Family Members of our Patients ....

Nurses General Nursing

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I mean no disrespect, but there are times when I get so frustrated by family members. Sometimes I really wonder if some of these people really understand what they are doing when they take up the time of the nurse asking us to do things that are really not a priority. Here is an excellent example:

Nurse: I will be hanging this TPN, changing the tubing and assessing the patient.

Family: Can you get my husband a box of tissues .... oh he needs these right now because his nose is running.

Nurse: certainly, I will be right back.

Nurse: Here are the tissues and assist the patient with the nose running.

Family: I am sorry, but he also needs some ice as he has a very dry mouth because the doctor will not let him eat anything.

Nurse: I can only give him a few pieces of ice dear as the physician has made it known that he does not want him taking anything by mouth. I will be right back.

Nurse: Here are a few ice chips. Now I really need to hang this TPN.

Family: Ok, I know, I have been such a pain today, I am sorry. But, he needs to use the bedpan, he says it is urgent.

The TPN is still not hanging.

Sometimes I think that families as well as patient's do not understand the thinking and the time that goes into providing care. When I am caring a patient, I am not just worrying about getting their bed made or about their ice water .... I am focused on what their labs are, why are they in a tachy rhythm .... and thinking (critical thinking) my way through their care all the time. When I enter the room to perform a procedure or complete a task, it drives me crazy that families take so much of my time. Perhaps it would not be so bad if I am not rushed at every minute of the day trying to get all that needs to get done, done!

I need some counsel here .... is it me or do the rest of you feel the same way?

Oh, here is another thing .... just as you are getting ready to do something important, the phone rings and the patient has to take the call. Guess who it is? Yup, usually his wife, who just left 5 minutes ago. :angryfire

(Delegate lol, i needed a good laugh at that word. Unfortunately i worked for a lot of companies that thought the word 'delegate' meant 'boss around and always take for granted'. Not all places and people are like that, but there are a few that are. Which is why that word has always griped me everytime i've read it in my Nursing Skills book.) Sorry for the rant, anyway:

Thing is, if you're hanging TPN and the FAMILY member is asking for something, you say "right now it is time to set up this scheduled prescribed nutrition, also called TPN that Mr. Patient needs since he isn't eating. As soon as i get this set up, i will go and (inserted whatever here). Is there anything else they need" (if the pt. cannot speak for themselves). I've seen several nurses make a statement like this while in the process of hanging the bags, priming the tubing (if it wasn't primed prior to getting in the room), and setting up the pump. It's not dismissing what a person requested, but it makes it clear that you are thinking and doing what's best for the pt.

Exactly! What is more important for your patient...TPN or tissues? Please find a way to explain the TPN is to be hung and then you will gather the other items the wife is asking for! I have to ask...did you set the TPN down to go get tissues?

Specializes in Emergency.

I feel you on this situation. I guess I would still prioritize if there is a box of tissues in the room i grab them and hand them to the family member, but the TPN is still my first priority. i wouldn't leave the room to get the box of kleenex. I would explain what I'm doing, and the importance of it, and say "when i have this TPN running, I'll be right back with the kleenex for you." xo Jen

I'm a CNA in a nursing home and we have this all the time. Each unit has 22 patients, 2 CNAs and 1 nurse. The nurse is busy passing meds, while we're busy toileting, changing and getting people to bed, or up from bed and to the dining room. The one unit I worked in last week, there were three residents who constantly had family there. The family was always pushing the call button for things like, "dad wants to lie down. He wants in his wheelchair, he wants to lie down again. he wants to go to the bathroom. He wants to get back in his wheelchair. he has to go to the bathroom again."

Finally, one night our nurse stepped in and explained that we had 21 other patients who needed care and that as much as we'd like to, we couldn't provide him with constant, individual care. They weren't thrilled with that, but it got them to cool it a bit. Our nursing home is pretty small, and honestly is one of the better and cleaner ones in the area. There is a waiting list of people wanting to get their family members in there, and once some of them are in, they think its the Hilton. We do our best and I'm afraid that is going to have to do.

Could you tell the patients' families that they should get the comfort items for the patients? A family member could easily go and get ice chips. Some families honestly do not know that they are 'allowed' to do anything for the patient.

Specializes in Nursing Education.

No, I did hang the TPN ... but I guess my point is that if you did everything the family wanted you to do, within the timeframe they wanted it, nothing else would ever get done.

Take for example the wife that comes out of the room, yelling at the desk, "my hsuband is in a lot of pain and needs to be medicated right now!" Patient is on a PCA and when you go into the room and inquire with the patient about his pain, he tells you, "I feel ok and have no pain." Ok - so what is the problem? The wife needs more control over his care? The PCA is working fine and the history shows that it is being used. I bet $100 that the wife is pushing the button when the patient is asleep!

There were sooooo many times when I worked in trauma that I wanted to tell the family "This ain't Burger King, you don't get to have it your way".

Another good reason to work in the OR.

"The PCA is working fine and the history shows that it is being used. I bet $100 that the wife is pushing the button when the patient is asleep!"

Would that be considered a crime?

Specializes in Emergency room, med/surg, UR/CSR.
There were sooooo many times when I worked in trauma that I wanted to tell the family "This ain't Burger King, you don't get to have it your way".

Another good reason to work in the OR.

Unless you work in an ER that thinks a Press Gainey score above 90% is a must every quarter! :uhoh3:

And chastises us when it's not! :angryfire

Pam

I hear ya. The energy required to edumacate these families-without-a-clue sometimes just isn't there is it.....LOL! And with open visiting, the challenge is even more immense with today's demanding public and customer service oriented healthcare facilities. It is the bane of my nursing existence for sure so I empathize completely.

Specializes in LTC,Hospice/palliative care,acute care.
I mean no disrespect, but there are times when I get so frustrated by family members. Sometimes I really wonder if some of these people really understand what they are doing when they take up the time of the nurse asking us to do things that are really not a priority. Here is an excellent example:

You must not be a mom. Moms have been juggling those incessant demands for years..... :p But seriously-you learn patience with your ...patients ( :rotfl: ) and their S.O.'s...and you get very good at prioritizing and juggling the needs of several people....You get very good at seeing to everyone's needs before they even verbalize them.....then they don't call you back twenty times in 2 hours....But-some times you are over -tired or something is on your mind and you could just freak....so then you come here and tell us all about it........ :crying2: Then you feel better-and you have not given any of your patients stat pillow therapy....We are all very good at telling others how to set limits and give advice according to what WE THINK we would do in a particular situation...In reality we can't know that---and I bet there is no-one on this board whom has never run into the impossible patient or visitor and been on the verge of or actually has "lost it" at least a little bit....If they won't admit it then they are not being thruthful....
Specializes in Nursing Education.
"The PCA is working fine and the history shows that it is being used. I bet $100 that the wife is pushing the button when the patient is asleep!"

Would that be considered a crime?

No, it would not be a crime, but it goes to show you that families do not need to do the things that they do. Afterall, it is a patient controlled pump, not a family controlled pump.

What makes me crazy with family is when half the family wants one thing and the other doesn't and you are caught in the middle.

I have seen family members agree to amputation of ALL limbs despite all education to the contrary.They become furious with staff because the patient is depressed and angry and wont talk to the family.

Somehow we were supposed to know that the patient would be horrifed to wake up without arms and legs.More importantly we should have refused to do what the family said because...( in this case) the son said we shouldn't have listened to them because they were under too much stress to make a good decision..and this is after we told them over and over what was going to happen when the patient woke up.

You can't win no matter what you do.

I hate the family that comes in with an obnoxious this hospital is a dump attitude before there is any evidence of trouble. I can understand if you recieved some suspect care and as a result have attitude, these people walk in expecting some one to screw up and they are ready to pounce in a heartbeat .

I had one last week like that, I had to start the preop IV because the floor nurse was unsuccessful and really swamped. I showed up and had to put up with attitude for every request I made. I asked the patient to get into bed before I started the iV (something I do in case the patient faints) and I got a 15 minute lecture on why he didn't want to, I said fine you can go home then. Then it clicked and he got into the bed.

I can understand a lot because I am a patient myself but sometimes it is just a nasty person and there is nothing you can do.

Being an IV nurse you get patients asking all kinds of questions and families grilling you and asking you to do a million things. I just tell them I know nothing.I don't fetch and carry either.

I think a lot of this can be stopped if the family got a good orientation and were told they can get supplies or ice themselves within guidelines from the nurse. Or if we were upfront with the family and tell them we are really busy and ask them for their help. I have had some good results involving the family in personal care. I have set up a little mouth/eye care tray and the family just jumps right in ..sometimes a little overenthusiastic but its a lot better than hearing nurse, nurse,nurse for 12 hours.

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