How to deal with those family members who are "nurses"? - page 6

1. 
   Nov 10, '09

   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!
2. 
   Nov 11, '09

   Here's what I do:
   
   If they say they're a nurse and start touching stuff, I say, "well, as a nurse you know that you are not allowed to touch the equipment/change settings. That's to safeguard YOUR license." And every time they say, "I'm a nurse" I say, "and as a NURSE, you know you shouldn't..." They want to wave the nurse flag, I'll beat them to death with it if they're being stupid.
   
   If they are writing down everything, asking about everything, I quiz them back. We have one family, the daughters come in and set up camp, write down everyone's name, what you came in the room for, what you said, what you did. I bring in the computer, and I'm like, "and what's YOUR name? and what's YOUR relationship to the patient?" I go over to the patient and ask the patient if they authorize me to discuss their condition with them. I write up on the board that I turned the pt to the left at 0130 and sign my initials. I come back and she's back on her back, I ask who turned her back onto the stage 3 decube and ask them to spell their name while I'm putting it into the chart. It's amazing how they leave me alone now and let me do the job of looking after their mom.
   
   I've also been on the other end. My dad was really sick, and I got on the phone with the nurse. I said, basically, "I know my mom's upset and I'm at work 50 miles away. I just want to make sure mom hasn't forgotten to tell you that dad's history is....and I can fax you his med list (I keep a copy of both their med lists in my wallet)." I make sure they know dad's a diabetic (he forgets to tell folks since he thinks if you don't take insulin, you don't have "real" diabetes), and that mom has had periods of extreme hypertension, and if they could keep an eye on her until I get there. Other than that, I stay out of the way. He's my dad, she's my mom, but they are that nurse's patient, not mine.
3. 
   Nov 11, '09

   Quote from kcochrane

   I also usually don't admit I'm a nurse either. I don't like to make them nervous. But my husband who has medical problems always pipes up to tell everyone.
   
   As far as the blanket. Why couldn't she have grabbed one since she seemed willing to do everything else? I've seen that nurses are busy and gone to get one myself.

   yes, I generally don't volunteer that I'm a nurse...but my husband loves to make the announcement..and defer any paperwork, etc to me.:heartbeat Funny, I don't usually bring up what he does for work....
4. 
   Nov 11, '09

   Quote from Roy Fokker

   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,

   when my daughter required an e/c/s, one of the anesthesia residents kept asking the staff if I could come into the OR(had been a rough labor, rushed to OR once, baby's hr stabilized, back to labor room, back to OR)...my daughter was literally trying to climb off of the table-with an epidural on board) I really was trying to maintain my role of support person. When I finally was allowed in I was able to "talk her down"...
   
   I really do think that family members can make a big difference...as long as they maintain their places, and allow staff to do their jobs
5. 
   Nov 11, '09

   I NEVER tell people I'm a nurse when my loved ones are in the hospital. Usually, they catch on once we start talking. I do ask a lot of questions, but not in a superior or accusatory way. I just wanna know why they're doing stuff and what their expectations for treatment are. I don't take names, but I do bring candy, cookies, and sheet cake!
   
   Now, my mother is another thing altogether. She has outted me a few times. Not only that but she has several times walked in wearing Tshirts that read "I AM A REAL NURSE." Oy...then she proceeds to change things, do things the way she wants, etc. When my sister was in labor(at my mother's hospital--big mistake!) my mother sat with her all day, turning her pitocin up and down, managing her epidural, and basically wouldn't let the nurses do their job. I was surprised that the staff didn't throw her out. She was so obnoxious that my sister and BIL sent pizza to the staff with a note of apology!:imbar
6. 
   Nov 15, '09

   Now on the other hand, when my son was in the pediatric ICU with respiratory distress and kalwasaki's disease I was asked to jump in on his care. Particularly after 2 different nurses stuck him 2 times each to no avail. I couldnt stand it anymore and did the IV myself on the first attempt rather than continue to let them stick him over and over. (something I have a gift for doing and thats venipunture and I was a CVICU nurse in this same hospital). After that blood draws or new lines I was asked to do on him. If I was working my shift then they would page me to the peds unit to do. He was also calmer with me doing rather then strangers at 3 years old. With me doing these task there was no tying down or restraints, most of all no screams lol. Funny as now he is 22 years old and still wont take a shot unless they allow me to administer it since he drops like a rock and hits the floor. He doesnt pass out if I give it. Cant figure that one out yet. Same with my 29 year old lol. guess they always stay mama's boys dont they LMAO.
7. 
   Nov 17, '09

   I haven't had much issues with patient's family members being nurses and problems, but I have taken care of doctors, and their families, and they have been pretty decent to me (maybe because they know that nurses rule all LOL...KIDDING)
   But I have also been on the recieving end too. In the past three months, I have spent more time visiting hospitals than I could ever imagine... (see thread My Crazy Month) Both my gma and my gpa were in the hospital....two seperate ones (opposite sides of the family) and I spent ALOT of time visiting them.
   My gma F was in the hospital for 8 1/2 weeks (one hospital for a week, the second hospital for the remainder of the time on three different floor/wings). By the time she left, every one of her doctors, nurses, aids, physical therapists, respiratory therapists and anxillary staff knew I was a nurse, and knew my mom was an x-ray technologist. Had my mom and I not know my gma F, visited my gma, and been around and asked questions, gma F would have died. Granted her care was excellent there, they just didn't know gma like we did. The only problem the staff had was with my gpa F who was stubborn as all get out....and for him....I apolgised profusly to them.
   As for my gpa M, he was only in the hospital for a total of 8 days, but the poor staff of the two three wings had my ENTIRE family to deal with, including my witch of an aunt, and my bull headed uncle. While I was there with my gpa M, I was basically a wall flower and let my family, my gma M, my dad, and my aunt and uncle do all the talking and asking questions, and if they had questions, I would answer. (gpa M died due to an MI....complications of a lower leg amputation)
   So....I have been on both sides....and for any of you who may of dealt with my gpa F, or my crazy azz family on my dads side.....SO SO SO SO SORRY!!!!!
8. 
   Nov 19, '09

   Oh Gosh I have had family members like that and I sympathize. First off you did a great job considering you are not an experienced nurse. Later you will be able to set some boundries and if you are lucky you will be able to do that with a great big smile on your face as you hand them the coke or coffee you had offered them. :wink2:
   
   Don't forget to notify your supervisor if you think you need help. Of course he/she might be busy at the moment writing the unusual occurrence report about a needle observed being recapped by another nurse. :icon_roll But they should intervene if you feel that you can't provide patient care due the actions of the family member.
   
   MP
9. 
   Nov 19, '09

   I've had many patients with family members as nurses...one occasion I was about to restart an IV that was leaking on the patient and had to leave the room for whatever reason and when I returned she had started the IV on my patient.
   
   She was very pleasant woman but that was a little odd for me.
10. 
    Nov 19, '09

    Quote from Lil'mama

    I've had many patients with family members as nurses...one occasion I was about to restart an IV that was leaking on the patient and had to leave the room for whatever reason and when I returned she had started the IV on my patient.
    
    She was very pleasant woman but that was a little odd for me.

    I will confess, after watching 3 nurses attempt start an IV on my granddad one night in the ER, my mom slipped one in while we were in the room alone with him. When the nurse asked, we just told her a nurse with brown hair started it (not a lie, she is a nurse, and does have brown hair). She's one of the best sticks I know, so it saved them time and him pain...no harm done.
11. 
    Nov 20, '09

    I've learned a few things in dealing with very similar situations. When a family member goes off on me for tending to a critical pt. vs. their family member, I gently explain to them that if it WAS their family member who was having life threatening issues, they can rest assured that I would be focusing all of my time on their family member in the same way. That USUALLY backs them down. The other thing that I have learned is that you MUST engage them in a light conversation to find out exactly what their job is. EXAMPLE: I had a pt who was being cared for at home by a daughter who made it clear to all that she worked at a large hospital that is world renowned. In my assessment I noted that the pt. was unkept and had multiple areas of skin breakdown! In conversation, I found out that the daughter was a unit secretary who worked 12 hr shifts, leaving her mother alone and obviously she was unable to care for herself. When the doc wanted to discharge the pt back home, I told her that she was not being cared for properly. When the doc stated to me that the daughter was a nurse at ***, I told her that she was assuming, that I had learned she was a secretary, and made the doc come into the room with me and pointed out what I had found in my assessment! Needless to say, we were able to intervene and get the pt. the care she deserved. Next advice I have is CHART, CHART, CHART!!!! Chart that family member is dumping outputs, etc., and let the docs know. If you have to, get your manager involved. If the daughter really is a nurse, she knows the importance of charting I/O's and such. Stay calm, every experience is a lesson learned
12. 
    Nov 20, '09

    I guess it may be a little different since I am a male nurse, but family can present many problems. Firstly, I would recommend being firm with the wife, she is acting inappropriately. When the patient was wet, you could ask a charge nurse, CNA to clean the patient, if unavailable reaffirm the family member you will be in his room as soon as it is possible. Next, once the wife starting emptying or doing anything that was specifically for me to do as the nurse, I would firmly ask the wife to allow me to do what she was doing, and reassure her that I have confidence in doing my job. If she did not listen my assistant manager would know right away, and one way or another the wife would have to back off.
    
    "Something like, I am sure you are a wonderful nurse, Mrs. ......, but please allow me space and respect to do my job."

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