Family: The Monitor Monsters

Trauma Columnist · May 4, 2006

I had to laugh at your terminology. I work in the ER and we have the same problems. In fact, our monitors are pretty sensitive and they beep a lot. I always explain to the family members that their pt is on our central monitor and is being constantly watched. THat has helped a little. Also, our ER is very busy with lots of blood and guts - sometimes in the hallway right outside their door so we try to provide additional diversions for the family - lol.

prmenrs, RN · May 4, 2006

Do you suppose, somehow, in their minds, the monitor gets confused w/a TV set? So they watch that cuz there's no TV? Maybe you could tell them the artifacts are just the commercials!

RoxanRN · May 4, 2006

i've had patients/families like this. explaining each line on the monitor helps. so does explaining that patient movement can cause wave artifacts and alarms (my wording is something like "the monitor doesn't like movement"). i also explain that the monitor has different alarms sounds based on the severity (as programmed into the computer) of the 'problem' and it's those alarms we listen and watch for. once i've explained the monitor, i tell them not to watch it and to pay attention to their loved one. they are who i am treating, not the monitor. i also reinforce to them that their loved one is being watched constantly.

Marie_LPN, RN, LPN, RN · May 4, 2006

Perhaps the focus on the monitor is something that shifts the focus temporarily from the seriousness of their loved ones condition (not excusing freak outs)?

Signed Marie, former Monitor Monster for Grandma

Artemis2 · May 4, 2006

Bwaaaahaaahaaahaaahaaa! Monitor Monsters! That is so funny! I hate walking into the room to see some poor patient lying there and everyone is staring at the monitor. I usually tell them that looking at the monitor is my job and that visiting with the patient is their job. I also try not to go into too much detail about the numbers because it only seems to make the monitor watching worse. I tell them that the monitor and I have a running conversation going and that the assorted beeps and squawks are its way of communicating and that just like some people it doesn't always know what it is talking about. I tell them that I speak its language fluently and that if they don't see me running into the room with my eyes bugged out they don't need to worry if it makes some sound. I tell them that we listen to the monitor but that we look at the patient and that ultimately the patient, not the monitor, gives us the best information about their condition.

Hee hee hee! Monitor monsters! I'll remember that one!

Nurse-o-Matic · May 5, 2006

Yes, I suppose it's somewhat fruitless to think there is an easy solution to the monitor oogling behavior. It's great to hear what everyone else is doing to ward off the monsters. I love your stories!

babynurselsa, RN · May 5, 2006

Over the years I have had many people come and visit the monitor.

I will explain to them how the monitor works, normal vs ranges, artifact, etc. I then let them know the monitor is there for me, not them and that if I do not look scared then neither do they. ( all in a jovial tone) This seems to break the tension for them and beyond that I rarely have a problem.

ZASHAGALKA, RN · May 5, 2006

I normally explain that some beeps are the monitor's way of saying, "I'm not sure" and some are it's way of saying, "Come quickly" and I know the difference. I also say that the monitor doesn't like movement - and WE know that.

I point out that several of those lines: pleth, cvp, pap, etc., are 'trending' devices and I am monitoring a trend, not a specific value or alarm.

I point out that the monitor is very sensitive because it doesn't have a brain and we want it to point out every little blurp or gurgle so that we can evaluate it rather than NOT point out something serious because it wasn't set so sensitive. That being the case, the monitor is going to become concerned MUCH MORE OFTEN than I am. And, it is DESIGNED that way.

I also point out that the monitor is MY job and that I'm very good at it. I point out that there is a central monitor that duplicates this data: just because someone doesn't jump up and run into the room doesn't mean nobody saw it.

I point out that we treat the pt not the equipment and that the monitor is but ONE piece of data that I look at.

And after ALL that, then I explain what all the lines mean.

And after THAT, any monitor hawking towards me gets the constant, pleasant refrain: "Remember, we discussed this; that's my job, and I'm good at it. So, you leave that to me."

~faith,

Timothy.

Dinith88 · May 5, 2006

Recently, I've had my share of family members who stare at the patient's bedside monitor looking for minute changes. Many times it's artifact or normal fluctuations but the family comes charging up to me freaking out. I immediatly do teaching regarding the monitor numbers, waveforms, etc, but it seems like this just causes them to scrutinize even more! Once, I had an art line go bad so I pulled the line and unplugged the sensor from the monitor. When the family returned to visit, they were furious that the red line was gone without thier consent--one less line for them to watch.
Does anyone have suggestions to keep visitors from becoming monitor monsters?

Thats so true...and one of my pet-peeves. I suppose it depends on my mood, but in general i try to explain the numbers and waves and stuff...and for the most part that alleviates alot of visitor-monitor-monster anxiety. If i'm busy or grumpy or tired, sometimes i'll point-blank tell them 'dont worry about that stuff'...but that ususally doesnt get the same results...and can even piss certain people off.

And...the WORST monitor monsters of all are (drum-roll please) visitors who are nursing students, nurses, and other medical-field type people. Not saying all of them, but occaisionally you get serious dorks who have a little knowledge but have no idea how icu-type waves work (pap, cvp, a-lines, icp, etc).

And look out for the icu-nurse visitor...sheesh. With some of them it's simply a matter of talking shop...but others need locked out of the freakin hospital.

ICURN_NC · May 6, 2006

This hasn't been a big issue for me, except 2 times when the pt had been withdrawn and the family kept staring at the monitor instead of the dying pt- I guess they wanted to "see" when the end came.

In this case, we are able to put the bedside monitor on standby, and still have the central monitor going.

fergus51 · May 6, 2006

I explain that there are different noises and some mean "come here now nurse!" and others mean "the patient moved, don't worry, nothing serious". I have told parents that it's their baby who cares that they are there and they need to focus more on the baby and leave the monitor to the nurses. Once they are reassured that we know when the monitor alarms are serious, they seem to relax a bit.