Do you tell family members that their loved ones are nasty and combative

TheCommuter, BSN, RN · Dec 17, 2015

It depends on the family member. If the family is receptive and willing to hear the truth about the patient's behaviors, I'll tell it.

On the other hand, I'll go out of my way to avoid belligerent families who believe the patient cannot do wrong.

freyarn · Dec 17, 2015

I will tell family members if my patient is having a hard time due to being confused. I keep my families and patients as informed as possible as often as possible. I feel that veiling the truth of a patient being combative and uncooperative can lead to a family not trusting you when they find out about their family member's current condition. I wouldn't say the patient was being "nasty" though, I would probably say something like, "Well, Mr. Smith has been combative trying to hit staff, he's seemed to taken an unfavorable liking to us. Is there any way you can think of to help us help him?"

Coldsvt · Dec 17, 2015

Depends...like mentioned above

But i always tell them if the pt is out of character. if that pt has been cool, calm and collected during thier stay and all of a sudden they get nasty and combative somethin may be up

ArtClassRN, ADN, RN · Dec 17, 2015

Depends. Sometimes the nasty apple didn't fall far from the tree.

NOADLS · Dec 17, 2015

If the family member is the health decision maker, that's my job if I am working during the day or evening.

Usually I am pretty blunt and to the point about it.

caliotter3 · Dec 17, 2015

I also weigh the effect of telling a family member when the family member is not "spry" so to speak, or when there is no reason to believe that the family member can offer any assistance in changing the behavior. Why upset people when no good is expected to come of it? Chances are high that they can see for themselves that there is something wrong with how the patient is behaving. They will discuss if they want to.

loriangel14, RN · Dec 17, 2015

You bet I let them know. what's the point in covering it up? Plus there is a chance it's completely out of character and something is going on. I have had families confess they are quite relieved to be having a break from having to deal with the patient.

Jensmom7, BSN, RN · Dec 17, 2015

Because we deal so much with symptom management, yes, we do discuss it with the family when a patient is combative or agitated.

Sometimes they need to be persuaded that there is a problem. Continued belligerence, anxiety, or agitation is not pleasant for the patient to experience, but we run into families who don't want their loved one "over medicated".

I had a LOL who would have bouts of saying one or two words over and over. Usually at the top of her lungs (she was little but LOUD). Ativan 0.5mg bid worked well for awhile. Then she started needing a PRN dose in the afternoon, which some of the facility nurses were reluctant to give. I called her son to discuss increasing the scheduled med to tid. He was reluctant until I said "Hang on a sec", held the phone up in the air so he could hear her and then said "That's your mom".

He agreed to increasing the frequency.

Tenebrae, BSN, RN · Dec 17, 2015

Absolutely.

I find a nice way to say it, eg the staff are finding that patient 'so and so" is not in a good place and unwilling to recieve cares

sometimes what I'd like to say is "your family member is an ass and if they behave this way at home, you have my abject sympathy"

Horseshoe, BSN, RN · Dec 17, 2015

Discuss the behaviors. There is no need to add descriptions such as "nasty." Stick to the facts and leave the subjective statements out of it. The objective statements of specific behaviors pretty much tell the tale.

DesiDani · Dec 17, 2015

I hope some of you really didn't think I meant "tell the family mom/dad is being nasty". It's just a creative way to get to the point.