Family: The Monitor Monsters

Specialties MICU

Published

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?

Funny, a local columnist recently wrote about an experience she had as a family member of an ill loved one who was hospitalized. It has created quite an uproar in our local community. I'll link it below -

Hospitals have forgotten their mission: Caring for patients

April 30, 2006

mug_doni.jpgDear Every Hospital Administrator/CEO:

Can we talk? Thanks. This will just take a few minutes.

I just returned from a four-day stay inside a relative's hospital room. (Not a north state hospital.) I traveled to my loved one's bedside with my doctor friend's words ringing in my ears: "Friends and family don't leave friends and family alone in a hospital. Ever." Be a guardian angel/squeaky wheel/advocate for your loved one, he's often said. . . . . . .

http://www.redding.com/redd/nw_columnists/article/0,2232,REDD_17528_4662321,00.html

Read the comments section at the bottom.

She had a follow-up article yesterday but I can't find it on the website. She printed some comments she had received - not the ones on the bottom of the article above though.

I'm thinking of emailing her and encouraging her to visit allnurses - maybe post a thread on this.

Whaddya think?

steph

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Specializes in Critical Care, Emergency.

now that is funny Dinith88 - -

i agree wholeheartedly and practice regularly..

i usually tell them not to stare because it will just make them crazy, and all the other shyte peeps have posted here.

what CAN be good about visitors who are nurses (and believe me, NOT nursing students >>way too eager and way too unknowledged

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Specializes in ICU, Neonatal ICU, CVICU.

I let the family know that we, the nurses, watch the mtr and they should look for change in their loved ones....ie.....is there color better, are they more awake today, how is there swelling etc....

I also tell them that there is someone watching our central mtrs all the time. This pretty much shuts them up.

Now if they are really bad, I will shake the pts gown and make artifact and say, now if you thought that was a lethal heart beat, we would shock the patient, but that's why we look at the pt before the mtr!

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Funny, a local columnist recently wrote about an experience she had as a family member of an ill loved one who was hospitalized. It has created quite an uproar in our local community. I'll link it below -

Hospitals have forgotten their mission: Caring for patients

April 30, 2006

mug_doni.jpgDear Every Hospital Administrator/CEO:

Can we talk? Thanks. This will just take a few minutes.

I just returned from a four-day stay inside a relative's hospital room. (Not a north state hospital.) I traveled to my loved one's bedside with my doctor friend's words ringing in my ears: "Friends and family don't leave friends and family alone in a hospital. Ever." Be a guardian angel/squeaky wheel/advocate for your loved one, he's often said. . . . . . .

http://www.redding.com/redd/nw_columnists/article/0,2232,REDD_17528_4662321,00.html

Read the comments section at the bottom.

She had a follow-up article yesterday but I can't find it on the website. She printed some comments she had received - not the ones on the bottom of the article above though.

I'm thinking of emailing her and encouraging her to visit allnurses - maybe post a thread on this.

Whaddya think?

steph

Another column in today's paper about a family member's experience when their relative was in the hospital and the lack of a standard of care. And how they had to intervene to get their loved ones sheets changed, laxative order changed from p.m to a.m., physical therapy instituted, etc.

While I understand these family members being "Monitor Monsters" and the fact that nurses are overworked, it does seem to be a bit of nurse-bashing.

Is it really true then that "Friends and family don't leave friends and family alone in the hospital ever"?

steph

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Specializes in Pediatric Pulmonology and Allergy.

Is it really true then that "Friends and family don't leave friends and family alone in the hospital ever"?

steph

Maybe the nurses here can help me alleviate some guilt over leaving my dh post-op without seeing him settled into a room. This happened 10 years ago. He had an appendectomy and came out of surgery at around 2AM. I waited until 3 but he still was not put in a room. At the time our son was 1yo and still nursing, and I had never been away from him that long, so I was nervous. I left dh in the recovery room and went home. (Of course the baby was sleeping peacefully all night...) Turns out that dh was put in a room together with a real jerk who smoked in the room and then cursed dh when he asked him to put out the cig. A real problem patient. If I had been there no way would he have been left in the same room with that guy. It took them until the next evening to change the room.

Nothing to do with the topic of the thread, but yeah, family members do need to stick around as advocates. Not that nurses are not well-intentioned but sometimes the patient needs someone who's there exclusively for them.

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I tell the family who are oogling the monitor and who panick with every alarm that they shouldn't get concerned until I get concerned. I also hesitate on the teaching aspect because everything is relative. Yes the blood pressure is better but I've had to increase the levo or phenyl. Hemodynamic waveforms are complicated to the person who just learned what a normal bp is. I will give them a brief rundown of the numbers but refuse to go into detail. I am their to look after the patient and not as a teacher to the family. I know this may sound harsh but the bottom line my time is better spent going over blood work then teaching hemodynamics to famillies.

It is important for the "nurse visitors" to recognize that they are there as family and not as a nurse. Our job is not to critize our fellow nurses or try to impress them with our knowledge, our job is to support our loved one. Those that do otherwise are being selfish.

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Is it really true then that "Friends and family don't leave friends and family alone in the hospital ever"?steph

No, unless both patient and family are comfortable with providing intimate personal care to the patient, seeing the patient recovering from anesthesia, and comfortable with the patient giving intimate personal information to the healthcare staff.

As a patient, I would not want friends and family present for any of these events, although I would choose being seen naked by friends and family over being seen with altered mental status.

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My monitors had no visitors. My visitors came to see me, not the monitors. And as for me, with 20/300 vision without glasses, I did not see much of anything more than a foot away.

Surely, I am not the only one to receive excellent care in the hospital. Perhaps the good stories are less likely to be written and published.

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It is true that bad experiences are more likely to be communicated than good ones (anybody here married to a mechanic?), and so I think the article, like so much of journalism today is biased. Most laymen don't understand or properly process 1/8 of a hospital experience, either patient or family, due to stress and fear. But I was a pt. back in 1984 for bilateral foot surgery, was placed post-op on a CANCER ward (you tell me), and had to ask a colleague from my M/S floor who visited me to do the first CMS check in 8 hours. I also irrigated my own hep lock after the iv antibiotic had been finished for 45 minutes. ( I just did not want another IV start).

It happens.

ON THE OTHER HAND, all of the posts dealing with "monitor monsters" are great, and I have used a combination of all of them.

It is just too bad that for some reason, families feel that the technology is more real than the blood and flesh nurse at the bedside.

Nurses are the most trusted professionals in America, according to a 2004 survey.

I don't always get that sense.

Cate

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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.

As an ICU nurse, I do try to explain to family members "what the lines and numbers mean". As a family member (a few times!) visiting my family in the hospital, I DO NOT get all spaz and give the nurses a hard time. I also DO NOT tell staff that I am a nurse. The one time I did get a little assertive was when my mother was having runs of V-tach and no one was doing anything about it. Nurse-0-Matic...sis...I feel your pain! LOLOL

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Specializes in ICU's, every type.

of course I explain all the colored lines and what not and what we'd like them to be. If the patient keeps staring at it, I TURN it away and tell them to watch the TV instead after making some lighthearted conversation about him giving himself "the big one" after seeing a flat line if a lead falls off.

for the family, after the usual explanations, I tell them that the machines just beep with the slightest bit of anything, and the nurses know the difference, so only worry if you see the entire staff barge in the room with the "red" cart, but then you can get the "red cart monsters".

My pet peve, like others is the "scantly skilled" family monster who provides inaccurate information about what they see, or use their "knowledge" to make the situation worse than it is.... HR of 45 in a fresh MI on beta blockers ("this is really bad, his heart rate is falling" (yeah, as the lopressor is peaking!) UGH! feeling the pain here too! just gotta laugh some days.

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Specializes in ICU/CCU, CVICU, Trauma.
I tell the family who are oogling the monitor and who panick with every alarm that they shouldn't get concerned until I get concerned. I also hesitate on the teaching aspect because everything is relative. Yes the blood pressure is better but I've had to increase the levo or phenyl. Hemodynamic waveforms are complicated to the person who just learned what a normal bp is. I will give them a brief rundown of the numbers but refuse to go into detail. I am their to look after the patient and not as a teacher to the family. I know this may sound harsh but the bottom line my time is better spent going over blood work then teaching hemodynamics to famillies.

It is important for the "nurse visitors" to recognize that they are there as family and not as a nurse. Our job is not to critize our fellow nurses or try to impress them with our knowledge, our job is to support our loved one. Those that do otherwise are being selfish.

"not as a teacher to the family"? That's part of our job. Your pt's families deserve more.

As a "nurse visitor" when I visit a family member I will ask EVERY question I deem necessary. They all deserve to be answered until I am comfortable with the care my loved one is being given. I do not consider this being selfish. I call it ensuring that my loved one is being given the best care possible.

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