Can nurse ask family to wait outside while doing treatment

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Specializes in burn, ortho, med-surg.

I work in a LTCF and we have a resident whose family is terrible. These people are never satisfied and blame staff for any and everything wrong with resident. This family attempts to micromanage everything. We have MD orders that tell us to call family and ask them if it is ok to give prn meds. Now this family wants to be present any time a treatment is done on their family member. My question is do I have the right to ask these family members to step out while Im doing the treatment?

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Specializes in ICU/ER.

You have the right to ask, it does not mean they will listen.

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Of course you have the right. Say something along the lines like "do you mind stepping out for a minute so I can ...". Most families are receptive from my experience. It allows them time to go grab lunch or a coffee. Sometimes its a relief for them as well. Like your giving them an excuse or permission to leave the unit and get some fresh air.

If they refuse to leave you can always ask a colleague to stay with you and help out, for moral support. I have done that before as well.

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Geez. So if the pt. needs an enema the fam runs over to watch? I would ask the MD to speak w/ the family. It does sound as if they are paranoid. Did they have a previous experience that has prompted this or was the loved one just placed recently in LTC?

It is rough when giving care and feeling as if you are being judged/watched!

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I work on a surgical/telemetry unit and I usually don't have to ask, the family usually asks me if they should leave. I usually let them stay, but it does depend on what I'm about to do. IV's, foley's, NG's, dressing changes, etc - I ask them to leave. But if I'm just doing a head to toe and the pt is comfortable with them staying, then it's fine with me. I did once have a pt's sister refuse to leave when I wanted to check his wound (he had an I&D of a peri-anal abscess.) I thought that was a bit weird. The pt made his sister leave, though.

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Specializes in LTC, case mgmt, agency.

Sounds like in the past something may have happened with this family. Maybe if they watch you interact with the patient a few times you can talk tot hem and get them to relax a bit. However, if they are not there be sure to have a CNA or staff member with you as a witness/back-up. Yes, you do have the right to ask them to step out while you give a treatment. Sounds like maybe social worker or MD may need to talk to the family. Is the person with-it? This can also make a difference. Perhaps they want their family there or not?

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I always ask everyone to leave the room and then defer to the patient if they ask for someone to stay. Depending on what is being done sometimes they want family in the room and sometimes they don't. If the family member is staying I make it very clear what will be done. Dressing changes can be really hard for families to watch. I also want to make it clear when it's of a personal nature so everyone is comfortable and on the same page. All patients have the right to privacy.

It sounds like this family might be having some trouble coping with the stress of having someone in LTC. I would see if I can get the MD, clergy and/or a social worker involved. They can sometimes help a struggling family.

I would also encourage the family to do what they can. Giving them some lotion to put on the patient's feet per se can make them feel needed and helpful.

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Specializes in Neuro ICU and Med Surg.
You have the right to ask, it does not mean they will listen.

Exactly.

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Specializes in Geriatrics, Home Health.

How does the patient feel about this? Do they want their familiy to watch everything?

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Specializes in burn, ortho, med-surg.

the resident is not able to communicate his needs and wants. only one family member has POA and is responsible party however we have his other children and spouse throwing in their two cents. they get him agitated with their constant pestering and then want you to do something when he cusses at them and tries to hit them. i am confident in my skills to be able to do wound care in front of anyone. my thing is this family is not looking out for the resident's best interest. they are just looking for ways to micromanage. cmon i hafta to call them to ask family is it is ok to give prn. these people think just cuz they have internet access they can google any med resident has and then come in and be like i wanna change this or i think he should n't get this. the MD doesn't even bother with them anymore he just agrees to what they want so they don't bother him. again can i say family wait outside while i do wound care and if they don't refuse to do it?

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Specializes in ICU, Telemetry.

Don't give PRNs anymore, get the doc to write an order. Maybe if you shift these folks back on his plate, he'll deal with his problem. It makes me nuts when the docs hide behind us because they don't want to deal with folks who are just around the bend. It's one thing if people have natural concerns, but when someone tries to "out doc the doc" and makes nurses the battle ground, we need to shift it right back to the doc. That's what they get the big bucks for.

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You can ask, doubtful they're gonna budge though. Sounds like there's more to this than meets the eye. Perhaps they've had a bad experience elsewhere and need to micromanage this time. Have you managed to build a good relationship with the family yet? Do they trust you? If they ask why they should leave the room, what are you gonna say to convince them not to be there?

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