Things You'd Like To Tell Visitors . . . . and get away with it

[Ruby Vee]

the other "things you'd like to tell" threads have been so great -- how about one more?

to the daughter of today's patient: i understand back pain, believe me. i've had the surgery and was off work for six months. don't tell me you're having such severe back pain that you need to sit in my chair -- the one that reaches all the way up to the computer keyboard -- instead of the visitor's chair (which i hunted high and low to find for you since we only have two on the whole 16 bed unit) when you're walking around in 5 inch stilettos. if your back pain were really that bad, you'd be wearing danskos like me. (or any type of shoe that doesn't involve a 5 inch -- or even 3 or 4 inch heel!) sit in the visitor's chair and be grateful that i found it for you. i'm sure your feet do hurt. again, try some more sensible shoes.

yes, your daughter does have dark skin on her forehead. it's the same color as the skin on the rest of her body. i assumed that was because she was african american, but you tell me she wasn't that color before her heart surgery? i'm baffled. no, i don't know what we can do about it, but i'm sure we didn't cause it. if you want to bring in cocoa butter to rub on her forehead, that's fine with me. you can put anything on her forehead you like, but i guarantee you she'll still be an african american when we discharge her. (oh, that's a picture of your daughter on the wall? she has bangs, but otherwise she looks the same color in the picture as she does right now. if i were you, i'd be more worried about the ventilator and the left ventricular assist device.)

anyone else?

[dotherightthing]

If I'm just checking on things, making sure she's properly connected to whatever, stay in the room as long as the patient's privacy is being honored, ask me the questions when I've finished, I love patient and family education.

And if I'm doing stuff, larger tasks like repositioning, dressing etc., and you can't/won't help-it's fine, you're not obligated. But since most rooms or areas are only so big...STEP AWAY FROM THE PATIENT. and BE CAREFUL, hospitals, LTC, IN-Patient Substance abuse, in-patient facilities in general are loaded with viruses and bacteria. So tell the visitors about that very serious infection (that's surely somewhere, so you're not lying) and they will probably STEP AWAY FROM THE PATIENT.

[Trishalishus, PhD, CNS]

If doing my job costs me my job, it wasn't worth having.

so true

[Trishalishus, PhD, CNS]

Things I have said recently and repeatedly:

1) Just because your relative has advanced dementia doesn't mean she isn't entitled to good quality care - please advocate on her behalf!

2) If you don't like the standard of care, write to your local parliamentary members, join the Council on the Ageing, complain to the Aged Care Advocate Service, or the Department of Health, or accreditation agency, the CEO, the Chair of the Board and anyone else you can think of; and demand that care workers get better pay/have more qualifications so that organisations have to pay them more and hire them in sufficient numbers that they're not run off their feet and so they know what they're doing. Alternatively, do some volunteer work to lighten our load - in other words - pitch in constructively or shut up.

3) Don't apologise to me for advocating to me about your mother's care - I would do exactly the same on behalf of my mother

4) Yes, visiting your (demented) wife/mother/whoever does make a difference to her. She might not talk, but she knows you're there and you feel better for being there, and that matters, too.

In other words, what ticks me off about visitors is how scared of the system so many of them are. In aged care we need more patient advocacy, not less. And if my visitors wanted to move in and lighten my load I'd help them pack!

[Patricia1101]

And you got your MD or nursing degree from where? Oh right, I forgot about the University of the Internet. I am sure your degree in I Know Just Enough to be Dangerous will serve you well.

.

Now that's funny:yeah:

[LelaRN]

If your going to stay overnight, bring your own, toothbrush & paste, and stop asking me to serve you juice and snack it's for the patients only. I don't care if the last nurse gave in to all your freeloading, you are a VISITOR not a patient.

[catwoman1]

9 family members arrive to see patient who has been in LTC. can't understand how she became unconsious. so I ask history and who is next of kin. Sisters look like I just told them I am Frankenstien. Who has POA? No one. You put your sister in LTC because she can no longer care for herself and no one is in charge. Call the grandson who says - don't call me, call the sisters! Aaaaahhhh!

[DLS_PMHNP, MSN, RN, NP]

The juice/pop/water is for patient use only. The vending machine is down the hall. And no, I won't get it for you.

[Ruby Vee, BSN]

in my experience the type of reactions from relatives you are describing are caused by fear and feeling inadequate - as is most bluster, anger, etc. i can see that you are really upset by it, but don't retaliate because it will only escalate the problem (and make you feel worse). take control rather than buy-in. here's how: try to defuse their fear: give them your full attention - eye to eye; stop what you're doing, listen wholeheartedly to them and respond to their feelings not their words; calmly paraphrase back to them as a question to show you have understood/are listening and to clarify your understanding - (part of their frustration and fear has to do with the fact that nobody is listening to them); give them an answer that explains/clarifies/clears their confusion and offer them an alternative solution (for example - "i can't give your mum more pain meds right now because it would be dangerous and might stop her from breathing. i know you want to help her and i can see how upset you are that she is hurting. you can help her right now by distracting her from the pain. massaging lotion into her hands/feet/wherever would be really helpful to her.")

remember that we are trying to develop our person-centred practice by using all means available. one of the best, cheapest and most rewarding means available is to enlist family. 1) they stop being pains in the neck and start being co-carers/helpers who thereby 2) enable you to do more with less and thereby feel better about yourself and your practice. most importantly, 3) health and wellbeing is tied up in our connectedness to others. therefore, the more loved ones help, the better off your patient will be.

this is a vent thread -- it's for venting. if you want to give advice, please put it in an advice thread.

[Ruby Vee, BSN]

in other words, what ticks me off about visitors is how scared of the system so many of them are. in aged care we need more patient advocacy, not less. and if my visitors wanted to move in and lighten my load i'd help them pack!

i don't know where you work, but i'd love to have visitors who were afraid of -- or at least respectful of -- the system. we get visitors who know how to milk the system . . . and milk it and milk it and milk it . . . meanwhile disrespecting us, the health care staff. there's nothing like visitors threatening you with knives and guns -- both of which happened to me just last week.

[anniemm]

If you don't know what the numbers mean on the cardiac monitor don't touch the "touch screen" to find out what it does.

No you can not have a meal try for yourself 5 minutes after you get here and your "loved" hasn't even been examined yet for their shortness of breath!

[CountyRat]

c0ntagion wrote, "Can I give both your father and you some Ativan? 1 mg for the patient, 1 mg for the family!"

How much for the nurse, c0ntagion? I vote for 2 mg, then titrate to effect.

[nerdtonurse?, BSN, RN]

And I "advocate" for the ultimate nursing dream, aerosol sprays of ativan in the patient/public areas of the hospital....and a valium salt lick in the ER.