Published Mar 9, 2001
I need to talk to other psych nurses about communications with families. Specifically I am interested in your ideas for establishing and maintaining appropriate and mutually beneficial communications with families of hospitalized patients. This is such an important component, obviously, because it helps us to get better info going in, better sense of family dynamics, and helps with discharge planning. What are your thoughts on how to optimize this relationship with families (significant others) without that becoming a full-time job in itself? Please reply -- need help! Thanks!
I'm a psych. nurse, too. Dealing with the families of pts. is my favorite part of their care!! Unfortunately, many times the number of family members involved in their lives is scarce or non-existent. However, when I do have that opportunity, I try to find out who really participates in this person's life and most importantly, securing the pt.'s permission to include and inform this member about his care, meds., plans, etc. Most families/friends really appreciate documented information about the diagnosis, what to expect, med. information, the pt.'s responsibilities and capabilities. Most of the population I dealt with was indigent and their family members were not very involved in the pt.'s care. Hope this helps.
I formerly did case management on tech dependent kids but now I do drug abuse prevention in a school setting. At times I see kids dismissed from psychiatric hospitals, treatment centers etc and I often have said, particularly of one national psych hospital chain, that their discharges looked a lot more like Jonah being ejected from the whale than a discharge with a plan. As far as the school end of things go, unfortunately at my school we have precious little organized help for either kids from treatment centers OR psych-mental health settings. Some schools will have post-treatment groups for D & A kids. I don't--yet--but it is my dream. I guess I think Student Assistance Programs should be doing more for those kids that are coming out of psych treatment too--and I am a big believer in support group format.
When we would discharge my medically complex kids we would have discharge planning conferences that includes hospital personnel, parents and community personnel including the school. The needs of my tech dependent kids were highly technical so I don't think psych mental health kids need quite the same broohah but just think how powerful it could be in complex cases that required frequent re-hospitalization if someone from the school met with hospital and community based treatment team, parents and student and formulated a plan for a teen's support back in school. This is starting to happen with wrap-around teams but I think their is still a lot of turfism from what I have heard. And imagine if the school could actually take back some treatment based pointers for helping the student when they feel upset, angry isolated etc.
Oh, also, in working with my medically complex kids, here's what those parents wanted. They wanted treatment people to listen to them and respect their knowledge. They wanted docs and nurses to KNOW that when they said, "Things are getting bad," that they were. Some of my parents would use hospitalization to get some badly needed rest; others would be constantly at the bedside and drive staff nuts ;-) Until my parents trusted me, they would not tell me what parts of the "divine plan" that I, the team, or others had dreamed up that just plain didn't work. Sometimes it was really hard on my part to let go of a solution and call it something we had tried. Sometimes this is true for parents, too. My parents sometimes tired mightily of their burden but had trouble allowing others to do care their way and that meant people that were willing to help them out didn't always stick around long. I am telling you some of these things because I think their are some parallels in the care of the chronically mentally ill, especially when their maintenance in the community takes heavy family or friend support.
Working with families is a part of my old job I miss sorely though I do a very little of it in this job. It is frustrating work and takes lots of listening but is potentially the most rewarding thing about any kind of nursing. Start with your families and SO's by showing your willingness to listen to them and value what they say.
I work on an open ward rehabilitation unit, that is the last step for hospitalized patients before discharge into the community. Whether it be in their own apartments, group homes, or homes for special care. When a patient comes to our ward from admissions or another area in the hospital, the primary nurse assigned sends the family a questionaire. In it are simple questions about the pt's home life, growing up, schooling..... etc... etc... I find that this is the perfect way for the prime Nurse to initiate contact with the family and develop a relationship for future contact... This creates an opening for the nurse to contact the family whenever needed for information, or for the family to contact the ward to inquire about their loved ones progress...
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