Meeting family needs....
- 0Sep 6, '11 by Noey67I am plucking thought my day and I thought I'd log on here and ask the question.
How is it that as a RN Case Manager does one meet family needs? Patients for me and families for me have always been two separate units that work together.
Lately I have found families need more from me than patients. I am not a social worker, nor a chaplain, but often times our roles merge.
Example? I had one patient who was on service and their spouse insisted I come before 3pm so I wouldn't interupt Judge Judy. That was easy to accommodate, but it was SUCH a priority for this spouse.
Another patients family complained because one of my visits was 10 minutes. I was actually just dropping off supplies, and it was not a scheduled visit. I made that clear ahead of time, but they called and complained. They wanted me to sit and visit for a minimum 1 hour, this was verbalized during the complaint process.
Hospice is SOOO pysch/soci oriented. Patient symptom management for me is the easy part.
How do you all cope with this? I just roll with the needs of the family.. but I think often social workers are spread sooo thin, not all needs can be met.
- 2Sep 7, '11 by leslie :-DQuote from Noey67instances like this, should be pretty much blown off with mgr gently reminding family that this was not scheduled.Another patients family complained because one of my visits was 10 minutes. I was actually just dropping off supplies, and it was not a scheduled visit. I made that clear ahead of time, but they called and complained. They wanted me to sit and visit for a minimum 1 hour, this was verbalized during the complaint process.
as for pt wanting to watch a tv show, personally i would try to accommodate (as you did), since it's a simple pleasure for pt.
just face it, pts/families can be irrational quite frequently, and it's up to us to either seek help or masterfully placate them.
often, their anger is a result of misunderstanding, miscommunication.
this would be an ideal topic at your next meeting.
leslieLast edit by leslie :-D on Sep 7, '11
- 3Sep 7, '11 by AtlantaRNI have a membership to a gun club and have an ar-15 as therapy.
I was out most of Sunday night, Monday morning w pt issues, then got a call ar 705a labor day w a family member (of a 97 yr old pt that died the previous Wednesday) insisting I give her direct phone numbers for branch director n medical director. Although the pt came out of an Ipu n lived 10 days at home----she insisted no one prepared her for the patients death. She insisted bereavement team come out on a holiday as well as social worker. She kept me on the phone for 30+ minutes w her demands and complaints. I had branch director call her n calm her down..... Lady was off the chain.
Some folks u justcant fix
- 1Sep 7, '11 by AtlantaRNMy boss was so mellow w the above situation.... Saying to me "so, she just woke up ****** this morning????". Come to find out, in those 10 days, chaplain n social worker were visiting 3x a week AND contacting by phone on days they weren't visiting. So we were going above n beyond.
- 0Sep 7, '11 by Hospice Nurse LPNSometimes I do feel as if the family is getting more of my attention than the pt. As long as the pts needs are met and they are pain/symptom free, what the heck. I don't view the pt and family as separte, though. I see them as a family unit. Even though the pt is the one dying, the family may have many other things going on.
I'm blessed to work w/ a great MSW and Chaplain. I'll do whatever I can while I'm in the home, but don't hesitate to call for help (backup) when I need to.
Funny though: My name tag reads: "Hospice Nurse LPN, CHPLN". Several family members have asked me if I was a chaplain. I tell them that the letters stand for certified hospice paliative licensed nurse, but I'll be happy to pray with them if they like.
- 0Sep 8, '11 by tewdlesNoey, I think you are correct, that too any agencies spread the MSW and Pastoral staff too thin thus displacing those burdens of care upon the nurse.
Unfortunately, the care of the family is a HUGE part of what we do, and without adequate resources our most needy families will have problems.
I am glad that your manager was "cool" with the complaint. Keep delegating the duties to the appropriate disciplines and hopefully your agency will respond with more professional staff if it becomes obvious that they are spread too thin.
Good luck. BTW, are you familiar with the national benchmark for caseloads for MSW and Pastoral professionals in hospice? Is your agency staffing similar to those?
- 2Sep 8, '11 by AtlantaRNI feel bad when I can't fix their problem. My husband reminds me it is the families "perception" of a need not met- but the customer is always right.
I feel ill equipped when I've has little sleep to deal w such issues. I thank god for the team and ESP branch director who speaks as the voice of reason when I'm exhausted.