I had a pt whose son was a pharmacist and daughter was a psychiatrist. This pt was on a natrecor gtt. Pharmacist son, probably a nice guy, hovering over his dad (I'm a night shifter), wanting to know things like... what is his Cr clearance, how often was he getting antibx and at what dose, etc. I have to say, I had the pt of a saint, and I kept telling myself "loss of control over situation....sense of powerlessness.... what if that was my dad...." I went online to find the formula of the creat clearance. Showed him, included him, telling him from the get go "our pharmacist does this, the nurses never do this, so this is new."
Then, daughter comes in. Asks a multitude of questions (how do his lungs sound, etc). I had my poop in a group, let me tell you, I jogged through all the meds and drips to be "prepared" before hand. I did not let the daughter know I knew she was a physician. She finally came right out and said, "I don't know if they told you or not, but I am a physician." I replied, "Ooooh! Okay!" I had been talking to her like any other family member of a pt. So I just cut to the chase. I was puzzled by some of her questions, because after all, she was a physician. I printed out a 16 page information sheet of natrecor and handed it to her. I did my best to give service with a smile.
Soon after, my pt goes into A-fib. This is a side effect of natrecor. Call doc, get orders for amioderone and stop natrecor, told on call doc of situation. He was ready to deal. Pt daughter is disgusted with him going into a-fib and states she read that it is a side effect of the natrecor gtt, and acts like his care at my hospital sucks. I'm standing there, feeling I've done EVERYTHING with smile on my face and had full confidence in what I was doing. I have done everything, short of pulling my pants down and bending over, and probably was ready to do that next hadn't it been for my pt going into a-fib.
I was recently put in the position of being the "family member" of a pt who was dying and on hospice. I was curious as to what was going on, did ask some questions, but never eluded that I was "a nurse" (and requested the rest of the family to not mention it).
Anyone else have experience with dealing with doc family members, or even moreso, see your hospitalist deal with them?
A more tender side to this scene - - many years ago I worked in an excellent acute dialysis unit. Got called in for an overdose of Elavil, which does dialyze out. The patient was the mother of one of our renal fellows. The doc was totally distraught about her mother's suicide attempt. The drug analysis, at that time, had about a 6-7 hour turn around. We dialyzed that pt for at least 10 hours. We kept sending the doc back to the unit to fetch supplies so she wouldn't feel so useless sitting at her mom's bedside. Her mom recovered eventually. The doc later told us she was so grateful to be able to 'do something' to help us help her mom. And she was happy that she knew us, and knew we would give her mom the best care.
Even before that, back in 1982, I had the awkward occassion to do an acute treatment on one of my instructors from nursing school. Kidney failure from lupus, peritonitis from CAPD. She was the one who taught us sterile technique! I was overwhelmed with anxiety about my technique. She was so sick, if I had dragged my hands in mud, she wouldn't have noticed! Later, she told me that she was so glad just to see a familiar face (she was one of my favorites from school) that she just stared at my face the entire time because she knew I wouldn't hurt her. I had the repeated opportunity to do her treatments and she thanked me over and over. I learned that the appearance of confidence in yourself truly helps the patient through a difficult time.
I just got through with a reply and it erased! Urgh... so...
To clarify: I never speak medical jargon to pt families, and when she let me know she was a physician I just went forward (speak medical "jargon" but chose my words carefully).
Had they threatened me like the dentist, it would've changed the scenario.
I documented my butt off with EVERYTHING I did. Dr was aware, charge was aware. The pt had pain issues which of course helps the situation.
This was the second pt I've had whose family member was a doc. The first one I had was at another hospital. The pt's son was an anesthesiologist at the hospital that I worked. *gulp*
The best thing I did was review POC, progress notes, drugs (I was floated to the special care unit, and they see natrecor more often than I do, so I reviewed it anyways), and doing that gave me wonder woman braclets to deflect whatever was thrown at me.
It was just difficult, because I had other pts who need care too!
I wish you had been my mum's nurse the last time she was in hospital. It sounds like you did a good job on many levels AND didn't get baited by the family.
What someone said about asking the family to identify one member to communicate...excellent idea.
I do ask that one member of the family be the "representative" usually if phone calls are crazy...etc, but in this situation the only two were right in the room! :0)
Thank you Dolcevita. It's just eye popping to review situations like that and think, "wow. I survived that!"
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I worked in an upscale, ritzy nursing home for a couple of years, and have taken care of several elderly people whose sons and daughters were physicians. My experiences with these people were all okay.
1) I took care of an older woman whose daughter was a psychiatrist. The psychiatrist was pleasant in all her interactions.
2) I took care of a 90 year-old lady whose daughter was married to a family practice physician. The son-in-law (the physician) was also her attending physician, so I had to call him for any telephone orders or changes in condition. He was pleasant.
3) I took care of the demented mother of a locally prominent ophthalmologist.
4) The mother of a locally prominent orthopedic surgeon was a patient at the rehab wing of the nursing home where I used to work. This orthopedic surgeon was one of the nicest, most respectful men that one would ever meet.
Specializes in Neuroscience/Neuro-surgery/Med-Surgical/.
Ooooh, I hate that! I treat ALL of my patients as I would want to be treated, and I don't need to know if someone is a "VIP". I'm not going to do anything differently, so why do I need to know that?
Ditto! I DETEST being told, "btw, this is a VIP! blah,blah, blah!"
Our hospital actually has a designated VIP Floor! I kid you not! Carpet and hardwood flooring, and beautiful furniture, and of course its the penthouse of the hospital. They even serve the patients a different menu from the rest of the hospital.
When I get report about a supposed "VIP patient", I quickly reply, "all my patients are VIP, and will be treated just the same, thank you!"
mamamerlee, LPN
949 Posts
A more tender side to this scene - - many years ago I worked in an excellent acute dialysis unit. Got called in for an overdose of Elavil, which does dialyze out. The patient was the mother of one of our renal fellows. The doc was totally distraught about her mother's suicide attempt. The drug analysis, at that time, had about a 6-7 hour turn around. We dialyzed that pt for at least 10 hours. We kept sending the doc back to the unit to fetch supplies so she wouldn't feel so useless sitting at her mom's bedside. Her mom recovered eventually. The doc later told us she was so grateful to be able to 'do something' to help us help her mom. And she was happy that she knew us, and knew we would give her mom the best care.
Even before that, back in 1982, I had the awkward occassion to do an acute treatment on one of my instructors from nursing school. Kidney failure from lupus, peritonitis from CAPD. She was the one who taught us sterile technique! I was overwhelmed with anxiety about my technique. She was so sick, if I had dragged my hands in mud, she wouldn't have noticed! Later, she told me that she was so glad just to see a familiar face (she was one of my favorites from school) that she just stared at my face the entire time because she knew I wouldn't hurt her. I had the repeated opportunity to do her treatments and she thanked me over and over. I learned that the appearance of confidence in yourself truly helps the patient through a difficult time.