Visitors who stay overnight. Vent.

Nurses Relations

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I love the ones who care so much about their family they want to stay by their side. Lately however, I am finding the other kind . Twice this week I have had to deal with a visitor who yells at me for caring for my patient. One demanded we keep the lights off, it was disturbing their sleep. Her mom had a major surgery and I needed to keep a close eye and empty all the drains often. I need to see her color and see that she is ok. This visitor complained to the house supervisor and we were told to use penlights. Are you kidding? Safety and care needs to come first. I continued to turn on the light and was told I will hear about this again. Another visitor had a tantrum because we could not provide her with her own room and bed to sleep in. Her fathers breathing was keeping her up and too many people coming in to check On him. Just go home then! This is a hospital. Our rooms have daybeds for visitors and chairs that recline which is more than most hospitals I have seen. I am required to see my patient at least every 2 hours I am sorry if that annoys you. But after surgery things can go wrong quickly. Ugh.

You would think that, but I have been surprised in many many cases where family has asked for a food tray for themselves. Or a family member who said "my mom needs another tray. She was sleeping, so I ate it. Now that she is awake, she wants a tray." :down:

At the hospital where I used to work the guest trays were getting so out of hand they visitors requesting them had to pay for them up front or go someone else for food.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i don't understand the mentality of a family member feeling like they need to camp out at the hospital with a patient (parents of young kids, new dads and family members staying to calm a confused or combative patient excluded) i've seen family members trying to camp out with patients after routine surgeries and you can tell that the patient just wants to be left in peace. I think some people just feel like they have something to prove. But then to gripe about their precious sleep being disturbed?? Go the heck home!! Even my short list of approved overnighters, i expect they will be sensible - sleep in a logical location. Don't get in the nurse's way. Many hospital rooms are set up so that they won't get in the way - particularly in maternity and peds.

It's very easy as a supervisor to just give in to a family member to keep the peace, but the right thing to do is to what's right for the patient and for the nurse. That means if a nurse needs lights on for an assessment at 3 am- well, then guess what - the lights go on. It's a hospital, not a Hilton.

Nursing (nursing management) has done this. The minute we went to "Family Centered Care" or "Patient Centered Care" and started encouraging family members to stay, the message became "If you love your family member, you WILL stay." So even people who might otherwise have, quite sensibly, gone home end up staying. They don't want to be the family that didn't love enough.

The pendulum has swung too far toward "customer service" and away from "patient care." It will swing back. Sooner, I hope, than later.

We have 24/7 visiting . I especially enjoy when the pt is a walkie talkie getting IV abx, post op from a surgery they could have gone home from but talked the MD into being admitted overnight, etc, and have 8-9 people in the room and trailing after me and going to the desk for things for themselves or another ice cream etc. on a calm night, I don't care, on a busy shift it gets annoying fast. Also , we have had many hospice patients lately with no one visiting them or staying with them..............I work night shift and the patients still have to be assessed at night, and some assessments have to be done more frequently.and i may have told a visior once after some rude comment on her part, " sorry to wake you , but your mother has to be turned inorder to help prevent bedsores" seriously the nerve of some people. sometimes i think some like to create these challenges so they have something to whine about.

Specializes in Public Health, L&D, NICU.

My primary area of nursing was L&D, so of course we had to deal with lots of family. Sometimes it's wonderful. Sometimes the husband or mother can calm the patient much better than I can. Many times I've come in to do a quick linen change on a patient with broken water only to find that the family has done it already. What I hate are the families who come in and act like it's a party and totally ignore the labor patient. The patient can't eat and may have nausea, and the family member goes and gets a plate full of fried food and brings it back to the room to eat. Or the family is loudly talking and laughing, and the poor patient is quietly trying to cope with labor while they all ignore her. Or worse, they actively make fun of the patient, scorning her pain or teasing her about it. I've even had family members mock and imitate the patient. And then there are the families that come in and immediately go to sleep. Why the heck are you here? I'm not talking about nights either, I worked day shift and we'd still have families that would come in and ask for blankets go to sleep! The patient is then basically alone in a roomful of people. Worse yet are the ones that question every single thing you do. "Is that going to hurt the baby?" It makes me so angry! Absolutely, you tool, it's going to immediately kill and/or maim the baby. That's why the obstetrician ordered it, he adores hurting babies and amazingly has managed to stay in practice all these years. And, the final category, the naysayers. The ones that tell the mom that she won't be able to endure labor, or have a lady partsl birth, or breastfeed, because they couldn't.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I had a new experience . . . walked into an isolation room and found the patient's son visiting. Both he and patient were sitting around in the room half naked. Patient was wearing a johnny which she had hiked up to her shoulders, and one fist was buried in her vuvla. "I think my catheter is leaking," she said. It wasn't. It was poop. She was covered in it. Son sitting right next to her wearing a tank top. That's all just a tank top. "So no one can see my bare chest when they look in the window." He sat right there while I cleaned her up. Suggestions about appropriate clothing and isolation garb were disregarded. There's a visit with Social Work and Security scheduled!

SHUDDER!

Ruby Vee what did you say? That's a new one for me. I'm glad CPS was called.

My patient with the testicular pain had his parents in his room the whole day, it wasn't until I came in and asked them to step out during our exam that he brought it up. So not all nurses are asking visitors to step out during exams for an open and honest discussion between patient and nurse so a person can get privacy. If I have a patient sleeping in the hospital and I am checking on them every 1-2 hours and something comes up that I don't know about, should I ask the visitor staying overnight to get up and leave the room? It is easier to not have the visitor in the room.

No one said nurses shouldn't use their judgment as far as visiting is concerned. That's a lot different from having rigid visiting restrictions or a general aversion to family-centered care. I already stated that there are times when it won't work. Such situations should be the exception and not the rule.

The real issue is about control. When nurses and physicians realize that they are better off being partners in the patients' care, which includes a family approach, it really isn't the nightmare they had thought it would be. For the nighmarish situations, you simply use good judgment and approach accordingly. You may well have to enlist others in making the approach, as most things come down to taking a team approach. So for many nurses, especially those that have not been introduced or instructed in family-centered care and applications, it's really a matter of making a paradigm shift and or letting go of a sense of control that often does more harm than good.

I had a new experience . . . walked into an isolation room and found the patient's son visiting. Both he and patient were sitting around in the room half naked. Patient was wearing a johnny which she had hiked up to her shoulders, and one fist was buried in her vuvla. "I think my catheter is leaking," she said. It wasn't. It was poop. She was covered in it. Son sitting right next to her wearing a tank top. That's all just a tank top. "So no one can see my bare chest when they look in the window." He sat right there while I cleaned her up. Suggestions about appropriate clothing and isolation garb were disregarded. There's a visit with Social Work and Security scheduled!

SHUDDER!

Dear God, how utter bizarre. What's a johnny? No, this is someone I wouldn't have staying around the clock. This is an example of someone that is clueless and needs strict parameters enforced.

What I hate are the families who come in and act like it's a party and totally ignore the labor patient. The patient can't eat and may have nausea, and the family member goes and gets a plate full of fried food and brings it back to the room to eat. Or the family is loudly talking and laughing, and the poor patient is quietly trying to cope with labor while they all ignore her. Or worse, they actively make fun of the patient, scorning her pain or teasing her about it. I've even had family members mock and imitate the patient. And then there are the families that come in and immediately go to sleep. Why the heck are you here? I'm not talking about nights either, I worked day shift and we'd still have families that would come in and ask for blankets go to sleep! The patient is then basically alone in a roomful of people. Worse yet are the ones that question every single thing you do. "Is that going to hurt the baby?" It makes me so angry! Absolutely, you tool, it's going to immediately kill and/or maim the baby. That's why the obstetrician ordered it, he adores hurting babies and amazingly has managed to stay in practice all these years. And, the final category, the naysayers. The ones that tell the mom that she won't be able to endure labor, or have a lady partsl birth, or breastfeed, because they couldn't.

OK, the people abuse being there by thinking it's a party and that ignore the patient and are demonstrating that they are being far from helpful and supportive need to go. They either get the general protocols and procedures and respect them, or they are gone.

Now people asking questions, well I got used to this in peds. Obviously many caring parents are going to ask a plethora of questions, and you have to respectfully respond in a sensitive manner. Generally speaking, there is no place for any nurse or doc taking an attitude or getting defense or feeling insecure with the parents and pt. These are not acceptable attitude and behaviors in the pedicatric critical care areas of childrens' hospitals in which I have worked. It's a skill to learn how to do this with supportive finese and reassurance. Building trust is everything in pediatrics--with regard to both the children and the parents/family. You don't learn how to handle it in a caring, professional way, you take the door to an adult hospital or floor, period. But even with adults in critical care, I have been innundates with questions from patients and families. It's experience, becoming more skilled in empathy and therapeutic technique, and confidence that makes all the difference in the world.

About the naysayers, it's also a skill to make a point--to redirect these folks--so that they get that the goal is to support the mom. You are right. Many a person I have seen has told moms or pregnant women, "You won't like breastfeeding." "Breastfeeding will kill your boobs." You won't be able to deal with labor." Here's another stupid one: "A lady partsl birth will kill you sex life, so a Cesarean is better."

I had large babies and I am a small person. The one I was able to have lady partslly did not destroy my tissue or integrity or sex life, period. Maybe I'm lucky, but it's nonsense.

Breastfeeding didn't destroy my breasts.

What I will say for some percentage of moms is that the weight gain and such from pregnancy and fluid volume build up and hormones may have some affect on the tissue; but that's not a result of breastfeeding. That was a result of the process of pregnancy and hormonal mechanisms.

When possible, people should gain the safe amount of weight for a healthy pregnancy, but they should NOT go hog wild with the weight gain. In fact, they need to be careful. Walking during pregnancy is very important in my view. Women should continue to exercise and keep in shape and not eat everything in sight or use pregnancy as an excuse to eat too much and a ton of junk. Some people, however, just don't have the same collagen tensile strength in their skin tissue as others. That's more of a function of genetics, nutrition, pushing the limits of reasonable weight gain, and not destroying skin tissue by sun or uva/uvb exposure.

Anyway, sometimes you have to pull family members aside and have chats with them about their level of support or lack thereof when it comes to the patient. The patient still much come first. And everyone needs to work together toward that end. If need be, you employ support from other professionals if the family isn't getting it. When they continue to be nons-supportive, detrimental, or a complete nuisance, they they need to go--period.

Specializes in ICU.
I had a new experience . . . walked into an isolation room and found the patient's son visiting. Both he and patient were sitting around in the room half naked. Patient was wearing a johnny which she had hiked up to her shoulders, and one fist was buried in her vuvla. "I think my catheter is leaking," she said. It wasn't. It was poop. She was covered in it. Son sitting right next to her wearing a tank top. That's all just a tank top. "So no one can see my bare chest when they look in the window." He sat right there while I cleaned her up. Suggestions about appropriate clothing and isolation garb were disregarded. There's a visit with Social Work and Security scheduled!

SHUDDER!

Ummm...now that's just disturbing.

Specializes in Emergency, Telemetry, Transplant.
I had a new experience . . . walked into an isolation room and found the patient's son visiting. Both he and patient were sitting around in the room half naked. Patient was wearing a johnny which she had hiked up to her shoulders, and one fist was buried in her vuvla. "I think my catheter is leaking," she said. It wasn't. It was poop. She was covered in it. Son sitting right next to her wearing a tank top. That's all just a tank top. "So no one can see my bare chest when they look in the window." He sat right there while I cleaned her up. Suggestions about appropriate clothing and isolation garb were disregarded. There's a visit with Social Work and Security scheduled!

SHUDDER!

I was planning on a good night's sleep tonight, but I'm not sure that is possible anymore after reading this....

Specializes in ICU.

I can SO relate to you, beeker. It is one of the biggest frustrations of my nursing career to have to deal with family members who either do not understand the visiting policy, or just don't want to! I had an intubated patient with pneumonia, and his girlfriend (who uses a wheelchair) had been allowed to sleep in the room for two nights before I took over his care. Our policy is open visitation during the daytime, and the unit closes at 9 pm for the night. After that, we do let visitors back by request, to check on the loved one or get updates, but we prefer to keep the room clear for patient care, particularly since the unit has less staff at night. At some point after I had done my initial assessment, the wheelchair bound girlfriend appeared at the bedside, box of chicken in hand, and settled herself in. I decided to leave her be, after speaking to the charge nurse about it. I gingerly let myself in and out of the room all night, taking care not to DISTURB the visitor! Occasionally, the visitor would ask me to be sure to shut off the lights so that she could sleep. When we did the patient's bath, we had to pick up chicken bones from the floor next to the bed. In the morning, I spoke to the visitor about our visiting hours, and told her about how we encourage family members to stay in the waiting room and check on the patient as needed. She told me that previously the staff was "nice" and let her spend the night. I apologized for this and told her that It was not our policy. About this time, the attending walks in and the guest asked to speak to him in private, of course. Not only did he make things worse, he gave the visitor money! He said he felt sorry for her, because she had no money! This guest had stayed in the room two nights before I came on duty, and was getting guest trays sent up during the day, and was also asking staff for help, snacks, etc. So, you might say, you get two patients for the price of one! I am frustrated by this situation. On one hand, I want to be helpful and compassionate to others and at the same time, I want to concentrate on my patient care, and not this kind of BS from visitors. I am open to any suggestions. It doesn't help to be undermined by the doctor, who now has made me seem like "the bad guy" . Why do we bother with policy if it is not going to be adhered to, and why are nurses so hesitant to speak to visitors about visitation policy? It gets harder to enforce the longer the visitor is allowed to stay.

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