How do I deal with patient families

NursesRmofun, ASN, RN · Mar 30, 2004

i am graduating in may 2004 and am so excited. my nursing skills are quickly progressing and i'm finally gaining confidence in my abilities. however, the hardest thing for me is dealing with families. i get so nervous when family is in the room. i somtimes avoid going into a room until family leaves just because they make me so nervous. i can't always avoid family. what are your suggestions?

with time, you will feel more confident because you will be able to give the family more facts and input, if they ask....and you will feel more confident in your skills. when you feel more confident, you won't worry as much about not having all the answers or not doing the right thing the right way. but remember, you can always refer the family to the patient's nurse or the doctor if they ask something you feel uncomfortable with answering or doing.

**canoehead, BSN, RN** · Mar 30, 2004

Time and confidence will make things easier. In the meantime, if you ask them questions to increase the patient's comfort they will quickly think you are the best nurse they've had. Simple stuff like how many pillows are usually used, window open or closed, how hard the illness must be on the family will help them feel comfortable with you. Don't be afraid to say "I don't know, but I'll look it up" Seasoned patients are well aware of professionals that try to fudge an answer, and they will trust you for being honest.

CCU NRS · Mar 30, 2004

I suggest two things

1. Go in and make a connection.

I mean when family is there just go in and open a dialog. Introduce yourself and that you are (add family member here)'s nurse this shift. I see that you are having abdominal pain when did this start etc.? Then ask the family if they have any questions and just get comfortable with them.

2. Ask them to leave whenever you do any interevention.

Just explain I am here to do so and so and if you wouldn't mind I would like you to step out for a moment. If they ask be honest and explain that you are adept at starting IV etc. but it's just that I get a little nervous with people in the room!

If you are good with people just extend on your people skills and make people at ease but also make your wishes known, with time it won't bother you for people to be in the room but it can never hurt to ask family to leave just in case one is a fainter at the site of blood and then you have an incident to write because they fainted and fell LOL

RNSuzq1, RN · Mar 31, 2004

I am graduating in May 2004 and am so excited. My nursing skills are quickly progressing and I'm finally gaining confidence in my abilities. However, the hardest thing for me is dealing with families. I get so nervous when family is in the room. I somtimes avoid going into a room until family leaves just because they make me so nervous. I can't always avoid family. What are your suggestions?

Lesley, I've wanted to be a Nurse for 20 years - spent 6 years in the Navy as a Corpsman, but going for my RN (with children, work, etc.) kept being put off.

It wasn't until my Mom was dying from Emphysema 2 years ago and I saw how the ICU Nurses treated her - that I finally decided I needed to do this and try and make a difference. Sorry for the length of this - but hopefully it will help you understand how "very important" you will be to your patients families.

I ended up living in my husbands home State - 700 hundred miles from my family. 2 years ago, My Mom ended up in the ICU (end stage of emphysema) and I had to rush home. I won't mention the hospital - but it's one of the very best in the Boston area - assumed she'd get top notch care. I knew the ICU was a busy place, but I spent almost 2 weeks at her bedside and was "shocked" at how poor the care she received was. My first day there I saw that Mom was slumped down in the bed gasping for breath (despite the oxygen) - told the Nurse she needed another pillow or two to prop her head up to ease her breathing. The Nurse came back an hour later with a pillow, tossed Mom's body forward - threw the pillow behind her and "literally" shoved her back onto the bed and said "there - that should do it" and ran back out of the room. Mom had just come off a vent. and wasn't able to talk - but just the look in her eyes said "please help me". I had many questions to ask the Nurse, but she vanished in a split second.

My brother and his wife are both Nurses and we ended up doing a lot of her personal care because when something needed to be done, the Nurse always said she'd help us in "a few minutes" but it always turned into an hour or more. What upset me more than anything was when the Nursing Staff was in her room for a few brief moments and would talk about her (like she wasn't there). For example: She was on a Vent. for a time and they'd say how bad her numbers looked and didn't see her lasting much longer. Good Lord, she could still "hear" very well - you can't imagine the panicked look on my poor Mom's face - she was totally flipping out and looking at me and my siblings for some answers - am I dying, is this the end, someone tell me something - it was horrible. Mom's Pulmonary Doc was an absolute *** - he wouldn't discuss her condition with us, said he only dealt with the patient, not the family. Since she couldn't talk and ask him questions - he wasn't a bunch of help.

One night after leaving her room I realized My Mother - who nursed me, changed my diapers and danced at my Wedding, My Boys Grandmother, The Very Best Friend I've ever had, The Woman I told all my secrets to and who loved me more than life itself - was dying and there wasn't a damn thing I could do about it - I can't explain how overwhelmed I was. I got as far as the Nurses Station and started to collapse (total panic attack) - an "Angel" named Cathy caught me before I hit the floor and took me into the Nurses lounge. She got me some juice, let me cry my heart out and spent a long time talking to me about Mom's illness. She was the first person who took the time to talk to me about what was going on with Mom and helped me understand how bad her condition really was and the end was near. Cathy was the reason I decided to finally pursue my dream of Nursing - that's the kind of Nurse I want to be - someone who goes the extra mile and understands that the patient lying in that bed has a family that is also in pain.

I called Cathy in the ICU after Mom's funeral and thanked her for all she'd done. She said she rarely got thanks from families and never from families of patients who had passed away - said it made her day to know she'd helped me that much.

Again, sorry for the length. Just wanted you to realize (especially dealing with critical patients) how truly helpless the family feels and any little kindness you can show them - goes a very long way. Susan

orrnlori, RN · Mar 31, 2004

This is beautiful story. I know this will stick with you for a long time and make you a wonderful nurse. I'm only sorry that your mom's care was so callous. Good luck to you.

MG-NotANurse · Mar 31, 2004

Hi, Lesley Girl.

I found this site while researching CVAs and end-of-life issues regarding a family member. The nurses on this site were extremely generous with their support and advice.

I don't think I can improve upon SusanNC, but, as a "family member," can I suggest the following:

1. Always introduce yourself.

2. Within limits of confidentiality, answer questions, and, if you don't know the answer, say so. It doesn't take any longer to be polite.

3. Remember that family members really can't be in the hospital 24/7, much as they would like to. You will probably be short-staffed, but guilt is the last thing that family members need.

4. Remember that family members will be seeing loved ones in discomfort, distress or pain, and, for better or worse, you will probably be the person "on the spot." Believe me, a little kindness REALLY goes a long way.

Thanks for letting me put in my 2 cents. Good luck to you!