I have been trying to search out information on a topic and am coming up dry. So, I'm turning to my on-line nursing community. Maybe I'm the only one that's had this experience. OR it's something that is negative in nature and not reported.
Here's the deal:
Adult med-surg patient. Nurse and patient getting along OK. But then... some family member/significant other comes into the room, and inserts themselves between the nurse and the patient. This is usually like a twisted sort of advocacy role.
Example: Older lady involved in MVA. Has a non-surgical back, burst fracture at T-12, being managed conservatively with a "turtle-shell" type brace, pain management, PT/OT. Has a daughter that lives about 50 miles away who has been calling the floor multiple times per shift telling us what mom wants and needs and demanding information. Finally, shows up. Sits down on mom's bed literally between patient and nurse, picks up my rounding log and states categorically that I was not in the room at any of the times noted, that the log is a complete fabrication and that her mother was ignored all day. The patient was passive. Didn't correct her daughter.
Another example: Mother of a 45 year old patient tells us we are not medicating her daughter with enough opiate. Then tells us we're giving the daughter too much ("she'll never get off that stuff if you keep giving it to her like that...") on and on. We are incompetent, we are ignoring her, we're giving her too much or not the right medication. Again, the daughter is passive, allows mom to drive all the action.
Another example: Chronically ill middle age woman, brought up from PACU with a lot of co-morbidities. From the jump her sister is taking the pulse ox off the patient because the alarm was disturbing the her (the patient). I explain purpose of pulse ox. Sister says I'm full of it and she doesn't see any reason for the alarm to go off until her sister is in the mid-70's range and if I can't make the alarm fit those parameters, she doesn't want it on at all. (No, the family member has no medical/physiological understanding, is clearly picking a number out of thin air.) Again, the patient is passive.
Common features:
1. There is nothing inherently defective in the nurse-patient relationship.
2. Objections of family member not rational, and are resistant to any explanation or education. (In fact, in my experience any attempt to educate or inform is taken by the disruptive family member as self-defensive excuses by the nurse and validates their complaints.)
3. This behavior places a barrier between nurse and patient that is poisonous, inhibits continuous assessment, treatment and evaluation. Basically short circuits the entire nursing process.
4. It is not directed at any particular nurse, since none of the nurses are competent in the family member's eyes.
5. Lots of threats and implied threats : "I'll contact my lawyer." "Who is the CEO of this place?" "Wait till I tell the newspaper how awful you all are."
Please help me NAME THAT BEHAVIOR? What mesh-heads can I use to search the literature? Is it just me? Do all nurses see this occur? If it's not in the literature, why not?
