Hovering Family Members

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Specializes in LTC.

What do you do with them?

We have one patient at my LTC who has a family member there 24-7... they come in shifts. They are ANXIOUS. They call each other constantly with "updates" like "Sarah just ate 3 bites of yogurt!" or "Sarah's temperature is 99.5!!!! I think you need to come down here!!!!"

They want care provided by 2 CNAs (whether or not 2 are needed for the task at hand) at very precise times. If you're 5 minutes late they practically have an aneurysm- they're never hostile but they'll put on the call light and hover in the hallway and flag down anyone who walks by. This is after supper when call lights are going off like crazy and people on alarms are jumping and there are only 2 CNAs on the floor. They seem to think if she doesn't get put to bed RIGHT NOW then something terrible is going to happen to her. They take everything way too literally- like I'm sure when they first came here that someone explained to them why we were repositioning her, so now as a result they think that if we're 10 minutes late turning her that she's going to have a stage 4 decub by the end of the night.

They used to leave the room during care but lately they've been staying in there to hover. It makes things really awkward because the visitor on our shift alternates between jumping up gasping over the slightest little things and cooing from across the room at her family member and saying "I'm HERE, Sarah." Tonight she was hyperventilating over the hoyer lift and how she doesn't trust it. It's a machine specifically designed for the purpose of moving people! Physical therapy would not have care planned it if it wasn't safe!

They are driving me CRAZY! I wish someone would give them a Xanax or 3.

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Specializes in LTC.

Oh and they also take every opportunity they can to "educate" us on pretty much everything, including but not limited to basic nursing care that we do with everyone every day, our facility's P&P, and even directions to stuff in the facility (I KNOW where the linen closet is- I WORK here!!!!!).

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i have had a bunch of those in my cna days! and beleive me you will have more. theres a few things you can do, you can just be patient and deal with them or talk to your charge nurse about them being in there while doing cares especially when you are using the hoyer, a lot of the time we requested that the family leave while we are doing cares and let them come in right after we are done, granted all they did was stand at the door and listen to what we were doing. just be extra careful on what you say and do when you think they arent around or if you do ask them to leave cause like i said more than likely they will be standing by the door.just stay calm and make sure you get this residents cares done first. it may seem like a pain in the butt, if you are good to them it could pay off! best of luck!

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Specializes in LTC, Home Health.

Yeah, I had to deal with a lot of people like these when I worked in a LTC. We had SEVERAL families who acted like that. This nursing home was located on the border of a "Posh" neighborhood. We had people in the hallway having fits because their loved one's pillow wasn't fluffed high enough....while someone was coding in the hall! I even had a family member demand I get salt for her mom while her roomate was coding!!!

Have you tried to nicely ask that they leave the room? I would definately alert the charge nurse about the "hovering". That could affect the quality of care the patient receives as well as it beeing privacy issue. How do you think the patient feels about all the spectatership?

I understand the family probably feels bad that they had to put their loved one in a nursing home. It sounds like maybe they should be a little more pro-active as well. We would try to "educate" these types of families because often they are tracking you down for something so simple..they could do it themselves.

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Specializes in Alzheimers and geriatric patients.

Yea, it can be a pain in the butt. One of my residents sisters is ALWAYS there, complaining about stuff. She once yelled at me becuase her sister wanted to go to bed (VERY heavy woman on a hoyer) and it took me 7 1/2 minutes to get there. Yes- she timed me. I mean, give me a break, I can't just drop everything and come runnin.

We aren't allowed at my facility to ask family to leave the room. It is considered rude or something. The best I can do is ignore them.

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I've had that happen to me when I worked LTC. I HATED it. What I did was I would ask politely if they could please step out of the room so that way we could provide the care for the patient. If they fussed about it then I'd explain that it's a hazard to have a family member hovering at the door way because if there was a code called and the nurses had to come right away then they run the risk of being ran into. That usually did it for us. But sometimes you had those family members who wanted to be there for everything and what I would do was I'd have the bedside table blocking them with the patients stuff there and then me and the other CNA would move around purposely to show them that they're IN THE WAY. After that then they would take the hint and they'd leave and stand outside the doorway.

I had a man who would do the same, he would time us until we get there and then I'd come back and state "Oh wow I'm getting better, I finished that last patient in 6 minutes. Now lets see if I can break that record for the day". I was sooooooooooo sarcastic back in those days but now I'm not that way so much. There's better ways of wording things.

What I used to do when a family member would yell at me because I didn't drop what I was doing with my current patient in order to go fix their family member was I would tell them "My charge nurse is yadda yadda yadda, you may go speak with her and voice your concerns, I encourage you to do so." and then I'd leave it at that!

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Specializes in LTC.

Last night instead of bringing the hoyer into the room I stood in the doorway with it, while my partner kept having to squeeze around this woman, who was to get things ready and ended up chasing her into a piece of furniture. The visitor was like "umm, maybe I could stand over there? Or there?" and we didn't really say anything in response. I remained standing there with the door wide open until she got the hint to LEAVE. Not only is there not enough room for an extra person in there, but she gasps and startles over every little thing. The other night I'm trying to take the patient's shirt off. It was a tanktop. You know how normally you take the arms out one at a time and then the neck... well I go to take her arm out and she goes, "ahhhh omg!!!!" like I was killing the patient. She runs over there and starts taking the shirt off herself, only she can't do it so she's just fussing for 5 minutes while I'm standing there. Anytime I tried to touch the patient she would gasp. So eventually I just butted in and took it off. I thought she was going to have a nervous breakdown when I pulled it over her head. Hello? It's a shirt. You have to move the person's body to take it off, unless you literally cut it off. It doesn't just dissolve.

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Ok, now that's preventing care of other patients by her doing that. It's time to go to the higher ups and have this put to a stop at once! You really should complain to them and let them know that it's preventing you from doing your job and by the family member interfering and stepping in is taking time away from other patients having their care. I wouldn't put up with that, there are ways to get them out of the room. That would be one patient that I would REFUSE do have. I wouldn't refuse care, but I'd do my best not to take that assignment.

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Specializes in LTC.

I AM refusing care from now on.

Tonight was totally crazy. We didn't get this patient into bed as soon as the family wanted it and we didn't pick up her dinner tray fast enough. We had a very good reason for not getting in there on time and I explained this as politely as I could and told her that we would get in there as soon as possible. Well that ****** her off and she started hounding the other CNA about it and was basically told the same thing. Then when we did go in there to provide care (25 minutes late) the family member was acting even worse than usual and accused us of hurting the patient! We told the charge nurse about it and she talked to her. The family member then accused me and another CNA of hurting the patient on a separate occasion and said she wrote down the date and time!

I have NEVER hurt this patient!!!! Never ever. I feel like my job is on the line... what's stopping this person from making another false accusation? I understand she is guilty about what happened to the patient that landed her into our facility in the first place but taking it out on us is not going to reverse what happened... and acting hysterical about everything just makes the caregivers nervous and distracted- not a good thing!

So tomorrow I'm telling my supervisor that I refuse to even go into that room, and why. If I don't go in there, she can't accuse me of doing anything wrong.

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Specializes in LTC, Home Health.
Last night instead of bringing the hoyer into the room I stood in the doorway with it, while my partner kept having to squeeze around this woman, who was to get things ready and ended up chasing her into a piece of furniture. The visitor was like "umm, maybe I could stand over there? Or there?" and we didn't really say anything in response. I remained standing there with the door wide open until she got the hint to LEAVE. Not only is there not enough room for an extra person in there, but she gasps and startles over every little thing. The other night I'm trying to take the patient's shirt off. It was a tanktop. You know how normally you take the arms out one at a time and then the neck... well I go to take her arm out and she goes, "ahhhh omg!!!!" like I was killing the patient. She runs over there and starts taking the shirt off herself, only she can't do it so she's just fussing for 5 minutes while I'm standing there. Anytime I tried to touch the patient she would gasp. So eventually I just butted in and took it off. I thought she was going to have a nervous breakdown when I pulled it over her head. Hello? It's a shirt. You have to move the person's body to take it off, unless you literally cut it off. It doesn't just dissolve.

For reasons such as this & your above situation, I ALWAYS ask the family member to leave the room while I give care. I nicely tell them it's a privacy and safety issue for the patient. It usually worked. Unless the relative insisted on helping us with a particular task, they had to go. I made sure the Nurse was ready to back me up, and usually they were. This almost aways ends up affecting the quality of care your patients receive. It has a domino effect too. If you spend all night trying to please one family member, other residents end up getting neglected. Then you have bigger issues to deal with.

I strongly encourage you to have a talk with your charge nurse about this family member. Often, these family members have no medical background so they don't understand what your doing is NOT to hurt the resident. There is a medical basis to almost everything we do and often, families will not understand that. That is why it is important they leave. Having them making faces and sounds at your every move makes everyone nervous and it's especially no good for the resident. Situations like this never turn out good.

I understand if you feel the urgency to refuse care to this resident. Because the family members is already beginning to throw false accusations out there, you don't want to put yourself in the line of fire. This is how good CNA's get into serious trouble. CYA. I hope it does not come to this....but it is a wise decision on your part to ask for a new assignment. This family member could get you in a world of trouble you do not deserve....

:nono:

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Specializes in Cardiac Telemetry, ED.

Yes. Definitely bring this to your supervisor's attention. The fact is that there are only so many caregivers available to provide care for many people. The time this family expects you to give their loved one should not take away from the time you are able to give to other people's loved ones.

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I would definitly take this issue to the DON and explain everything to her/him. Explain everything that has been going on and emphasize the fact that you have never hurt this patient or any other patient for that matter. If the family member hasnt taken this to the DON yet they probably will and it would be a good idea for you to get in there first. Most DON's (if they actually pay attention) know what a lot of the family members are like. If you explain the situation first then the DON might go and talk to them and request that they are not in there during cares. It is a good choice to request another assignment but realize that this isnt always possible because ltc centers are usually short on help anyways and although you are having a falling out with the family you dont neccesarily want this patient to not recieve care because then you could get in even more trouble becuase of neglect or abandonment. Its messed up but a lot of people are just out to get other people. Good luck and remember everything works out in the end. :)

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