Spouses being asked to leave the room - Page 4

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  1. May 10, '12 by
    Quote from Fiona59
    I don't come to their job sites and hang around to make sure they do their job well. Just give me space and safety to do mine.
    Yeah, but we don't know HOW to do their jobs. EVERYONE knows how to do the nurse's job!
    prinsessa, nrsang97, canoehead, and 9 others like this.
  2. May 10, '12 by
    Quote from applewhitern
    I always ask people to leave the room. Otherwise, I would never get anything done. If I want to ask the patient a question, I want to know what the patient has to say, not the wife, girlfriend, sister, etc. It amazes me when I try to talk to an alert, oriented patient, and the wife (usually the wife!) wants to do all the talking! I try to stare directly at the patient's eyes when I talk, to assess them, but if there is a family member in the room, you can bet that person will jump right in and try to answer every single question, as if the patient wasn't able to talk. We always ask everyone to exit the room when we are transferring a patient; there is no reason for anyone else to be there. Once the patient is settled, they can come back in. I want to allow my patient to feel like they are part of their own healthcare, and give them the opportunity to tell me stuff they might not say if other's are in the room. I have had patients who did not want their spouse to know they took viagra, and once I had a 21 year old woman who didn't want her mother to know she was pregnant. What about the female who couldn't tell me her husband hit her, because he was in the room?
    I recognize how a wife who wants to do all the talking for the patient can be a problem, and I recognize the necessity for patients to be able, if they wish, to disclose information without a spouse/family member present. But please consider this particular situation, which I'm certain is quite common: When my husband has been hospitalized, and I have answered questions posed to him, i.e. admission assessment; it has been because even though my husband may be alert and oriented, he is also very sick, and I can at this moment in time answer more accurately and completely for him. It is that simple, and it takes the burden off him, when he is using all his energy just trying to stay alive. I want him to get the best care possible, and if I can contribute by recalling important health information for him, I'm going to do so. Just because someone is alert and oriented doesn't mean that they will easily recall important information, especially when they are very sick (as people usually have to be to get admitted to hospital). I am actually more interested in remembering the details than my husband is; surely what one wants as a nurse is an accurate database, regardless of whether the wife does more or even most of the talking. As a nurse, if the patient was willing for the spouse to be present, I would be more concerned about obtaining correct information about the patient's medical problems, past illnesses/surgeries, allergies, medications etc. so that I could give appropriate care, than I would be worrying about whether the patient personally relayed what they could recall of that information to me.
  3. May 10, '12 by
    .....
    Last edit by wooh on May 10, '12 : Reason: oops
  4. May 10, '12 by
    From the term consultant and porter I guessing you are in the UK/RoI

    The being asked to step out during the physical exam may be due not just to privacy but to allow for a objective exam, you have already said you had spoken with the consultant and given your account of your patient health.

    Asking to step out while your husband is being transferred could be due to space however they may have also taken the opportunity to check pressure areas and perhaps do admisson mrsa swabs.
    Fiona59 likes this.
  5. Guide
    May 10, '12 by
    Quote from Susie2310
    But please consider this particular situation, which I'm certain is quite common: When my husband has been hospitalized, and I have answered questions posed to him, i.e. admission assessment; it has been because even though my husband may be alert and oriented, he is also very sick, and I can at this moment in time answer more accurately and completely for him. It is that simple, and it takes the burden off him, when he is using all his energy just trying to stay alive. I want him to get the best care possible, and if I can contribute by recalling important health information for him, I'm going to do so. Just because someone is alert and oriented doesn't mean that they will easily recall important information, especially when they are very sick (as people usually have to be to get admitted to hospital). I am actually more interested in remembering the details than my husband is; surely what one wants as a nurse is an accurate database, regardless of whether the wife does more or even most of the talking. As a nurse, if the patient was willing for the spouse to be present, I would be more concerned about obtaining correct information about the patient's medical problems, past illnesses/surgeries, allergies, medications etc. so that I could give appropriate care, than I would be worrying about whether the patient personally relayed what they could recall of that information to me.
    As a nurse, I ask the patient questions for which I am interested in his/her answer. And observing the patient's ability to answer questions gives me important information about the patient's mental status. If I have any doubt that I have complete information, I will then seek out additional sources of information, including family members present.

    Edited to add: Patient assessment and filling out an admission database is not simply filling out a form and checking off boxes. During a conversation with a patient, I am assessing not only his/her basic history and current symptoms, but mental status, emotional state, his/her understanding of primary disease process and co-morbidities, and getting a feel for the individual's perceptions and attitude toward treatment.

    I hope this better explains why it's important to speak with the patient.
    Last edit by Altra on May 10, '12
    SENSUALBLISSINFL, nrsang97, Fiona59, and 12 others like this.
  6. May 10, '12 by
    Quote from applewhitern
    I always ask people to leave the room. Otherwise, I would never get anything done. If I want to ask the patient a question, I want to know what the patient has to say, not the wife, girlfriend, sister, etc. It amazes me when I try to talk to an alert, oriented patient, and the wife (usually the wife!) wants to do all the talking! I try to stare directly at the patient's eyes when I talk, to assess them, but if there is a family member in the room, you can bet that person will jump right in and try to answer every single question, as if the patient wasn't able to talk. We always ask everyone to exit the room when we are transferring a patient; there is no reason for anyone else to be there. Once the patient is settled, they can come back in. I want to allow my patient to feel like they are part of their own healthcare, and give them the opportunity to tell me stuff they might not say if other's are in the room. I have had patients who did not want their spouse to know they took viagra, and once I had a 21 year old woman who didn't want her mother to know she was pregnant. What about the female who couldn't tell me her husband hit her, because he was in the room?
    I have to say this. I am primary caretaker for my mother, who is alert and oriented and quite capable of taking care of herself, though that is a whole different topic. Maybe some mild confusion, but I am mostly in denial about that at the moment. I am her MDPOA. I go into her appointments and into the ER with her and I stay. I guess the point I am trying to make is, while she is more than capable of stating her history and for the most part taking care of herself (she primarily has mobility issues), sometimes, she isn't entirely truthful either. For instance today, after nagging her for a month to fill prescriptions and make an appointment (see totally capable) she wasn't going to tell her NP that she hasn't been taking her Warfarin for a month, and would need to bridge with Lovenox. She wasn't going to mention that she has been more depressed lately. This lack of information would have impacted her treatment plan significantly.

    I will stay in the room, and I will answer questions that she is hesitant to answer, or I will give information that she doesn't want to share. I stay out of the way, leave when asked, and will shut up (for the most part) when reminded, and sometimes, I do need a reminder. However, I may have information that might impact her care. Her doctors know me, and for the most part so does the ER staff, from when I either had my mother, or grandmother in, or from when I would cart patients in as a Paramedic.

    I am that type of daughter, and I won't apologize for it. I try to not be a pain in the tuchus, however, I will see to it that my mother is taken care of and treated appropriately.
    canoehead likes this.
  7. May 10, '12 by
    To Altra,<br><br>
    Quote from Altra
    As a nurse, I ask <em><strong>the patient </strong></em>questions for which I am interested in <em><strong>his/her </strong></em>answer. And observing <em><strong>the patient's </strong></em>ability to answer questions gives me important information about <em><strong>the patient's</strong></em> mental status. If I have any doubt that I have complete information, I will then seek out additional sources of information, including family members present.
    <br>
    <br>
    Perhaps ambgirl2nurse's post above will encourage you to reconsider your self-righteous statement.
    Last edit by Susie2310 on May 10, '12 : Reason: Hit wrong button by mistake; this is a reply to Altra
  8. May 10, '12 by
    I have spouses/etc. leave unless the patient requests they stay. They have their right to privacy as well, and maybe they don't want their significant other knowing some pertinent details regarding their stay. Case in point, what about the man who came in with a 'bowel obstruction' self-imposed that the little old lady wasn't to catch wind of?
    Fiona59 and anotherone like this.
  9. May 10, '12 by
    I don't think Altra was being self-righteous, and I understand the need to assess the patient completely for yourself, and not rely on the family members completely.

    I also understand the need to get family members out of your way. I have done it on more than one occasion.

    I guess my point was that sometimes, it is beneficial to have a family member therem or at least do a secondary interview to get their view of what the problem might be.
    nrsang97, Fiona59, Hygiene Queen, and 1 other like this.
  10. Guide
    May 10, '12 by
    Quote from ambgirl2nurse
    I don't think Altra was being self-righteous, and I understand the need to assess the patient completely for yourself, and not rely on the family members completely.

    I also understand the need to get family members out of your way. I have done it on more than one occasion.

    I guess my point was that sometimes, it is beneficial to have a family member therem or at least do a secondary interview to get their view of what the problem might be.
    I agree with this completely.

    It can be helpful to remember, also, the amount of objective data that is going to be obtained through labs, diagnostics, etc. A patient and 15 family members can all attest that the patient is/is not taking Coumadin, using sliding scale insulin as prescribed, etc. ... but the PT/INR and the HgbA1C will tell the story without the complications of family dynamics.
    Fiona59, anotherone, DizzyLizzyNurse, and 2 others like this.