Family Angry About ER Transfer

[SilverBells, BSN]

Anyone ever have a family member angry about an ER transfer? 

The other day, a patient experienced sudden onset of abdominal pain, nausea and vomiting.  This was while we were doing a telehealth visit with a provider.  The provider, seeing how much in distress the patient was, recommended an immediate ER transfer.  Family was notified.   They wondered if they could see her first,  but they were 3 hours away and the situation appeared more urgent than that.  Within a relatively short period of time, she was transferred to the ER.  She later on returned after testing which reported no significant findings. 

As a consequence of the ER due to medications given, a surgical procedure was postponed.  Family was angry about this as the procedure was intended to alleviate a condition causing the resident chronic pain.  They demanded to know what necessitated the ER transfer, despite being informed the previous day, and were angry that a provider had seen the patient without them being notified in advance.   I apologized for their frustration, but also explained that the provider had wanted to ensure that the patient was medically stable before her procedure.   At our facility, we also don't always notify family of every provider visit as many of them are spontaneous and/or do not result in any care plan changes.  

Anyway, I understand their frustration but at the time felt it was in the patients' best interest.  Thoughts? 

[Emergent, RN]

I think that they are being unreasonable.

[Wuzzie]

They’ll get over it. Take care.

[MunoRN, RN]

Unless the patient has been declared incompetent or incapable of making medical decisions and one of these family members is the POA then none of this is the family's business except for what the patient chooses to tell them about.

[Emergent, RN]

They need to realize that they turned over care of their relative to a Skilled Nursing Facility. If they want to have a more hands-on role they need to take care of their relative in the home. A Skilled Nursing Facility has certain protocols that it has to observe. 

[TriciaJ, RN]

The pt is seeing a provider regarding an upcoming procedure.  During that visit the pt develops abdominal symptoms.  The provider recommends ER transfer.

But you decide not to transfer for fear of angering the family.  The pt dies of a ruptured appendix.  The family accepts the blame for this and absolves you of all responsibility.  Sure.

[Guest1144461]

LMAO just disregard and refer to patient relations. Sorry someone caring about their family members well being delayed an elective procedure. FOR SHAME.

[Been there,done that, ASN, RN]

This is not your problem to address. This is a doctor problem. Refer them to the provider  that ordered the ER transfer. Let THEM deal with the nutso family.

 

 

[Davey Do]

[hppygr8ful, ASN, RN, EMT-I]

6 hours ago, Davey Do said:

This put me in mind of a recent conversation with my husband, He is very paranoid about getting Covid (he is fully vaccinated ) and stated that if he caught covid and died he feared that our son and I would blow though all the savings and be homeless in a matter of weeks. I opined that it would take at least 6 months. My son then stated "Well dad you will be dead so it really won't concern you!"

[SilverBells, BSN]

16 hours ago, Wuzzie said:

They’ll get over it. Take care.

I figure so.  Better for them to get over what was apparently an unnecessary ER visit/postponement of a routine surgery than a death.  

[SilverBells, BSN]

11 hours ago, TriciaJ said:

The pt is seeing a provider regarding an upcoming procedure.  During that visit the pt develops abdominal symptoms.  The provider recommends ER transfer.

But you decide not to transfer for fear of angering the family.  The pt dies of a ruptured appendix.  The family accepts the blame for this and absolves you of all responsibility.  Sure.

I actually wasn't worried about angering the family--if anything, I thought they were in agreement since the spouse said "Do what you need to do."  Granted, the person who was upset was someone I didn't contact, but this patient had at least 8 contacts on their list and there was only time to contact the first and second.  Even so, I thought they would have appreciated having the patient checked out prior to undergoing a procedure.  

At any rate, I think I get what you're saying.  I completely believe this family would have no problem throwing us under the bus if we hadn't sent this person in and there had been something wrong.  

I have a feeling this is the type of family that no matter what explanation we gave or action we took, they were going to find something they felt should have been done differently.