Do you check on your patients less when family is in the room?

[3dayRN]

Here it is 0500 sitting in the hospital. Not as a nurse but as a daughter. Someone has been staying in the room for the past few nights. Last night it was me. I am EXHAUSTED. I stayed because he does not want to be left alone. I have not slept because the nurse didn't make rounds for the better part of the shift. I'm all about helping but I think a nurse should have come in room when sats dropped to 86 . No that didn't happen. I had to wake him up to cough and suction him. I will be here all day today and again tonight. I am not complaining about that but I think its unfair for the nurse to assume because I'm in the room he doesn't receive the same care. I had to suction him a couple times during night. I will absolutely do whatever needs done but like I said I'm emotionally and physically EXHAUSTED to the point I want to just cry. So my question is do YOU check on your patients less when visitors are in room?

[Chin up]

You need to go get his nurse and tell her your dad needs her attention, right now. I don't know a nurse, that would refuse to give care, based on what you wrote. I don't know what is going on there, but something is not right.

[silentRN]

Sadly to say, some nurses just don't care, or they're lazy, or maybe they are just tired.

[loriangel14, RN]

I have been on the other end of this. I always explain to families(especially when there the room is crammed with people) that I am going to give them privacy with their family member but if they have any concerns to ring the bell or come and find me. I do certainly check on the patient on a regular basis but I try not to intrude any more than I have to. I think sometimes we assume we are giving a family privacy and it comes across as neglect.You are there as a visitor and it's not right if they expect you to provide care that theyshould be doing. I would ring the call bell and ask for some attention from the nurse.

((((((((((hugs))))))))))) Take care and try to get some rest, a shower and something to eat.

[JSlovex2]

do i check on patients less when visitors are in the room?

the simple, short answer is YES.

for example - there was a guy yesterday morning who was getting ready to have surgery and there was not a soul there to visit him all day (although he was talking on the phone to family). he was gone for quite awhile to surgery and when the doctor came up to check for family members so he could talk to them - there weren't any. he did have a family member who called to ask about him. after he got back to his room - still yet, he was alone. not only was he alone, but he was HEAVILY medicated - to the point that he was grabbing at the area where he had surgery. did i leave him? NO! not at all.

another example - there's a patient whose family member comes out to ask for ice. five minutes later they come to ask for a blanket. ten minutes later they come to ask what time her dinner will be there. 30 seconds later they want to know if she can get a sandwich instead of a burger. am i going to give THAT patient the same attention as the patient who just came up from surgery and is disoriented while trying to tear off his dressing? absolutely not.

is it fair? i don't know. it's a matter of perspective, i guess. i figure the patient who is getting ready to be discharged and has family members who are worried about whether or not they have enough mustard for dinner doesn't need me as much as the patient who is completely alone after surgery and trying to dig in his wound.

let's pretend it's a less dramatic scenario. i would assume if a family member is camping out at the bedside it's so that they can keep an eye on their loved one. am i going to check on that patient? of course. am i going to assume that if the patient's sats drop that the family member will at least hit the call light (assuming they know what that means - like the OP does)? yes. in essence, i'm going to be less "worried" about the patient who has a family member by the bedside as opposed to a patient who does not.

what i wonder is when you say that you "had" to suction him a couple of times during the night is if the nurse checked in and asked if he needed anything? if so, did you speak up - or did you say no? did you notice that he needed to be suctioned and call for the nurse? i DON'T depend on family members to do my job, but i do "ASSume" if they notice something needs attention then they will call for me - which is a luxury that many patients don't have. i typically always comment to patients who have lots of visitors by the bedside how lucky they are - and it's true. i wouldn't expect those visitors to try and help a post op patient to the toilet for the first time, but would i assume they would hit the call light and let me know he/she needed to go vs. letting him/her wet the bed? absolutely.

once again - my simple (and unpopular) answer is yes.

[Forever Sunshine, ASN, RN]

Yes. When theres family visiting a resident I let them be unless I urgently need the resident for something(fingerstick, stat med, requested pain pill etc)

[headinsandRN]

Depends on the condition of the patient.

If my pts o2 sat decreases into the 80s, I don't give a hoot if florence nightingale is at the bedside. ideally, I am going in to see that patient or sending another nurse and respiratory in on my behalf if I am attending to something more critical.

[BluegrassRN]

I do check in less frequently. I tell the family member I make regular rounds, but that if they need anything or if there is a change in status to let me know immediately. I'm not going to check every half hour or hour that someone is ok if there is someone in there able to tell me if the pt is thrashing around, appears to be in pain, or has fallen to the floor.

If the pt is unstable, if the family member is sleeping, if the family member doesn't seem capable of recognizing when to call me (ie scared, mild dementia, that sort of thing), etc, I will check as regular as if I would check someone without family.

You need to speak with the nurse, let her know how often you are needing to suction, and that you want the nursing staff to check on him more frequently. Or, instead of providing all his care yourself, you need to hit the call light and request the nurse come to suction, etc. If a patient's family initiates the care (suctioning, turning, that sort of thing), and it's something they are comfortable doing, particularly if they are used to doing it at home, I typically let them do it. If they do it routinely at home, they know exactly how they want it done, and often as not, I don't do it like they do it. Many times it's their preference to perform this care.

As a nurse, you know how frustrating it is when family or the patient have a problem with the care, but don't actually speak up about their concerns. We've all heard the "I was in pain all night but no one offered me a pain pill." Really? In the 7 times we interacted over the course of the shift, why didn't you ask for one?

It's quite a new perspective, isn't it, being on the other side of the process. Your post is a nice reminder for all of us to keep those communication lines open and to ensure our patient families know that if they need assistance, they need to use their call light.

[mpccrn, BSN, RN]

No. I work in ICU and assume families are there to visit, not care for the patient. The patient and his care is completely my responsibility. Visitors delivering care under my license does not work for me and I make that very clear from the start. I'm nice about it but make it clear that if the patient needs something I have not already addressed, visitors can and should verbalize it. I encourge visitors to ask about things they don't understand and give them guidelines as to what is acceptable behavior. Smilingly I tell visitors it's better to ask first then to cause their loved ones harm under the guise of trying to help.

[annakutty]

Yes,sometimes..........Not in patient condition like this.Also i am wondering what kind of hospital?unit is this??Very unsafe practice..........I understand you may a nurse.........BUt if i get a patient who can desat &need suctioning,i would round more frequently & i won't allow the visitor to suction my patient...........Hey its my patient.....Any visitor can claim as a nurse but i am a compassionate caring nurse who wanted to be fully responsible for my nurse.

If i am in your situation,i would have a chat with the unit manager.Please get some rest&eat something while you Are with him.I am Hoping it will be a one time incident &your father will get good care.Good Luck

[sassy_cassie]

I check on all my patients as frequently as possible, but a pt that needs me less gets less visits. If there is a family member in the room who is competent they get checked on less, because they are a lower priority then the confused pt who is alone. I hate that we have to divide our time based on need, but I have multiple pts so I have to give the worst off the biggest chunck of time.

[ninaricci]

I check on my patients EVERY hour even if it is just to peek in on them whether family is present or not. If they are asleep I let them sleep unless patient care requires otherwise at that time. At the start of every shift I let the patient and/or family know that I will be by every hour. This is actually policy at my previous hospital and has worked well to improve patient satisfaction.