On two occasions we have had "helpless" visitors come to our floor. What do you do in these situations.
1. An older wheelchair boud lady was brought by her son to visit a patient and essentially abandoned. It was in the evening and she kept saying he was supposed to come back and get her. She was incontinent at times and needed assistnace to transfer to the toilet when she wasnt having incontinent episodes. Our asst nurse manager was able to contact appropriate family the next day to come and get her if I recall...but for that night a tech assisted her.
2. A morbidly obese woman...over 400lbs came to visit her mother. It started with the ER calling our floor and asking if someone would wheel her from there to our floor because she wasn't able. We did not and security brought her to the room. At some point the woman needed tp use the bathroom and could not get up. Eventually security + 3 staff got her on a bariatric bedside commode and back into a wheelchair with much difficulty. Our night supervisor warned after this incident that if injured the staff wouldn't get workers comp and also assisting someone is entering into a contract with them and we could be liable for injuries.
My question for the 2nd one is how did this lady even get from her house to a car to the hospital and in a wheelchair anyway. Of course no one asked. And for both we are busy as it is without having essentially another patient needing full assistance but these people were helped as not to be cold.
Specializes in Trauma Surgery, Nursing Management.
I don't know how it all ended but I'm thinking she stayed all night..not 100% sure.
It was really a mess...6 people to transfer her.
Everyone was probably scared of this type of response if help was refused: "it's a hospital; I thought you are supposed to help people."
The scary (all of it is scary actually) part is that since she did have assistance to toilet, she will expect it again. Then if it is refused, she will more than likely complain. However, that may be a blessing in disguise so that "the powers that be" can intervene. Is the pt still in your census?
Funny you should ask..this has been weeks ago maybe even 2 months but the VISITOR was admitted with DVT and A-fib a short time ago and transferred to our floor recently (general medical). The patient went to a nursing home 1-2 days later from that incident if I recall correctly.
I could not place her face at first but then I remembered her as the visitor that needed more help than the patient.
2. A morbidly obese woman...over 400lbs came to visit her mother. It started with the ER calling our floor and asking if someone would wheel her from there to our floor because she wasn't able. We did not and security brought her to the room. At some point the woman needed tp use the bathroom and could not get up. Eventually security + 3 staff got her on a bariatric bedside commode and back into a wheelchair with much difficulty. Our night supervisor warned after this incident that if injured the staff wouldn't get workers comp and also assisting someone is entering into a contract with them and we could be liable for injuries.
In this case, your beef is with security. They should never have assisted her to the floor in this manner. If a visitor cannot get where they're going on their own, they need to provide their own helpers or stay home. If anything had gone wrong in assisting this woman with using the commode, not only would you not have been covered for your own injuries, you could have ended up being sued.
If security pulls a move like this again, I would head them off and say, "Sorry, but unless you folks (the security staff) are willing to take care of her, she can't stay." I'd be willing to bet they would see things differently.
Everyone was probably scared of this type of response if help was refused: "it's a hospital; I thought you are supposed to help people."
This post has really made me think today. I imagine that we've all come up against various similar visitor scenarios. I seriously doubt that there are many of us who wouldn't want to help if it were within our power and didn't take away from our patient care. The elderly spouse of the patient who sits steadfastly at the bedside until she starts zoning out from low blood sugar because she isn't leaving her loved one in order to eat, the emotionally distraught spouse who needs a little extra TLC and a little quiet time....
But there have to be limits! Can you even imagine the PR nightmare if that 400# woman had been told that no one could push her up to see her mother? Or if no one had been able or willing to toilet her?
"TONIGHT ON THE 11:00 NEWS, HEAR FROM A WOMAN WHO WAS FORCED TO SIT IN HER OWN FECES BY UNCARING HOSPITAL PERSONNEL!!!!"
I don't know what the answer is but I am glad to see the responses from others who show that their hospital has a policy in place to take care of some of the issues..
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
maybe it's because i'm old and cranky, but i do not take care of visitors. at all. unless they dfo right in front of me.
since we're not allowed to have food and drink in the room (staff or visitors -- it's just plain rude to eat or drink in front of someone who's npo, and since we have six patients to a room, someone is always npo) i don't fetch drinks for visitors. the cafeteria offers drinks. i don't fetch food for them, either. if they bring in their own snacks, they're welcome to go out to the waiting room to consume them. same goes for their starbuck's.
if a visitor wants a bp check or a glucose check, they're directed to the er. amazing how most of them really don't need their bp or glucose checked after all. if they have a headache, they're free to go to the outpatient pharmacy or the gift shop to buy themselves some tylenol, and if that's not an option there's always someone in the waiting room. (if you trust something that comes out of some of those purses.) any visitor who cannot propel themselves into the unit on their own steam or toilet themselves(or bring their own helper) ought not to be visiting in a hospital. if security brought them up anyway, security can take them back to where they found them. or anyplace else they deem appropriate. unless there are special circumstances and it's been arranged in advance, we don't allow children or the helpless to visit.
my pet peeve is staff who offer visitors their own chairs to sit on all danged day. first, the staff then have no place to sit to chart. second, if you then don't offer your chair, visitors complain about your customer service skills -- even if you explain to them that after back surgery and knee repairs you're no longer able to stand up all day. third, our chairs have wheels. offering a visitor -- especially an elderly one -- a chair with wheels is a bad idea. a really bad idea. i've seen some really bad (and expensive) outcomes from that. nevertheless, the newer nurses continue to do that. they're trying to be nice. how nice will it seem when the patient's spouse falls off the chair, breaks a hip and sues you? fourth, once the visitor is camped out at the bedside it's almost impossible to dislodge them when you need to do care. or when someone else in the room is having a sterile procedure.
maybe i'll start a thread about visitor disasters . . . .
When I have time, I am happy to get drinks for a visitor. We are a TINY hospital and our "cafeteria" has all of the cups and drinks and things like that locked in the kitchen. Getting them some water or iced tea is no big deal...and is usually very appreciated. I won't make them a sandwich or give them a slice of my pizza though...and no one really expects that here...at my previous hospital, they did!
I was once asked to take a very large and very incontinent wife of a clinic patient to the bathroom and give her a bath. My supervisor did make me take her to the bathroom and I did some good peri-care, but that is it. I've given the son of a dying patient half of my sub (again, a small hospital with no cafeteria in the middle of the night). I won't change the infant son of a visitor and I won't warm his bottle or fetch him some formula from the nursery. I will get independent visitors blankets and pillows when they are staying with their loved ones all night. I refuse to check blood pressure, blood glucose, or incisions of visitors.
I would feel sort of guilty if someone wasn't able to visit their dying loved one because there was no one to care for them, but when did people get so self-centered and expect us to take care of visitors as well as patients?
Wow, this thread is eye-opening (new RN here, just had my 90-day eval). I hope I never encounter some of this stuff, but my thinking is that I will. For the past three days, I have had a particularly "whiny" patient (sorry, but he is) with a militant and diligent cadre of family who is constantly in the room. I have to step over them to get to him, and I have to get to him a lot (40 mg Lactulose q.i.d.). They don't budge and I am too new to really know how to tell them to shove off...
I agree with the other posters, though... send the poor elderly person to ER and call Security to deal with the 400# visitor. I'd rather get fired for poor customer service than to get insured and/or sued.
I had a patient once whose daughter was visiting. She had some sort of disability that made walking difficult. She used a walker or wheelchair if she was tired. I think there was some mental issues going on too. Someone had dropped her off to visit mom. No one came back for her. Luckily the bed next to her was empty since her mom was on precautions. She was going to stay there as a last resort. She did have to call the "old man" to let him know what she was going to do. I'm wondering why the "old man" couldn't come get her, but I figure he was probably as bad off as her. I did call the supervisor and eventually got her a cab voucher. But then someone had to wheel her down to ED.
Security is really nice about helping people in wheelchairs get back to their cars. Our hospital is huge and it is quite a walk for anyone.
It is just inappropriate to leave a family member to visit in the hospital if they can't take care of themselves or get home. We are stretched too thin to be taking care of everyone. I honestly wish I had the time...but I don't.
I will get drinks, blankets, reclining chairs, pillows and snacks for family members. The lengths I will go depends on the circumstances.
We get elderly visitors left by family every couple of months. The usual scenario is the hospitalized patient is the main caregiver of their disabled spouse. The adult children just seem to assume that we will care for both.
"Oh (s)he won't be any trouble."
Or they just leave them.
They are informed that this is abandonment and adult protective services will be called.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I don't know how it all ended but I'm thinking she stayed all night..not 100% sure.
It was really a mess...6 people to transfer her.
Everyone was probably scared of this type of response if help was refused: "it's a hospital; I thought you are supposed to help people."
Very tired of this ridiculous thinking. Helping people doesn't make us idiot martyrs. Well, anyway those of us who don't think in this dysfunctional way.
Caffeine_IV
1,198 Posts
I don't know how it all ended but I'm thinking she stayed all night..not 100% sure.
It was really a mess...6 people to transfer her.
Everyone was probably scared of this type of response if help was refused: "it's a hospital; I thought you are supposed to help people."