooo helpful, some make you want to rip your hair out!!! If you take a look at her actions, she may be a nurse but obviously does not completely know what she is doing. Dumping gastric contents down a sink...that's a nice one. I've dealt with a few "nurses" before that have run me into the ground. In my experience, those are the nurses who suck at the jobs and don't know what their doing. Keep up the good work! Don't ever feel bad for taking care of your most critical patient first instead of getting the other patient a damn blanket. We are nurses, not waitresses!