What do you do when you are assigned patient is a someone you know?

  1. Last week my assignment included a gentleman from my church. A very dear man who I am very fond of. I usually arrive early and when I saw his name I asked if I change assignments because I was concerned about his privacy. My charge nurse reassigned me but, in a way, I felt like I was asking for special favors and perhaps irritating the coworker who was asked to change. He ended up having a major stroke a few days later. The following days when I worked he was not assigned to me. One those days I touched base briefly with the family since they were on my wing and went to see him on my breaks. Well yesterday I was on after several days off. I arrived later that I usually do to work (Just a few minutes before taped report started). My assignment included this gentleman who is now not expected to live. I felt very uneasy about taking him but I didn't want to inconvenience anyone. Some of my coworkers had already started taking their notes off the kardexes. He is now comatose which made it easier for me to care for him (He is incontinent and we changed in 4 times, turned him every 2 hours, gave him some suppositories...) Had he been lucid I'm not sure what I would have done! Furthermore I was very aware of how precarious his health is and it grieved me in a more personal way than it usually would. His family, who had been in the room almost constantly, was not there on my shift which was a mixed blessing because I had four other needy patients. All through the shift I was hoping that he would not die on my shift.
    I live in a small town. This situation will most likely come again form time to time. Am I being unprofessional for not wanting to care for people I know? What do you do when your "patient" is a friend?
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  2. 16 Comments

  3. by   shavsha
    Oops! Please excuse the typos...I guess I am more tired than I thought!!
  4. by   fergus51
    I think what you did was absolutely right. I don't think it is appropriate in most situations to care for people you know. It's often uncomfortable for them as well as for you so I consider it being a patient advocate and not asking for special favors. I am adamant about this because I work L&D and I don't think anyone I know personally wants me to be giving them a vaginal check.
  5. by   NurseDennie
    It depends on the circumstances. I've taken care of friends that were nurses on my floor (my best friend hurt herself at work, and then had to be in hospital for about 4 days. I was off that day, and the nursemanager called me and asked me to take her home from the ED. When I went to get her, she was still in an awful lot of pain, and when I tried to walk her out of the ED, she couldn't walk for the footdrop!!!! So I made them admit her. The admit process was a little bit strained, with my friend in the bed, me at the bedside, and another friend asking the questions. Sheeesh). The actual taking care of her later was not a problem. But she's a nurse, and a really good one. She's the one that will do the Kevorkian consult on me, if ever necessary. She tended to start out by alienating the nurse who would start the IV (she's had to have several procedures done since then) so I kind of mediate there, too.

    My other situation was VERY different. I used to work as a computer lady at a very well-known music organization. One of the gentlemen who had been on the board of directors when I was there ended up in MY care having had major surgery. He didn't REALLY remember me, so he didn't have a problem with me taking care of him. I didn't really have a problem with it either. Poor guy ended up with urinary retention and darn near had an ilius. I remember doing the foley and bowel regime thinking, "yeah, this is different to a day on Music Row." LOL

    PS you'd need to have spent a day on Music Row to understand how funny that really is. *sigh*

    Love

    Dennie
  6. by   kennedyj
    I agree with Fergus, but feel it would depend on the situation and diagnosis. To see someone very sick may impact your ability to properly care for that patient. Your instructor should have complied with your wishes to not take that patient.

    I do congratulate you on a job well done and your courage to take on the situation under those conditions. It shows you a strong nurse.

    Once when I sold computers a made a system for a couple that asked me if I could buy them Pot. They poured me a large glass of Jack and coke when I was putting together their computer. They were also very strange. A few weeks lated I saw her as a patient during my Psych rotations. When picking assignments I did not pick her.

    Jared
  7. by   RNKitty
    I agree that it depends upon the person, but I have requested specifically not to take friends as patients. I work L&D, and when I was pregnant I would not take a fetal demise due to my pregnancy inadvertantly hurting the grieving couple. If I ask for a "special" favor at report time, I usually volunteer to take a more labor intensive patient to show the other nurses I am not slacking or foisting a patient on another nurse.
  8. by   thisnurse
    when i was a student i was assigned to a patient that had a penile implant. i was excited about it because it was something i had never seen. i didnt recognize the name but i did recognize the face when i went in the room. he was a perv that used to harass me where i used to work. the docs did a diservice to womankind that day...lol
    he didnt recognize me, or at least thats what he let on, so i didnt ask to be reassigned. he was discharged that morning. i NEVER had to look at the implant. the thought of pulling back the covers and checking him out, knowing the pleasure he would recieve from that made me sick. the doc was examining him when i came in and i stood by, but not too close.
    stuff like this only happens to me i swear...lol
    i dont think id care for someone i know because knowing them might interfere with the care i give.
    guess it all depends on the situation. i dont think you are out of line or asking for anything special by asking to be reassigned.
  9. by   P_RN
    What about when it is someone you know, AND someone you hate and hates you back?

    My "neighbor" the crack dealer was a patient on my floor. I REALLY did not want to take care of her, and because I didn't no one else wanted to either. And I never said a word about her either. Her "presentation" was enough to describe her.

    Oh and when we were out of the country once, my dear hubby called me "overseas no less" not to say he loves me and misses me BUT to tell me she had been busted for dealing. Made my day!
  10. by   Teshiee
    I think you did the right thing. It really depends on the situation. When I was struck down with meningitits my class mate from nursing school took care of me and I didn't have a problem with it. We just talked about old times and she learned from me. I had a central line and everything. I think you did the right thing.
  11. by   sassynurse78
    I have encountered this prob once. It was a mother to one of my good friends, I had been at many slumbar parties at her house when I was young. It was very hard considering she (the pt) was very young, but even as nervous as I was at first, it worked out for the best, my friend who I had not seen for awhile was having a hard time dealing with it all, but knowing me made her more comfortable with everything that was being done. Her mother also was more comfortable talking with me. I was even able to help her decide her code status and go to hospice care, she was in severe CHF & uncontrollable IDDM and there was nothing else to be done. She passed peacefully and without pain. I think everyone needs to make their own decision, because nothing should affect a pts care.
  12. by   ikimiwi
    I work in a small city ER. I know many people who come in, I have cared for my next door neighbor who had a massive MI, the nieghbor on the other side who coded down the street on a walk, my daughters best friends grandmother, aadn many parents of old high school friends, many who died All said they were glad I was there and felt better having me there. I dont care for family as a primary nurse, but I do keep my eye on them! It is very hard sometimes, but in this big mess we call healthcare, I think people find it very comforting to see a familiar face in a scary situation.
  13. by   ikimiwi
    one added thought that I didnt mention, my parents and aunts and uncles are getting older and its very scary to think I might be workning if they get brough in. Not long ago I took a call for EMs for a woman down, unknown cause at my parents address..............longest minutes of my life.........turned out they meant 14 not 12 Steven Dr, they lady across the street broke her hip, I almost needed to be coded. I was so scared. unfortunately this could be a reality and that does scare me!
  14. by   rdhdnrs
    I don't think you should take care of family members under any circumstances, but I have taken care of many of the staff and resident docs at my hospital when they were having babies. I took care of one resident's wife when they had an IUFD of one twin at 33 weeks. It was very special to them and to me and we have a neat bond now. I don't know I guess it depends on your personality and whether the patient has a problem with it. Also L&D is a little different than med-surg. I guess it's just a judgement call.

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