Advice Needed For Dealing With Patient's Family Members

[lisa41rn]

We've all been there. We can have a great patient, but the family burns you out!! I had one where the 40ish year old son would allow his very capable mother to answer any questions. Long story, but very bizarre. Didn't think I'd survive, but in the end, he said I was the only nice nurse during their visit. I probably was the only fool who put up with it!!

Yesterday I got a new admit who was a very kind elderly man brought up from the ED. I was cleaning him up and could hear his family in the hallway wonder what was taking so long (trust me I didn't take much time cleaning him up at all). Well in comes the family, the wife, three adult children and then grandkids!! There was another patient in the room with him. It was close to change of shift, so I didn't have to deal with this for long, but I wasn't too happy. It was like getting two patients. The elderly wife needed water for her meds, they wanted to know if their mother could use the patient's restroom as she was in a wheelchair. I asked them to use one of the public restrooms, and you'd think I was the biggest jerk going. Not only was I running crazy to get the new patient setup, I was having to get the wife/mother taken care of as well. Luckily the oncoming nurse worked on the database with the patient with the adult children butting in on every question. What should take 15 minutes was going to take two hours for her!! While she was doing this I was calling down to the ED because of a "reaction" to a med the son told me his father had in the ED yet was reordered for the floor. The reaction was far exaggerated. These people were very self centered. This man had what was suspected to be a UTI, yet family was driving two states away to be at the hospital. Family support is great, but this was nuts! It's one thing if the wife wanted to stay in the room (by the way she was a retired RN), but the children all stayed there, in the way, constantly. I'm sure I could have sent them out as they really were in the way, but again I was just glad the shift was almost over.

How do you all deal with families like this? Another thing is we lock up the kitchenettes so not everyone can use it freely. Seems obvious why this is done!! Family members get so mad!! I'm running around like crazy and they think nothing of bringing popcorn in for us to pop or ask for sodas as if we're waiting on them as well. Any creative ideas folks for these issues??

[babynurselsa, RN]

Sometimes you have to smile sweetly and just say NO. You can do it kindly and graciously but still say NO. "I am so sorry but I cannot pop that popcorn for you." "There is a microwave in the cafeteria, kitchen, (your house). :)

"Pardon me but those chairs that you filched from 3 other patient rooms left the 92 year old wife down the hall with no place to sit."

I understand what you are saying. Sometimes a gentle reminder that they are pushing the limits brings them around, sometimes security does.

[Thunderwolf, MSN, RN]

Sometimes you have to smile sweetly and just say NO. You can do it kindly and graciously but still say NO. "I am so sorry but I cannot pop that popcorn for you." "There is a microwave in the cafeteria, kitchen, (your house). :)

"Pardon me but those chairs that you filched from 3 other patient rooms left the 92 year old wife down the hall with no place to sit."

I understand what you are saying. Sometimes a gentle reminder that they are pushing the limits brings them around, sometimes security does.

[bjm]

If it is an elderly pt. I always tell family I need one person who is most familiar with pts meds, routine, etc to stay in the room during data gathering and ask family members to wait in the waiting area and that it may take approx an hour for us to get all the necessary admission orders started - sometimes this works and sometimes it dosen't; however, most facilities do not allow popcorn to be popped on the floors as the odor can be very offensive to often sick, nauseated pts. As far as delivering water for family members, I provide directions to the area where cups can be found, or a water fountain, or the cafeteria. By directing them, they immediately get the message that THEY are not the pt. It is unfortunate that some family members treat hospital staff as if they have come to the Ritz - however, sometimes it becomes necessary to remind them as kindly as possible, that you must get to your tasks of taking care of the rest of your patients and hope that they understand.

[Daytonite, BSN, RN]

Hi, Lisa! I've had my share of pushy, demanding families over the years. What I particularly wanted to address, however, was the fact that this was a situation of a patient being admitted. A long time ago I learned that admission was a hectic time for us nurses, the patient, and particularly some families. Sounds like what you had. I have found that it is best to get off on a good foot and just find the time to answer all the family's questions and concerns with these admissions. It sets up the tone for the way the family will treat the nurses for the remainder of the hospitalization. Believe me, I know how time consuming it is, but I have learned over the years that it is better to have the family pouncing all over me during the admission rather than every single day of the patient's hospitalization. I found that once you get that family's trust, they generally are no longer a problem. I know that there are some families who will be exceptions. Grandpa getting admitted to the hospital is a big deal for some families and I try not to forget that. Some of the older generation saw hospitals as a place you go to die, so getting grandpa to come into the hospital as a patient might have been a daring feat in itself and he needs his family by him for support. If the family or the patient wants to reinterate their entire experience of how they ended up being admitted I encourage it because it is therapeutic and cathartic for them. Also, I would just like to add that my mother was a nurse for many years. However, at 85 she doesn't remember a whole lot about the work anymore, although she will be the first to tell a nurse that she used to be a nurse herself. So, when a family tells me that their grandma was a nurse I smile and acknowledge that, but I don't assume that grandma remembers exactly how a nurses day at work goes or she is going to be sympathetic to me, the nurse. If anything, some of these old nurses feel entitled to special treatment and attention because they were in the profession. I will often give them that attention since it makes them feel a little more important and recognized, and it makes them much easier to get along with for the rest of my shift!

[lisa41rn]

Thanks everyone (Good to "see" you Daytonite!!). Great advice. Being so new, I find family members challenging sometimes. I really want to concentrate on the patient!! Spouses I can understand, but when families fill a room and seem to have no regard about the other patient in the room, it just seems rude!! I know I need to speak up, but keep that smile on my face. Thanks all!!