Don't Tell Mom/dad/wife

[cokie]

how do you handle the "don't tell Mom how sick she really is" demand. had one recently where the husband didn't want us to tell the wife that she if getting chemo. she was not competent, but had not been judged so by a court of law. since cancer had mets to the brain, was this really a good call to give chemo anyway. anyone else had experiences and how did you handle them.............

[purplemania, BSN, RN]

It is not only cruel to deny a competent adult their autonomy, but it is also illegal. The patient has a right to know. How can they give informed consent? Remember that the patient is the priority, not the family.

[deespoohbear]

Originally posted by nurseandmom

I agree that the patient has the right to know and it steams me when the docs speak to the children of elderly patients who are perfectly competent before speakin to the patient.

I once had a 23 year old man whose father wanted to control the entire situation and was giving me orders about what visitors his son could and couldn't have and how all the test results should be given to him. The son was fully competent and didn't even live at home and in fact was married.

We have recently been told that to respect cultural differences we should be aware that in some cultures it is normal not to speak to the patients only to the head of the family. I don't think I agree with that either.

Wouldn't some of this be some major HIPAA violations? I mean how could you let the father of the 23 y/o know what is going on without asking the son if it was okay? I don't think HIPAA allows for cultural differences when it comes to privacy.

[Whisper]

we had a patient we were hoping to discharge back to her home, she was working with physio and OT's really pushing to go home.... when the family came in and said we weren't to tell his mum but they had sold her house.

Son was then overheard telling his mum, that the medical staff wouldn't discharge her home, so she was going to have to go to resi care!!

....also had families acusing us of lying to pts' by telling mum or dad they have CA when they don't! just going into a hospice for a holiday:rolleyes:

I hate things like this, but at least at the moment I can pass the buck, and say I'm sorry I'm just a student I'll go and get the SN for you.

[susanmary]

Serious HIPPA infractions with this. Legally, you have no authority to discuss the patient's care/treatment with anyone

(excluding health care team members on a need-to-know basis) without their permission UNLESS there is an appointed health care agent, conservator, etc. A family member may or may not have the patient's best interest at heart -- but it is not THEIR decision whether or not a patient is given information. If the family were to give you flack, refer them to your manager or the patient's physician.