Encouraging peds parents to call/text the nurse during off-hours? Common occurrence? - page 2

In my job, I work closely with the NICU. It's not uncommon for there to be patients who are there for months at a time, and so there will often be a nurse who is a "primary" - she will take care of a particular baby every time... Read More

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    This is inappropriate. Not super common but I have seen it happen before. Actually, I guess I shouldn't say it's not super common- it varies by the floor. Floors where patients are inpatient for longer tend to have more of this. I know it was something that happened with relative frequency on the Stem Cell transplant unit of my old hospital.

    The ONLY time I would ever call the hospital to check on a patient would be if something happened on my shift (i.e. a rushed a baby to the OR at change of shift) or I was a primary nurse for an end of life patient and I wanted a general idea of what had been happening before I had to come in and take care of him. And in this situations, I would always call the nurse caring for the patient or the charge nurse to inquire about the patient. Would NEVER give a parent my cell phone number and have them text me with questions when they have a nurse caring for their child 24/7, that's who they should be asking.

    It also undermines the nurse caring for the patient when nurses do this... if you're trying to take care of little Sarah in a crisis but Kelly is her primary and has given mom her cell phone number, how would you feel if in the midst of assessing Sarah and trying to get her to wherever she needs to go (CT, the OR, ICU, etc), the mom says "I think we should call Kelly." Um, no. And, what kind of nurse wants people calling them about work on their day off? No, thank you.
    Gold_SJ and wooh like this.

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  2. 7
    So wrong on so many levels. The BON would have a field day with this scenario. It's unprofessional, it's unethical and it's quite possibly illegal.

    There is a (former NICU) nurse on our unit who has done things like this. She gets herself very enmeshed in relationships and truly believes no one can give the family what she can. She has gone so far as insist that she be called, day or night, if one of "her" babies (she has a weight restriction so all she ever is assigned are the babies) is nearing the end of life. I've seen her come in late in the evening to "support the family", pushing out the nurse assigned to the patient and even escorting the body to the morgue under the guise of being asked to be there by the parents. She then, of course, puts in for (unauthorised) OT. She calls it "family-centred care" while I call it abuse of influence.

    I suspect that individuals like this may be displaying features of an Axis II disorder along the line of a narcissistic personality. Very difficult to observe and more difficult to do anything about.
    KimberlyRN89, Lynstat1, NicuGal, and 4 others like this.
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    We practice primary nursing on our unit (surgical NICU in a children's hospital). The primary nurse is in charge of discharge planning, such as making sure the chart is updated as to what types of teaching parents need to take the baby home, etc., and are assigned to the baby whenever they are working. They definitely aren't supposed to encourage parents to call them instead of the nurse on duty, although some might. I have seen some nurses get a little territorial, but that type of thinking isn't encouraged. NICU babies, and kids in general, can get sick fast. How on earth would a nurse at home be able to update parents with current information? There's no way to know if the kid got septic, coded, or what have you. Last week I started my night with a baby who was supposed to go home the next day, had no lines, no O2 requirements, really seemed totally straightforward. By 0600, he had an IV, was on O2, had an NG tube, was on a radiant warmer, and was undergoing a septic work-up. All happened within about 6 hours. There's no way his primary nurse would've had any idea about any of this.
    maelstrom143 likes this.
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    No, not appropriate for reasons stated by others. It's not therapeutic for the families, and feeds into the type of personality that likes the ego stroke of feeling indispensable.
    Lynstat1 likes this.
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    I agree that this is totally inappropriate for so many reasons. I work in a NICU unit that encourages primary nurses, but our management team discourages this type of behavior. I know of a few nurses that over-step this boundary at times, but not to this extent. Is your managment team aware of this practice? If not, I would make sure that they are made aware. This type of practice could cause problems for other people and ruin the career of these nurses.
  6. 0
    It definitely seems inappropriate especially as there is already facilities set up, such as home health care, baby community centres, hotlines to call... Sounds like some education needs to be done on the ward.
  7. 1
    No, no and no. Where I work, this can get you fired if they find out the parents are texting you, esp if you aren't at work. I don't know why people think this is okay, you have to draw a line between your professional life and your personal life. And once the kid goes home, and mom texts you and says, hey ABC is happening what do I do, and you give advice and something happens to Johnny, and they show the text to someone and it says your name and advice, you are going to be hung out to dry. You are held to a higher standard as a nurse, esp if you had a relationship with this family.
    maelstrom143 likes this.
  8. 1
    I agree 100% with all these comments , and just wanted to add that even in home health care nursing (Paeds) we would never give out our personal phone number and would be counseled and disciplined if we did. This type of emotional over-involvement has no place in delivering professional, competent and compassionate nursing care to children and their families.
    maelstrom143 likes this.

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