I had a repeat offender today, multiple visits to ER for unexplained abdominal pain with N/V (whom I also caught drinking water out of the sink when he had strict NPO orders). Labs show nothing, radiology show nothing. Pt also has not followed up as an outpatient with GI docs. He was all set to go home and then an angry family member showed up...."he can't go home, he's in pain, he's sick, you all usually keep him overnight and give him medicine, I'll just have to bring him back here again, I want to talk to the doctor right now." Doctor comes in and attempts to stand his ground, explaining the rationale for sending Pt home. Family member flips out and yells at doc, telling him that she wants to see his manager. Doc responds, "well, I am the doctor here tonight," then doc caves and admits the patient anyway. Ugh, the cycle repeats itself. Then the family member starts harassing me Q5 minutes, "when is his bed gonna be ready, the doctor told me there is a bed ready for him now, you are a RUDE nurse." Now, I try to keep my cool but I want to scream at her and say, hey lady, I don't waltz into your job and tell you how things should go, nor would I give you a timeframe based on my own theory of how things should be...why on earth do you think that staff at the hospital should follow your requests on demand? Hell, we aren't even capable of meeting instantaneous admission demands. Sometimes I just don't understand why patients and/or family think that they can have it your way, right away. This is not Burger King. Kind of a rant, I realize this.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I agree, when the doc caves in you are sunk.
When the doc does that I try to direct the family to the doc to answer all their questions and find them some food and drink, and I tell them that the doc is finding the bed for them.
But I love the idea of a Patient-Visitor Relations rep.
I want one : )
I thought it sounded wonderful until I had to work with our latest PVR. Whatever the family wants, she promises it, ridiculous as it might be. Family wants patient to stay in the ICU until they're discharged to Rehab, that's what they get. (I wonder what will happen when/if the insurance company gets wind of this!) Visitor wants to bring her little pink poodle in to visit, slap a "Service Dog" vest on it and come on in. NPO patient wants a bucket of fried chicken -- no problem, she'll bring it right in. Families catch on real quick that if the nurse says no, the PVR won't back the nurse, but will go around her.
Specializes in Acute Care - Adult, Med Surg, Neuro.
This is what I call 'No one in the family has a job or a life syndrome'. They all march in, mid-day, reeking of cigarettes, carrying 24oz soft drinks, making demands, bellies hanging out, often in their pajamas. Another, related, diagnosis is 'no-copayitis'.
These people are hard to deal with, to say the least. They come in all colors, shapes and sizes.
Omg this is true life! LOL. I deal with this on a daily basis!
I thought it sounded wonderful until I had to work with our latest PVR. Whatever the family wants, she promises it, ridiculous as it might be. Family wants patient to stay in the ICU until they're discharged to Rehab, that's what they get. (I wonder what will happen when/if the insurance company gets wind of this!) Visitor wants to bring her little pink poodle in to visit, slap a "Service Dog" vest on it and come on in. NPO patient wants a bucket of fried chicken -- no problem, she'll bring it right in. Families catch on real quick that if the nurse says no, the PVR won't back the nurse, but will go around her.
Oh Ruby Vee, that's awful. You're 100% correct, if patients/families know they have a way around the "rules," they will certainly over utilize it. It's going in the opposite direction of bringing people back to the reality of necessary medical care. I would certainly guess that insurance companies refuse to pay for unfounded cares (ICU requests!!), but it makes no difference to most of the people who are on state funded insurance anyway. Those types of promises made by a PVR would infuriate me.
I am a new nurse in the hospital; pt is a mid age paramedic hx hpt r/o stroke. Wife is a RN. He took scheduled altace at 8 am (sbp 168) now they want a hydralazine. I phoned the doc sounding like a dummy. The doc says he needs to let the altace to kick in and doc doesn't want to overmedicate. Relied the message now they are rolling their eyes. I feel like telling them, dudes your bp was in the 200s now is better controlled, why all the rush now chill out.
When that kind of situation is happening, I know the doc should have back up. I make the time to stand right by him and usually repeat his statements. Its easier as a group to say, "we are not going to tolerate non compliance, and there is no reason to admit." If the family gets aggressive I'm more than happy to call the police as they are being inappropriate in a hospital and no other place would tolerate this behavior.
9/10 it works pretty well, even if it involves both the patient and family screaming and cussing us out on their way out the door. Better out the door than worming their way into the rest of my shift for absolutely no reason.
imintrouble, BSN, RN
2,406 Posts
Whenever a doc stands tough against those kind of patients, he becomes our hero. We are currently hero-less where I work.
It's all about CYA.