Dealing with "Web-Trained" Patient/Family Members.

wooh, BSN, RN · Apr 2, 2012

Yep, I tend to do a lot of research on all my problems. But I let my providers take the lead, and respect what they have to say. When I was struggling with an issue that I was going back and forth to my GYN for, I'd ask what she thought about trying this or that, not do a, "Well the internet says that you're stupid for thinking that this is going to work, I demand THAT!!!"

Pepper The Cat, BSN, RN · Apr 2, 2012

Knowing about your own medical condition is a far cry from being a lay person thinking they know everything because they saw a segment on Dr. Oz.

this is true.

BostonTerrierLover, BSN, RN · Apr 2, 2012

Oh yeah, I never meant anyone who has something rare and unusually treated.

I don't even mind tracking down or calling a specialist from the ER when a patient comes in that usually sees another Doctor for their unique diagnosis, and doesn't want the ER doc to begin treatment without consultation of that physician who "Knows" this patient's Hx.

I even also see ER docs say, What normally helps with this problem?, if it's unusual or recurrent. -Or- if it's a recurrent Chronic Patient who know what is going to work for them. I totally understand, and stand by all these types of issues.

Once again, it is the one who (and it's usually not even the patient, but someone in the entourage) derails a whole "active" treatment plan because they got on XXXXXXX.com and found a new treatment in South Africa for XXXXXXXXXXXX at 3am in the morning, and the Physician must be notified to be "educated" by his new "Lay" Colleague who just spent 30 minutes researching Herpes Complex Infections, Chicken Pox, and Shingles, and is now convinced this "Quack" doesn't know his Stethoscope from his rear orifice because "he is treating my mother like any other case of shingles he's seen, and my mother is 83-and she swears she never had chicken pox!" The "mother" was an angel, she was ready to go home, she was now pain free, and was slated for discharge the following AM. "If you send her home without this [proper] treatment, y'all haven't done anything for her! Can't you see this woman is unstable??!!!"

My assessment: Elderly appearing W/F resting quietly in bed with eyes open watching television. Denies pain or discomfort. Denies any needs. Turned with minimal assistance. Offered BSC, drink of water or juice of choice (refused). Daughter at bedside C/O patient "unstable." When asked, "Why do think patient is unstable?" She stated, "Because of the treatment, or lack of treatment she is recieving here." Patient/Family Teaching done on Stability vs. Unstable Status. Safety Measures in act, SR up x2, Bed low position, HOB up at 30 degrees, daughter remains at bedside------------------------------Boston, RN

HR: 74 bpm No Abnormalities, ar/dys-rhythmias, or murmur

Resp: 22 rpm Even and Unlabored, No Adventitious Sounds

B/P: 129/68

Temp: 98.8 F Afebrile (x3 days)

SpO2: 99%

I wouldn't have gone through all of this if the family member was just "having a moment," the daughter is a MSW and LCSW!!

A complaint was made against me by the daughter the next am, and I was "educated" on customer relations (although the patients Physician totally agreed with me, and signed on my "Complaint Report" that I would have been in worse trouble had I phoned him at 3am for this patient's daughter to speak with him about changes in treatment.

This was my first "Complaint" made against me in 8, almost 9 years (May) of Nursing. I did everything I could to communicate with the family member that everything was being done correctly for her mother. The patient was already being treated VIP because of the daughters status with the Hospital.*

Cache22 Strikes and Wins again (oh Cache22 always wins when it strikes, huh?)

*relationships to patient, genders, occupation, and diagnosis possibly changed to protect privacy.

CapeCodMermaid, RN · Apr 2, 2012

I had to have surgery years ago. Of course I researched my options and knew what I wanted done. Off I went to the surgeon. I didn't tell him what I wanted. I asked him what my options were. He thoroughly reviewed all the options and I picked the one I wanted. He then asked me what I did for a living. When I told him I was a nurse, he burst out laughing and said "You've probably read up on all these different procedures. Why didn't you tell me which one you wanted when you walked in?" I told him I only knew what I read since this wasn't my specialty and wanted his expert opinion.

Not_A_Hat_Person, RN · Apr 4, 2012

One thing that alternately infuriates and sadens me is when people refuse to take certain meds because their minister told them not to. I don't mean Christian Scientists, or other faiths that emphasize faith healing, but "My minister said Jesus will heal me if I fast/pray hard enough/give the church x$" or "My minister said those drugs (especially psych meds) are a sign of weak faith."

RNsRWe, ASN, RN · Apr 4, 2012

One thing that alternately infuriates and sadens me is when people refuse to take certain meds because their minister told them not to. I don't mean Christian Scientists, or other faiths that emphasize faith healing, but "My minister said Jesus will heal me if I fast/pray hard enough/give the church x$" or "My minister said those drugs (especially psych meds) are a sign of weak faith."

hoo boy, that's a rough one; glad I haven't come across it! But if someone puts a greater faith in his religious leader than his doctor, perhaps his minister should also give him routine physicals, check his blood pressure, and run labs?

caroladybelle, BSN, RN · Apr 4, 2012

My mother needs ___________, I read it online! Call her Doctor Please. (3am)Now, before I upset anyone, I am not talking about the desperate "Cancer Families" seeking other treatment forms, or the Patient that hasn't got any better despite all Medical efforts.How do you deal with patients/family members who get an online 24 hour Medical Degree?[/size]

Actually, you should include the "cancer families". As they often harm the patient with this nonsense.

We had a run of Pts with a particularly fatal cancer, come in with ghastly end stage liver failure. They had been diagnosed by reputable facilities, given data regarding supportive and palliative care, and had been declined for surgery, as it would have been futile, significantly decreased QOL, and possibly lifespan.

They were not happy with this and sought care in Mexico.......where anyone with a few bucks can buy chemo without a license/script. The "innovative" clinic reported that they cure them, gave massive amounts of drugs, and when the pt turned yellow, told them that merely needed some liver irradiation in the USA, and then could return to finish being "cured". No word as to why such an "advanced clinic" couldn't do the radiation therapy.

Needless to say, the PTs were in varying stages of multisystem failure from ODs of chemo.

I work for one of those places that everyone refers to as expert. But when there are no more treatment options, we will tell them honestly. The large number of laypersons that argue or try to order or force us to give inappropriate therapies and unproven/disproven meds is astounding. The lawyer that tried to legally "order" a dubious treatment for his father. Even better when he presented a paper on a treatment with a 50% cure rate, that had 3 participants?!? (still wonder how the half of the 1.5 Pts "cured" is doing)

I have also had numerous purported "cures" for all forms of cancer email forwarded to me that reference the entity I work for, as having done the research, approved the product, employs the so-called expert, when nothing could be further from the truth.

These groups that do this, cause at the very least false hope and unrealistic expectations, and at worst, do reparable harm, destroy finances and hasten death in vulnerable patients.

We also have well meaning people that actually harm the pts therapy. Pt (with several family as physician in totally unrelated specialties) undergoes induction chemo at another facility. Family reads up and analyze that parent MUST start to have increased CBC counts on Day X of therapy. Pt doesn't, though is doing fine. Children, though are wringing hands, freaking out and having conniptions over the issue, no matter HOW many times they are told that pt will in time recover naturally and needs to do so without intervention. Finally after much harassment, someone orders and gives neupogen ... Which does increase counts but contributes to development of major blast crisis, basically undoing the chemo and worsening things.

Some people have just enough knowledge yo be dangerous to themselves and others.