Conflict of intrest issue

ageless · Jan 18, 2005

I think we can all agree on what we would do if we were placed in the position of caring for a family member, but I believe the question herein is how would we respond if another nurse appeared to be doing so?

UM Review RN, ASN, RN · Jan 18, 2005

I think we can all agree on what we would do if we were placed in the position of caring for a family member, but I believe the question herein is how would we respond if another nurse appeared to be doing so?

Wouldn't that mean that her Charge or Supervisor should've assigned the patient to someone else? Or are they thinking that liability-wise, the relative would be way less likely to sue, since suits usually are blanket-type arrangements and the relative would be included?

There really should be a policy on that, now that it's come up. Hmmm...

ageless · Jan 19, 2005

bump

mattsmom81 · Jan 19, 2005

I've been in this situation several times and to be honest my actions depend on the behavior of the relative staff member. I try to be extra compassionate when staff's ill family present as I know we are only human and our professionalism can suffer when loved ones are in crisis.

If staff can remain professional, don't act out or demand extraordinary measures from coworkers and the facility (and I've seen docs do this as well as nurses) I try to understand, and bear with them, giving extra TLC whenever possible. BUT I've also had family staff members want chart and computer access, want to pick the nurses giving care and become worst of the worst among bad visitors...LOL!

THEN I have had to refer to my supervisory team who will make recommendations.

Risk management and ethics committee has become involved in several situations. One example: a physician insisted on 'running the show' on his 90 yo father, going to extraordinarily expensive means to prolong his life, disregarding other specialists recommendations even past the point where it was apparent to everyone Dad was NOT going to survive. His peers reported him to ethics committee' not sure if it went further. Everyone was fond of him and tried to understand but he was making everybody miserable...he and his respiratory therapist brother were present 24-7, demanding multiple nurses be in his Dad's ICU room at once...unfair to the other ICU patients. He was being so hard on the staff nurses they did not wish to care for his father...sad.

So...again, depends on their behavior IMHO. Yes it could be considered unprofessional of a nurse (or doc) to directly care for her friends and family and the wisest thing would be to refrain. If I were the most qualified I MIGHT be tempted to forego this however (as I'm sure many here would be as well) but it can be risky. Its one of those 'crossing a professional boundary' issues that can get sticky.

stbernardclub · Jan 19, 2005

I just don't see any problems here. This sounds like a typical community hospital near me. Many times a relative comes into a local e.r. with a nurse on duty that is a relative. And if it was my family member that I was concerned about, you can bet Im chacking on them!

I did a search and couldn't find any advice.
I learned in nursing school that taking care of family members while working in the hospital is a conflict of interest, (and understandably so. I myself would show favoritism to a family member in my care if in that situation).
My story goes like this: I received report from a nurse in the ER who was sending her Grandfather up to a Med/Surg unit after she had been taking care of him. I knew right away this was a conflict of interest. This nurse also said these words to me in a hostile (or frantic it was difficult to tell) manner "I'll be up to check on him tonight. take good care of him" Her report was detailed yet she sounded stressed out/hurried on the phone and was very curt towards me.
I took report but was at a loss for words about what to say to this nurse about the concern I had for the others she was looking after while he was there.
What would you do/say in that situation? I don't have the policy/procedure manual of my hospital here. Do ER nurses have different policies in this situation? (figuring that they all rotate the triage, walk-in, Trauma areas, they'd eventually HAVE? to take care of the loved one?)
thanks for advice

peeps79 · Jan 19, 2005

Thanks everyone for your interesting and informative advice. I'm now realizing that this practice is not something that is universal, and that hospitals may have differing policies on that matter.

It certainly has made me think more. I guess there was no clear answer for that one.

Thanks again

llg, PhD, RN · Jan 19, 2005

I grew up in a small town and my father was the "town Doc." Yes, he took care of us for routine things, but sent us elsewhere when appropriate.

If you have a concern, I suggest talking to your manager, or educator -- someone on your unit that you trust. That person can probably tell you about the standards/culture at your hospital and if necessary, follow-up with your concerns in a discrete way. Perhaps your hospital needs to discuss this and develop a policy for future situations. Bringing it tactfully to the attention of your unit's leadership may the the best way to handle it politically.

My hospital has strict rules against such things.

ddd