I am struggling with patient families lately.

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Anna Flaxis, BSN, RN

1 Article; 2,816 Posts

"Family Centered Care" is most appropriate for pediatric settings.

When working with the adult population, many institutions (mine included) promote "Patient Centered Care", in which the individual's preferences, family system, cultural background, etc. are taken into account. The patient is an active participant in their own plan of care, and it is the patient who is the focus of everything we do.

If Nana prefers having a family member spend the night, then that can certainly be accomodated. If, however, having another family member present is having a negative impact on Nana's health status, then it is completely appropriate for the nurse to ask the family to leave. It is Nana's well being that drives the decisions regarding family presence, not family preference. Nana is an adult human being whose autonomy should be respected and protected as much as is possible.

nursej22, MSN, RN

3,810 Posts

Specializes in Public Health, TB.

Have to agree with OP for the most part. Of course, we all love the helpful, cooperative family members, but I think he/she was referring to the kind we too seem to have a run on lately: tying up staff for hours repeating the same questions to the point of interfering with patient care, stripping our pantry of all foodstuffs including tube feed formulas, trashing waiting rooms, and best of all, injecting patients with Lord knows what when the q2hour Dilaudid just wasn't cutting it. I swear we are using more Narcan than the ER.

I would love to report every single test result and interpret it for you, and tell you exactly what the doctor thinks it may be and when your loved when will be discharged, but it don't work that way. And by the way, thank you for calling the CEO to complain.

I know you are hungry and our cots are uncomfortable so just go home. I will get written up if I give you food meant for patients and the cots are hard and narrow for a reason. Swearing at me and threatening to sue won't change anything.

Yes, cousin Bobby is hurting a great deal, but short of general anesthesia we can't take his pain completely away. This could be a wake up call for him to consider rehab, if he survives endocarditis. And if we can't wake him up and his resps are 6, we will give him Narcan and then he will know what pain is.

Specializes in PCCN.
@SCSTxRN: YOU are an example of the family we like to have around. Helpful, aware of your loved one's safety needs, etc. Unforunately, most family is, as aforementioned in a previous post, trying to sneak in KFC for dysphagic nana, or having family reunions in the middle of the ICU, yelling at me because I won't tell you (the long-lost cousin who flew in from Timbucktoo) the intricate details of my patient's past 3 weeks in hospital. One thing that I will be snippy about is HIPPA.

Most of the nurses I know have stopped even trying to enforce any rules about visitation because we know that administration will roll over on us. What's the point of even having rules. Things have gotten to the point where, in the name of "satisfaction," we have lost their respect.

This this, and this. :no:

Specializes in MR/DD.

What drives me crazy is when people bring babies/toddlers and allow them to crawl on the floor...

sixela21

76 Posts

Specializes in Mental & Behavioral Health/Geriatrics.

Wow--do people here need sensitivity training much?? Continuing education--how to deal with patient families 1101? Does your facility have set visiting hours? Are these families somehow skirting around the institutions policies by staying? If someone is ill enough to be admitted to the hospital, I do not see why family members do not have a right to be concerned. I can understand your frustration, but it is something that comes along with the job, and you have to handle it with professionalism. If you are doing your job properly, why does it matter if someone is watching so long as they are not actually interfering with your performance? From your post, it does not sound like you are commenting about the families being rude or somehow preventing you from doing your job. I find that nurses these days are quite grumpy and somewhat controlling--the bottom line is about the welfare of the patient.

When accompanying my grandmother to the hospital (who actually had a cancerous tumor removed not long ago and has major gallbladder and bladder issues) the nurses were very rude and made disrespectful and patronizing remarks when my mother asked about the procedures and the family wanted her to simply explain what they were doing and what was wrong with my grandmother.

Families sometimes need that comfort as well. If the patient does not request that the family leave the room for a certain procedure, why should their very presence bother you so much unless it is directly against some sort of hospital policy? (Unless, like I said previously, they are making smart remarks or directly interfering with your care). Many other things to focus on in this career, and this seems bottom of the line as far as complaints go.. Sorry I couldn't jump on the "woe is me, patients have families who visit them in the hospital--who knew!!" bandwagon!

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

I have found for the most part when you acknowledge family members and treat them kindly they will cooperate. I even appropriately use them to the patient's advantage. Many are also a wealth of information about the patients medical history. Yes! at times they do get in the way of providing medical care and dealing with that is jut part of the profession. That is why the profession always includes in it's educational process all of the social sciences. Accept it as part of the job and learn skills to deal with it and you will enjoy the profession more.

It is not always pleasant and at times can be very upsetting when you have to deal with family and visitors from hell . I have seen and dealt with quite a bit in my 32 years as a nurse. Instead of being outraged I go into a problem solving mode and try to use any resources that I have. For example, one thing that I have noticed that if you have another healthcare professional with you when you approach a difficult family member or visitor the situation usually get resolved faster and with less angst. Use all those therapeutic communication skills you learned with them too..they do work well if the family is of sound mind.

Remember that this may be just another day of work for you and you may not be in the mood for any drama but for the families it is often traumatic,stressful and frightening. Always take care of yourself so you can nurture your empathy because it it such a huge part of being a great nurse and it is the way you would want someone to care for you and your family if you were in their shoes. One time when I went into surgery I remeber being really frightened and a nurse took my hand and comforted me and that little act helped me so much that I still remember it and this was a long time ago!

sixela21

76 Posts

Specializes in Mental & Behavioral Health/Geriatrics.
I have found for the most part when you acknowledge family members and treat them kindly they will cooperate. I even appropriately use them to the patient's advantage. Many are also a wealth of information about the patients medical history. Yes! at times they do get in the way of providing medical care and dealing with that is jut part of the profession. That is why the profession always includes in it's educational process all of the social sciences. Accept it as part of the job and learn skills to deal with it and you will enjoy the profession more.

It is not always pleasant and at times can be very upsetting when you have to deal with family and visitors from hell . I have seen and dealt with quite a bit in my 32 years as a nurse. Instead of being outraged I go into a problem solving mode and try to use any resources that I have. For example, one thing that I have noticed that if you have another healthcare professional with you when you approach a difficult family member or visitor the situation usually get resolved faster and with less angst. Use all those therapeutic communication skills you learned with them too..they do work well if the family is of sound mind.

Remember that this may be just another day of work for you and you may not be in the mood for any drama but for the families it is often traumatic,stressful and frightening. Always take care of yourself so you can nurture your empathy because it it such a huge part of being a great nurse and it is the way you would want someone to care for you and your family if you were in their shoes. One time when I went into surgery I remeber being really frightened and a nurse took my hand and comforted me and that little act helped me so much that I still remember it and this was a long time ago!

Very nicely put. I myself remember initially complaining about all of the Psychology, Sociology, Liberal arts, etc. classes needed for entrance into the nursing program. A friend of mine who is pre-med was quite puzzled by the amount of Social Sciences we need for our profession in comparison to Doctors. It is apart of direct patient care and makes us better nurses! I have never heard such rubbish about patient families "disturbing" my job, "asking too many questions about procedures" and "getting in the way of my med rounds"...what are we in this for if we cannot exhibit the patience and love for people we boasted about upon entering this field? In any field, you will have your challenges, but I personally have always tried my best to simply practice professionalism and never show my bad side--customer service is a universally useful job skill. Patients will respond to kindness and respect.

As a teacher, I have had concerned and upset parents, but instead of patronizing them or making them feel like they are "getting in the way" of me teaching their child, I have always tried to work with them and encourage them to come into the classroom and observe--they are an essential part of the child's life, and cooperation is essential, and at the end of the day, what is best for the student. Nurses should be skilled at encouraging patients and their families to be apart of the healing process--encouraging them to engage in the care, without interfering with the nurse's duties of course. My mother had a nurse tell her (in regards to her grandmother)--"You don't need to worry about that anyway...that's why I'm the nurse." Not in a joking manner. You cannot dismiss patient family involvement and their right to be informed about the care. To put it very bluntly--Suck it up and do what you were trained! Let's love those patients and their families! =)

sixela21

76 Posts

Specializes in Mental & Behavioral Health/Geriatrics.
If you expect me to be on top of everything then I expect the same of you.

Why should the family have to meet any expectations of yours??? YOU are the nurse. YOU work for the hospital. Yes, as a nurse, YOU are "expected" to be "on top of" matters regarding the patient. The expectations rightfully belong to them and the patient. Their loved ones' care is in YOUR hands.

WildflowerRN

37 Posts

I work in a facility with 'open visitation.' Dealing with family members 24/7 gets exhausting. They sometimes create problems and issues when the patients don't actually have any! And the spending the night in the unit? Not the best idea in the world...

Dealing with families is part of being a nurse. Not everyone is going to be to your likeing. This is a time of great stress for family members. The last thing they need to deal with is a confrontational nurse with an attitude problem. If you don't like your job, then please find a different one. My mother recently spent time in an ICU unit. Some of the nurses were top notch, while others I wouldn't have looking after my dog. God forbid family members would be worried about their loved ones and not fully trust a healthcare worker they don't know and who has a bad attitude.

And if you can't deal with family members who are not at their best and worried sick about their loved ones, perhaps it's time to find a new profession.

GilConRN

7 Posts

Oh me too! I have been caught a few times by coworkers making my "disgusted" face when I see a pacifer hit the floor and then the baby crawls over picks it and pops it back in their mouth. yuck!

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