Am I asking too much from a nurse? - page 2

by monkey2008

4,210 Views | 29 Comments

My dad had surgery Tuesday to remove pituitary adenoma. This is his second surgery in 5 years for this issue. Both last time and this time, he developed diabetes insipidus, which I understand is a common complication from the... Read More


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    As others have said, you have to be careful when answering questions. I feel comfortable giving info such as "Your father is more alert today, has been up to the chair, and appetite is improving," all of which are squarely in the nursing scope. Often, answering these types of questions lead to medical questions that I will not answer. It really all depends on the situation, what I know the patient or family member has been told, what I know they understand, etc. Sometimes they'll ask why a test was being ordered. A RUQ u/s when the pt has been complaining of abdominal pain? "The docs just want to take a look at some organs in the abdomen to see what may be causing the pain." Other times, I won't answer why things are being ordered. It really all depends on context; every situation is different. Most family members and patients are very understanding when I say, "It is best that you talk to the doctors about the test results and the medical plan. They can give you a more complete answer and address any additional questions you may have."For the nurse you encountered, she could have been brushing you off, she could have been replying within her personal comfort zone of providing medical info, any number of things. The problem is that we are so accessible as nurses being there 24/7, but the docs are ghosts that materialize in human form for 10 minutes a day. That's why we get all the questions!
    wooh, Dazglue, anotherone, and 3 others like this.
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    My unit got slammed recently for disclosing information to family members. Your Dad is a not under a guardianship order so we cannot give you information unless he authorized us to prior to his surgery.

    Who knows what's been happening on that unit lately?
    jadelpn, wooh, prmenrs, and 3 others like this.
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    Again, thank you all. You've given me exactly what I was looking for-different perspectives from people not as "close" to the situation, and with way more experience than myself. I appreciate the help!

    And dad is doing well-just bored out of his mind and wanting to escape Hoping to be discharged tomorrow.
    Altra, Meriwhen, and aknottedyarn like this.
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    You'll find your own ways of dealing with those questions when you start getting confronted with them. There are ways to deflect giving out information that the MD should be going over while giving a somewhat satisfactory answer:

    For instance- "It is standard to check calcium levels after a thyroid surgery. Your doctor will let you know the results after she interprets them."

    I try to be as honest as possible about why we draw certain labs without giving out too much info and overstepping my bounds. It can be difficult sometimes, and I may sometimes be guilty of appearing to brush off questions. Also, as other posters have said, med-surg nurses often have many patients and we don't always have the time to look at every patient's individual labs. (And unless it's critical, I don't have anyone's lab values memorized)

    Short answer, your dad's nurse probably #1. didn't know your dad's sodium level off the top of her head and #2. felt uncomfortable discussing lab values when that is really the job of the MD. and #3.probably hadn't eaten/peed/sat down in 10 hours and was too physically exhausted to think of a good reply. Med-surg is fun!

    Welcome to nursing! Glad your dad is doing well!
    GrnTea, Fiona59, and Meriwhen like this.
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    I don't think you asked too much... Very touchy subject indeed. Although I've only been working for a little less than 2 years now, I can definitely say to stay clear from giving out or hinting at diagnostic results for things like CTs, XRs, and all that good stuff...

    The only time I'll bring up a lab value is if I go in the room to give blood, hang a K-phos drip or give insulin, or a corrective med, and the family's around. I explain why I'm giving the medication then (usually family will ask what and why I'm giving something anyway...). By that time, the doc has already made rounds and talked to the family in regards to his plan.
    Last edit by tmartin83 on Jan 31, '13
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    Keep in mind three things:

    1. Facility policy can prohibit nurses from disclosing lab results to patients as well as families--they want the PCP to be the one explain them. In my facility, I can't even tell patients their test results were normal/negative without the MD's blessing first. So while it may seem like I'm brushing you off, it's because they will not let me tell you this info.

    2. The fact that you are a daughter present at the bedside doesn't mean it's a given that you are on the patient's release of information form. You probably are...or you may not be. Rather than risk a potential HIPAA violation, healthcare staff are going to err on the side of not discussing patient care with you until they are sure.

    3. The fact that you are a nurse doesn't mean that rules #1 and #2 don't apply to you. I'm not saying this to be mean, but sometimes it's easy to forget that in this instance you are not a nurse but a family member who happens to be a nurse. The problem is that you are not his nurse...

    I've experienced myself when it comes to sick family members. The reality is that we can't expect facilities to bend/break the rules for us because we're also licensed. And that's not always easy to remember because as you yourself said, when it comes to sick family members, we're too close to the situation.

    While the nurse technically did answer your question, I do think she could have explained it a bit better, like a poster above me suggested.

    Hope your father has a speedy recovery!
    jadelpn and Fiona59 like this.
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    Quote from monkey2008
    The nurse came in and said he needed to draw blood to test his sodium, she drew one vial. I asked if his levels were high. She responded "oh we just test it".
    Another thought came to mind. . .are you sure the person drawing the blood was your father's nurse? At the facility where I'm employed, phlebotomy techs perform the vast majority of the venipunctures and blood draws.

    If the woman who drew your father's blood was a phlebotomist with a very narrow scope of practice, I can see why she would say, "We just test it." After all, they just collect samples and test them.
    KelRN215, aknottedyarn, nrsang97, and 7 others like this.
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    Quote from Meriwhen

    3. The fact that you are a nurse doesn't mean that rules #1 and #2 don't apply to you. I'm not saying this to be mean, but sometimes it's easy to forget that in this instance you are not a nurse but a family member who happens to be a nurse. The problem is that you are not his nurse...
    Not mean at all, very truthful and 1000000% accurate. Sometimes I just need to hear another point of view for the lightbulb to go off.
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    Quote from TheCommuter
    Another thought came to mind. . .are you sure the person drawing the blood was your father's nurse? At the facility where I'm employed, phlebotomy techs perform the vast majority of the venipunctures and blood draws.

    If the woman who drew your father's blood was a phlebotomist with a very narrow scope of practice, I can see why she would say, "We just test it." After all, they just collect samples and test them.
    That's exactly what I thought when I read the OPs post.Where I work it would have been a lab tech not a nurse.Also we aren't allowed to discuss lab results with patients or family members. We have to direct questions to the MD.
    NurseKatie08 and anotherone like this.
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    Quote from loriangel14
    That's exactly what I thought when I read the OPs post.Where I work it would have been a lab tech not a nurse.Also we aren't allowed to discuss lab results with patients or family members. We have to direct questions to the MD.
    She was the nurse-her badge said RN and she introduced herself as the nurse


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