The Family - page 2

I work in the icu where family members are given certain visiting hours but almost always fail to acknowledge them. My patient had spiked a fever while recieving ffp prior to a scheduled open lung... Read More

  1. by   baseline
    Originally posted by SmilingBluEyes
    Just my observation here. I only think this was a vent. I found myself feeling badly for this patient's family----- and this nurse. I don't think she is an appalling nurse, especially--- when I put myself in her place. Her thoughts, she is entitled to. Her frustrations are shared almost universally by anyone in the "do more with less environment" in which nursing finds itself today. But what do I see here? a RANT/VENT...and it's appropriate and in the right place. On a board, and not at that family or patient. Can we allow this or anyone in her place such a luxury? I say it's a must. Now... That said, the suggestions about including family in careplanning are very valuable. It can save us all immense trouble and often they are very HELPFUL when we work WITH THEM AS MUCH AS POSSIBLE. But I have to ask: can we reserve judgement on this overworked nurse for the time being and just let her let it all hang out?
    Well put. Seems to me that one of the reasons nursing keeps falling apart is that they just can't hang togeither! Having worked ICU and ED I can so appreciate the difficult family situations. I try to take the time to explain the careplan for the shift first thing with the patient and the family. Most of the time this works, but there are always those families that are going to be more difficult. Families are part of the careplan. They are part of the deal. And it is seldom an easy task. And there are no easy answers. Vent to an understnading friend or co-worker and carry on!!!
  2. by   RNinICU
    Originally posted by sjoe
    "When they rubbed his feet, his legs, his face, they were conveying their love and support because that's the only assurance they can give him. "

    Don't kid yourself. These peole are only trying to assure THEMSELVES. If they were actually focused on the patient, they would be seeking advice from the people actually taking care of him to find out the best things they could do (which certainly include letting him sleep).

    They need to be gently (if that works) or not-so-gently when to leave, and possibly to be given tasks and errands to assuage their feelings of guilt and helpless (IF the nurse has time to deal with them)--BUT the patient is in the bed, not all the people who wander in with their own personal needs, and this is the person whose needs come first.

    The patient is depending on his healthcare providers to take care of and protect him from everything that might interfere with healing (infections, intrusive visitors, etc.). Sometimes social niceties and potentially wounded family members' egos are much more distant goals--whatever nursing theories and textbooks and "well-meaning" people might have to say about it.

    My opinion, too. We have all dealt with overbearing families at one time or another, and know how distressing they can be to the nurse, and to the patient. One point Krissy made is that some of the nurses in her unit are not consistent about enforcing visiting hours. This can create a real problem for staff. Our visiting hours are liberal, but strictly enforced. We do make exceptions in some circumstances, but for the most part we stick to visiting hours. Our unit manager gives verbal warnings to staff who do not adhere to these hours, and a written warning after three verbal warnings. This policy has helped reduce the problems with visitors. We also give family members a pamphlet explaining our visiting policy and the reasons for the restrictions when a patient is admitted to our unit. That way they know up front what to expect.
  3. by   Talino
    Originally posted by NurseKrissy
    His wife, sister and mother were all in the already small room swooning over him rubbing his legs, up in his face.
    Originally posted by NurseKrissy Once again, I was polite and simply asked them to leave I didn't beat them with a stick!
    yet in your original post ----
    Originally posted by NurseKrissy Maybe I was harsh in asking them to leave ... I understand looking at it from their perspective how the majority of their actions were emotional, however I can't get over how angry it made me.
    My own conclusion: You defined anger. Now define "polite?"
    Originally posted by NurseKrissy
    They were driving me crazy too, coming out the nurses station to tell me/ask me something every two minutes. But I'm SORRY!!! I can not teach people everything about nursing in twelve hours!
    Boy, you're really mad.
    While in nursing school I visited my mother in CCU. Every time I was there, none of the clinical staff spent time to talk to me about my mom's condition. They were busy like you too. For the 10 mins. I was allowed, I sat at bedside holding my mom's hand. Twice, a middle-aged lady tech came by to draw blood. On my 3rd visit , she came again. After drawing my mom's blood, not a word uttered, the lady tech held my arm for 2 seconds before she left. It was very very comforting. Twelve hours of nursing lessons was not necessary. My mom didn't pull through. Hopefully she passed away in peace.
    Originally posted by NurseKrissy Ummm were you there, because I didn't see you in the room? Are you sure you are a nurse?
    I wish I was. I would have taken the time to appease you, because I'm a nurse like you too.
    Originally posted by NurseKrissy I thought this site was a place for nurses to support each other, not eat each other alive.
    So you found a place to ventilate, now you can go back to the families and do it again whenever you get irritated. I listened to you vent but condoning a co-nurse's insensitivity is not my forte.

    That's why I like this place... everyone gets to bring out their own opinions.
    Last edit by Talino on Jan 31, '03
  4. by   cindyln
    I think people should lighten up on each other. It is true nurses eat their own. Let's step back and take a deep breath before typing anymore mean and insulting replies. And that goes for the senior as well as the junior members here.
    The opinions I said I said to you were opinions..... Nothing was flaming or bashing to you or your work ethic..... but however you seem to think that it had been. Maybe you have something else going on? Who knows.... as you put it "Whatever"....
  6. by   altomga
    I feel that some of you are being a little harsh on this forum not for us to vent our feelings? Ask questions? Get advice? I feel for every family member that visits my patients. (I work Step down Medical ICU and have 1-4 ratio) I attempt to get the visitors to abide by the visiting policies and one person IS ALLOWED to stay overnight. There are those family members that cause more trouble than good...we have all been there. Would you prefer we tell these people what is really being said inside our heads or vent them out here with people who will understand we aren't devils; we are nurses attempting to CARE for OUR patients ! Have you never had the subdural hematoma patient that is supposed to be in the dark, quiet room and the family comes turns on all the lights, blares the T.V., and starts having a "party" in the room? Are we supposed to allow that b/c the family "cares" and "wants" to be there? This occurs even after the entire P.O.C. has been explained and the reasons for the quiet/dark room. Some families really just don't give a rats a**! They are "just there"!!!! Hospitals have reasons for visiting hours.....PEOPLE ARE SICK!! I do believe in the need for family to be close and visit to help with the healing, but the sick also need the rest to heal!!!!!! GEEEEEEEEEEZZZZZZZZZZZ......I guess some of you have never had the druggie/drunk's wife/husband bring the addict their craving and then refuse to leave. Or attack you in the hall b/c you asked politely for a visitor to leave b/c visiting hours are over !! Or be blamed that it's your fault a patient is agitated, increased HR, and restless (couldn't be b/c they had way to many family members in the room having a agrument! How about a family member requesting you to "drug" the patient b/c THEY themselves want to sleep and the pt is bothering them Get over it!
    Zoe,,,,you did the right thing. It still amazes me how some families think I can do my job to the best of my ability when I am having to intervene with their squabbles, inappropriate interactions with me and the patient and plain stupidity. No none of us expect the family to know what we do, but they could listen to us when we explain something to them or give them educational material to read. Or is that just My Opinion?
    Anyway..continue to be your patients advocate. That is one thing I remember from nursing about you guys??
  7. by   Sally_ICURN
    Originally posted by NurseKrissy
    I just think it is fascinating how a reasonably stable situation can worsen tenfold when you are struggling with the family. Maybe I was harsh in asking them to leave but it was certainly in the best interest of my patient.
    You did absolutely the right thing.
  8. by   KRVRN
    Our unit (NICU) is open 22 hours a day. Usually not a problem. A problem we do run into is that we occasionally have parent(s) that stay late into the night and snooze at the baby's bedside. We have trouble drawing the line. If they were awake and sitting there, there isn't a problem. But if they fall asleep then they truthfully shouldn't be there.

    We have no unit policy on this. Our policy states when visiting hours are but nothing else. It doesn't specifically state that a parent CAN'T come if he/she is drunk or stoned but we obviously won't let them in. Sleeping is different. Since it isn't actually on paper anywhere we have trouble with this sometimes. If a parent claims "other nurses let us do it" what can we say? No one can prove or disprove that. If they aren't in the way maybe we should let them do it.

    *sigh* we were just dealing with this the other night. These parents don't have reliable transportation and don't visit much and were finally able to ride the bus down and ended up staying until about 0400. We kept arguing with them about not sleeping there, but didn't have anything on paper to back it up. Maybe we should have just let them sleep...

    What would y'all do if the family wanted to sleep at the bedside? Our unit is all open so one bedside is about 5 or 6 feet from another. These particular parents had twins and were sitting in-between their beds.
  9. by   NurseKrissy
    I'm not arguing with you anymore Talino. If you care to notice the majority of replies are claiming that I did the right thing. Yes I'm pissed, you were extremely rude! I don't know what your problem is. Just leave me alone to vent to people who care to understand.
  10. by   catrn10
    Wow, this one sure split people right down the middle. I'm afraid I go along with the venting crowd, rather see it done here than at the bedside. I have had families I have spent much time with explaining things (and I mean everything), only to have them repeat the question over and over, etc. I give try to match my explainations to their level of understanding, but sometimes, they are so torn up, they never get it. Sometimes, they hear what they want. Sometimes they have a family reunion over the patient, or the infamous"I care more about Momma because I...) fights. Sometimes, you can't wait until visitation is over and neither can the patient. I'm afraid I don't care for open visitation, I used to think it was a good idea until I got trapped in a 3 bed ICU with a patient in DT"S who had a daughter that refused to belive it was DT"S because"he has been in jail plenty of times and never had them".,and believed that it was the drugs we had given him. She insisted that I transfer the patient to another facility and jumped the Doctor about it when he came in. The patient had no insurance, so you know how far that went. Then she insisted that the violent patient be unrestrained, and be given no sedation, the Doctor agreed as long as she stayed at the bedside. I had a lovely night. So did the other 2 patients in the unit. It was bad all the way around, none of the patients got any rest. And by 0300 the daughter was asking me to "tie him up and give him something". Before you start, I did call the supervisor and the Doctor to tell them that the OTHER patients were having problems resting due to this patient and the daughter, but as the Doctor had said she could stay(She also mentioned lawsuit), I got NOWHERE. I don't work there anymore. I work in nice ICU's with visitation hours now.
  11. by   Chiaramonte
    That was a good vent, and I have to agree that sometimes visitors impede your ability to complete your care in a timely manner.
    You did the right thing by asking them to take a break from the action, as they probably needed time to get away from the situation themselves.
  12. by   Pamelita
    Don't you just love when 20 family members come in the room and don't want to move??? ha,ha we don't have visitor hours at all!! there is family members that come every day and stay from 8am until 6pm they do 12 hours shifts and then another comes in and since we are long term vent-facility we see them for months even years!!
    What upsets me the most is when there are obese family members and you ask them to move so you can get through your patient and they look at you like saying can you just get by me????? like there is enough space??? they kill me!!
    I always try to be nice when I ask them to leave the room, some people don't like it some people don't have a problem, but YOU are the nurse and you have the power to do it. I never forget that.
    family can be the heaviest thing in an assigment..
  13. by   shoelace
    Wow, this was quite inflammatory. I agree with the consensus that NurseKrissy was just venting. I'm sure she took her anger out on the board instead of the family. Everyone knows that families show their concern in different ways, and even if they are showing it not to comfort the patient, but themselves, they are human and that's how it goes.
    On the topic of visiting hours, my manager always says that the patient does not belong to us. They are on loan to us so that we can help heal them and we have no right to separate them from their families, unless THEY want it, which clearly your patient did. Our visiting hours are open, there is no limit except at the discretion of the nurse. There's no 10 minute every hour rule or anything. Of course we have had problems with some visitors, but we handle it case by case. Would asking the 3 visitors to stay in the room, but try not to bother the patient have been effective? I know that sometimes they simply don't listen, or would agree to comply only to restart 5 minutes later.
    When I'm exceptionally busy, sometimes I tell a family that is demanding a lot of my time that I'm very interested in answering their questions, and that right now my main focus is on their loved one because they are requiring a lot of attention. I then assure them that when I get a few minutes, I will address their concerns.
    Then I carry on with whatever I need to do with my patient and when I find a few minutes, I go straight to them and give them an overview of why I've been so busy with that patient and what I'm doing about it.
    The key is telling them that you're interested/eager in helping them understand what is going on. Sometimes all it takes is 5 minutes of undivided attention to help calm them. Sometimes it takes more.
    I agree with NightMoonRN in that in asking family to leave, they will sometimes respond to the old "go get rest so that you can effectively be here for the patient," and it is the truth... They do need to take care of themselves and just want to know that their loved one is being cared for.
    Unfortunately, you had about 3,000 things to get done, and had another patient besides. We're only human. You did the right thing, both in asking the family to let the patient rest, and in taking your frustrations out in an arena that should be comforting and supportive.