I've had a bad experience with a pt's family member who I "think" is a nurse. During report, I was told that this pt's daughter, who is the "nurse" and the wife made the day shift pretty miserable and guest relations was called and the day nurse was reported for being "rude".
Well, I work in a MICU, still in orientation, and my preceptor and I decide to be open minded about this family. I work nights and visiting hours are over at 20:30. Well, I get report and I have another pt who is considered "ICU" status, while this pt is considered "tele" status (just waiting for a bed). I'm at the desk looking up my medications and this pt's daughter and wife barged to the desk demanding to know who "my daddy's nurse is" and I need to see her "right now". My preceptor explained that we are just now getting out of report and his nurse is looking up his medications and will be in there shortly. The daughter states "well, he is wet and needs to be changed". I told her I will get there as soon as I can.
Since my other pt was the more critical pt, I went to see her first, grab her vitals and do her assessment. I then go see my other pt, and his daughter "the nurse" had taken out linen, a gown, and pads and placed them on the bed for us to change him. I went to get my preceptor because I didnt want to be alone in the room with them, and we decided I will do my head to toe assessment while we change him. We wash him up, check his bottom for skin break down, and the daugther and wife BOTH is sitting there watching us clean him up and once we turn him back on his back and change his linen, the daughter asked us if he had a bowel movement because she thinks he did! I said, we just checked him, cleaned his bottom and checked for skin breakdown, there was no stool. She says "are you sure because I think he did". I said, "you can check the sheets if you like".
The daughter is dressed in scrubs and as we are trying to bathe him and turn him and assess him, she is looking all in the cabinets, put on gloves and started cleaning the counter with alcohol wipes, took his suctioning canister out and dumped it in the SINK, cleaned it out, and wrote the date on it and placed it back in the holder! She also took his NG gradual and "threw it away" (according to her) because it was "filthy". Not only that, I was doing gastric residual because pt was on tube feeding and I put the pump on hold and pulled out the gastric residual with a large syringe and dumped the residual in a gradual so I can measure it and she tells me I shouldnt do it that way! My preceptor stepped in and told her that I am a new nurse and I am still learning and have been trained to measure gastric residuals that way. She then asks what school I went to, do I have a BSN, etc. I calmly answered her questions, but wanted so bad to tell her if you are a nurse yourself, you will understand you are making a very difficult working environment. I put the residuals back in the NG tube and turn the pump back to feed and she is standing there watching me like a a hawk. She then asks me for a blanket.
I leave the room to get the blanket and in the meantime, my other pt bp is dropping. She also have a 21:00 med due, so I grab the med and head off to her room to give her a bolus of NS, and the daughter sees me with syringes in my hand and STILL asks me for a blanket. I politely told her that my other pt is critical right now and I have to pass meds before she crashes and I'll have to get her a blanket when I'm done. She then "yells" for another nurse to come to the room to give her a blanket. It was way after visiting hours.
This upset me greatly. Something tells me this person was not really a nurse, but probably a tech. And oh, by the way, I caught her giving oral suctioning to the pt. I told my preceptor about it. Any advice on how to handle these types of family members in the future? The ones that are "nurses" or part of the medical profession?
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.
Specializes in Med/Surg and Critical Care Stepdown.
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:D
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."
jessiern, BSN, RN
611 Posts
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.