Family in or out during procedures???

[CyndieRN2007]

I was at work last night and I had a patient who needed some procedures done, (I had to drop a foley, start an IV and do an ekg) and her family was very demanding. I asked them to step out while I worked on her and that we were doing everything to make sure she got the best care, but they refused. Inside, I was furious, but since the patient (older woman who was a bit confused) did not object to adult sons being in the room while I was dropping the foley, I didnt push the issue... but I think I should have.

So Im asking, if you dont feel comfortable with the family in the room, do you make them step out or let them stay???

[cardiacRN2006, ADN, RN]

I've had people not want to leave during things like Foley insertions. I tell them that it is a sterile procedure and I can't have them stay as it increases the patients risk for infections.

For things like 12-lead EKGs, I do emphasize the pts feelings, and that it is my job to protect them.

I agree with Gompers that a code is different-I believe that the family should be there if they can handle it.

[ortess1971]

I just had a situation today dealing with this. In our outpatient surgery area, family members are routinely allowed back there, while the patient is getting interviewed by the OR nurse and anesthesia. Most people are fine but some are inappropriate. Some people even bring children back there, and the kids proceed to jump around, make noise, pick stuff up and put it in their mouths etc etc. My patient today almost had her son pass out, (about 12 years old)because he was there when she was getting her IV put in and he heard the doctor mention that they will be cutting bone. Well, this kid turned gray, got all sweaty, and we had to put a compress on him. Of course, now the patient is all worried and upset. The other problem is with parents who insist on following their adult kids(18 years and up) into the pre-op area. Anesthesia will be asking questions about possible pregnancy, drug and alcohol use etc and it's hard to get a truthful answer out of some of these kids because mom/dad is there. I'm old school about the family issue-I don't think they belong in PACU, for example, and they should be expected to follow visiting hours. One nurse that used to work on the floors told me that when a patient's family wouldn't leave, she'd tell them the patient in the next bed was going to be having a bowel prep! :chuckle She said most times, that worked like a charm. To me, being in the hospital is not a social occasion or a party.

[MomNRN, BSN, RN]

I think it all depends on the procedure, the mental state of the patient as well as the family, and the circumstances surrounding the pt's hospitalization.

I had a family last month who came to check on Mom in the ER. They were loud, very anxious, and very demanding. Mom was in a state as well. I decided to keep family out until all procedures were done and Mom was stable. Also got her calm with the help of some ativan.

Once I was done I warned them that Mom was doing good, but that I expected them to maintain their composure and not enhance her anxiety. Surprisingly it worked.

If the family is overbearing, getting in the way, hysterical, and will not listen, I have no qualms about contacting security. It is hard enough to do the job without having to worry about appeasing the family members.

[Antikigirl, ASN, RN]

I will typically ask the patient in PRIVATE if they wish for a family member to be there. I ask in private so they don't feel pressure in having to explain to a loved one why they don't want them there! I find that is just poliet and typical common sense!

[froghair]

family out especially the mother if its a child your putting an iv in. and not just outside the curtain but out of ear shot.......for there sanity and mine

[tencat]

Personally, if it is my child getting an IV, I will be there. That doesn't mean I'm there to critique or tell the nurse how to do the job, never would go there :nuke: . It means I'm there to support my daughter, period.

[shazbo]

basically, out you go,with many exceptions. trust your gut.

[Tweety, BSN, RN]

It should be the patient's choice. Sometimes it's a comfort to have their family present.

If the family is one of those nasty demanding families, I might ask them to leave.

I don't ask them to leave for my own comfort or convenience, it's all about the patient and I take each case individually, but most of the time I ask the patient if they want their family member present or not. Most of the time when I say "I need to do such and such.......", they automatically get up and leave on their own so it really isn't an issue.

[Dianne6]

I let the patient decide if they are able....

[ERTRAVELER]

I work emergency and during a critical situation my first and foremost concern is the patient. I ask family to step out until we can get their loved one stable and then I bring them in one at a time. It is difficulty to get around family when trying to stabilize a critical patient. If I know the patient is not going to make it I make sure the family is at bedside.

My decision is based on an individual basis. You need to use you best judgement.

[Nurseboy1]

Generally when we receive an admission or transfer from the floor we send the family out until we stabilize the patient.

If the patient has been in the unit it depends, if I'm starting an IV or something that is not incredibly invasive I go with the patient/family comfort. However, for a foley or NG I would ask the family to step out.

[mariedoreen]

I'm a new grad RN still working on figuring this one out... I oriented with one RN who was great about having family leave for anything that would expose the patient. She was tactful, yet firm. Another RN I oriented with had an anything goes attitude... I'm not saying I thought one was right over the other; however, I have to say that there was nothing like putting in a foley on an elderly lady (who was used to receiving caths, even at home) and having her son stand at the end of the bed and TALK ME THROUGH the procedure (it was my 5th time or so) as he had done it for her multiple times at home. The RN orienting me was also present and didn't seem to have any problem with the entire situation. I however, was a entirely creeped out.