How to deal with those family members who are "nurses"?

systoly · Nov 5, 2009

As many others, I've been on both sides. Several family members make it a point to introduce me as "This is systoly, he's a nurse", to which I will say something such as," yes, but I'm here as your brother-in-law". I believe some of us, during times of stress, may succumb to family pressure and expectation to be all knowing, all healing, no matter what our area of expertise.

meandragonbrett · Nov 5, 2009

Having been on both sides of the bed recently.......I am well behaved when I am not the patient and don't tell anybody I'm a nurse but the family always says "This is so and so and he's an ICU RN" I don't intervene with anything unless if something serious is going on. I'm not there to work but I haven't turned the RN off either. I do ask a lot of questions though :)

As a patient...I try to be a good patient but tend to become hell on wheels when it comes to certain things. I was just recently in the hospital and I cleaned my bed with dispatch and sani-wipes before I would get into it. We all know how well those beds are cleaned :yeah:

I was also a nazi about hand washing. I did not allow ANYBODY to touch my PICC unless they had washed their hands with chlorahexadine in front of me.

Just my perspective

Orca, ADN, ASN, RN · Nov 5, 2009

I went to visit a cousin in a hospital in Canada several years ago. He had just had surgery, and he was asking me about recovery, medications, etc. I gave him some general information about how things were likely to proceed. His nurse happened into the room during this time. Rather sarcastically she said "You seem to know a lot. I suppose you're a nurse." Without saying a word I pulled out my RN license and showed it to her. She hastily apologized and left the room.

Virgo_RN, BSN, RN · Nov 5, 2009

I engage them in conversation, like "Oh, where do you work?" "Do you like it there?" "How long have you been a nurse?", "How long have you worked at XYZ facility?" etc. Often I find out that the "nurse" is really a CNA, but not always. Sometimes they really are a nurse, or a retired nurse. Sometimes it's the patient who tells me "My daughter is a nurse" because they don't understand the distinction between a CNA and a nurse, and I don't correct them. I just run with it. It's really unimportant, since the patient's safety and well being is the priority, not whether the family member is really a nurse. I let family members help with care, unless it is a safety issue, like trying to give a drink of water to Grandpa who aspirates because he had a stroke. Then I step in and educate, politely and respectfully. The other place I draw the line is with looking at the chart. I had a patient who was getting a procedure done, and I caught the daughter, who identified herself as a nursing student, reading the chart. I took it from her hands and said "I need that, thank you." in a polite tone of voice.

I once had a very complex elderly gentleman whose daughter had "a nursing background" (that's all anyone was able to get her to reveal) and was very demanding, antagonistic, and hostile. We all loved caring for the patient, as he was a very nice man who needed a lot of attention, but we hated having to deal with her. Even if we bent over backwards to please her, to be nice to her, to make her Dad our top priority, she never let up on her attitude. She must have figured she had to be a bulldog to get good care for her Dad, and that she was doing the right thing by him. She fired two hospitalists, demanded access to the medical record without going through the legal process, and many other things that just made dealing with her extremely unpleasant. With someone like that, you just keep doing your best for the patient, and don't take their attitude personally. It's their problem. Remain professional, don't let them get you flustered, and do not give them any ammunition if they decide to go after you.

In my short time in the ED, I have had lots of practice at dealing with demanding/rude family members in general. People get really cranky when there is a long wait, they will stand in the doorway and glare at everyone, they will ask the first person in scrubs that they see for a blanket or some soda, even if that person in scrubs has an armful of medications, tubing, syringes, etc. and is walking very quickly, they gripe about how cold it is, how hard the gurneys are, that their family member hasn't eaten "all day", and everything under the sun. You would think we went to their family member's home and dragged them to the ED just so we could torture them.

How I handle them is to just be polite. If they ask me for something I am able to help them with, I just say "Oh, sure, I'll get that for you now.", or something like that. If I can't help them with it, I just politely tell them "I can't do that right now, but I will be there as soon as I can.", then go about my business. If they want to be upset about it, too bad. I just let it roll off my back, because patient safety trumps everything. As long as I am polite to all patients and family members and place patient safety above all else, then no complaint anyone can ever make because I didn't get Grandma some juice or little Johnny a warm blanket, will ever be valid.

I recently have become the "supportive spouse" of my partner, who has been diagnosed with a chronic illness. At his most recent appointment, I instructed him NOT to tell ANYONE that I am a nurse. When I am with him at appointments, I am wearing my "family member" hat, not my nurse hat. Though the nurse hat is in my back pocket, just in case I need it! ;D

jbjelus1 · Nov 5, 2009

I've had a bad experience with a pt's family member who I "think" is a nurse. During report, I was told that this pt's daughter, who is the "nurse" and the wife made the day shift pretty miserable and guest relations was called and the day nurse was reported for being "rude".
Well, I work in a MICU, still in orientation, and my preceptor and I decide to be open minded about this family. I work nights and visiting hours are over at 20:30. Well, I get report and I have another pt who is considered "ICU" status, while this pt is considered "tele" status (just waiting for a bed). I'm at the desk looking up my medications and this pt's daughter and wife barged to the desk demanding to know who "my daddy's nurse is" and I need to see her "right now". My preceptor explained that we are just now getting out of report and his nurse is looking up his medications and will be in there shortly. The daughter states "well, he is wet and needs to be changed". I told her I will get there as soon as I can.
Since my other pt was the more critical pt, I went to see her first, grab her vitals and do her assessment. I then go see my other pt, and his daughter "the nurse" had taken out linen, a gown, and pads and placed them on the bed for us to change him. I went to get my preceptor because I didnt want to be alone in the room with them, and we decided I will do my head to toe assessment while we change him. We wash him up, check his bottom for skin break down, and the daugther and wife BOTH is sitting there watching us clean him up and once we turn him back on his back and change his linen, the daughter asked us if he had a bowel movement because she thinks he did! I said, we just checked him, cleaned his bottom and checked for skin breakdown, there was no stool. She says "are you sure because I think he did". I said, "you can check the sheets if you like".
The daughter is dressed in scrubs and as we are trying to bathe him and turn him and assess him, she is looking all in the cabinets, put on gloves and started cleaning the counter with alcohol wipes, took his suctioning canister out and dumped it in the SINK, cleaned it out, and wrote the date on it and placed it back in the holder! She also took his NG gradual and "threw it away" (according to her) because it was "filthy". Not only that, I was doing gastric residual because pt was on tube feeding and I put the pump on hold and pulled out the gastric residual with a large syringe and dumped the residual in a gradual so I can measure it and she tells me I shouldnt do it that way! My preceptor stepped in and told her that I am a new nurse and I am still learning and have been trained to measure gastric residuals that way. She then asks what school I went to, do I have a BSN, etc. I calmly answered her questions, but wanted so bad to tell her if you are a nurse yourself, you will understand you are making a very difficult working environment. I put the residuals back in the NG tube and turn the pump back to feed and she is standing there watching me like a a hawk. She then asks me for a blanket.
I leave the room to get the blanket and in the meantime, my other pt bp is dropping. She also have a 21:00 med due, so I grab the med and head off to her room to give her a bolus of NS, and the daughter sees me with syringes in my hand and STILL asks me for a blanket. I politely told her that my other pt is critical right now and I have to pass meds before she crashes and I'll have to get her a blanket when I'm done. She then "yells" for another nurse to come to the room to give her a blanket. It was way after visiting hours.
This upset me greatly. Something tells me this person was not really a nurse, but probably a tech. And oh, by the way, I caught her giving oral suctioning to the pt. I told my preceptor about it. Any advice on how to handle these types of family members in the future? The ones that are "nurses" or part of the medical profession?

Sometimes when dealing with difficult family members I have to remember that if the patient is really sick, then the family may feel a sense of guilt. Often times I have found that when I am dealing with family members who have siblings or children that are nurses they usually do not like to make this known because it may make the nurse that is caring for the patient nervous, especially if it is a new grad. In contrast if you find that you are caring for a patient that has a nurse as a family member and they are vey demanding, this may be a sign of power control. Some people like to have control whether they are nurses are not. Moreover when dealing with family members like this you have to remember that you can be firm in you word without being mean. If you have someone that is very sick always remember that priority comes first and if you have problems expalining things to the family members then let the more experienced nurse talk to them and observe his/her actions.

OldnurseRN · Nov 5, 2009

I'm guilty of recapping needles everytime I use a filter needle to draw lido out of a lido amp. I need to put the smaller needle on the syringe for the doctor to inject that lido and I'm NOT going to remove that filter needle without a cap.

As for revealing I'm a nurse to those providing care to my loved ones, if the situation requires it, yes I will. If my mother is the patient no need, lol. She's told everyone, from the admission clerk to the housekeeper already!

jbjelus1 · Nov 5, 2009

I engage them in conversation, like "Oh, where do you work?" "Do you like it there?" "How long have you been a nurse?", "How long have you worked at XYZ facility?" etc. Often I find out that the "nurse" is really a CNA, but not always. Sometimes they really are a nurse, or a retired nurse. Sometimes it's the patient who tells me "My daughter is a nurse" because they don't understand the distinction between a CNA and a nurse, and I don't correct them. I just run with it. It's really unimportant, since the patient's safety and well being is the priority, not whether the family member is really a nurse. I let family members help with care, unless it is a safety issue, like trying to give a drink of water to Grandpa who aspirates because he had a stroke. Then I step in and educate, politely and respectfully. The other place I draw the line is with looking at the chart. I had a patient who was getting a procedure done, and I caught the daughter, who identified herself as a nursing student, reading the chart. I took it from her hands and said "I need that, thank you." in a polite tone of voice.
I once had a very complex elderly gentleman whose daughter had "a nursing background" (that's all anyone was able to get her to reveal) and was very demanding, antagonistic, and hostile. We all loved caring for the patient, as he was a very nice man who needed a lot of attention, but we hated having to deal with her. Even if we bent over backwards to please her, to be nice to her, to make her Dad our top priority, she never let up on her attitude. She must have figured she had to be a bulldog to get good care for her Dad, and that she was doing the right thing by him. She fired two hospitalists, demanded access to the medical record without going through the legal process, and many other things that just made dealing with her extremely unpleasant. With someone like that, you just keep doing your best for the patient, and don't take their attitude personally. It's their problem. Remain professional, don't let them get you flustered, and do not give them any ammunition if they decide to go after you.
In my short time in the ED, I have had lots of practice at dealing with demanding/rude family members in general. People get really cranky when there is a long wait, they will stand in the doorway and glare at everyone, they will ask the first person in scrubs that they see for a blanket or some soda, even if that person in scrubs has an armful of medications, tubing, syringes, etc. and is walking very quickly, they gripe about how cold it is, how hard the gurneys are, that their family member hasn't eaten "all day", and everything under the sun. You would think we went to their family member's home and dragged them to the ED just so we could torture them.
How I handle them is to just be polite. If they ask me for something I am able to help them with, I just say "Oh, sure, I'll get that for you now.", or something like that. If I can't help them with it, I just politely tell them "I can't do that right now, but I will be there as soon as I can.", then go about my business. If they want to be upset about it, too bad. I just let it roll off my back, because patient safety trumps everything. As long as I am polite to all patients and family members and place patient safety above all else, then no complaint anyone can ever make because I didn't get Grandma some juice or little Johnny a warm blanket, will ever be valid.
I recently have become the "supportive spouse" of my partner, who has been diagnosed with a chronic illness. At his most recent appointment, I instructed him NOT to tell ANYONE that I am a nurse. When I am with him at appointments, I am wearing my "family member" hat, not my nurse hat. Though the nurse hat is in my back pocket, just in case I need it! ;D

I find myself doing the same thing. I do not like to let people know that I am a nurse unless I have too. It seems to make people nervous when they are caring for you. I do however keep the nurse hat in my back pocket just in case I need it, but for the most part I usually have had pleasant experiences

Virgo_RN, BSN, RN · Nov 5, 2009

I'm guilty of recapping needles everytime I use a filter needle to draw lido out of a lido amp. I need to put the smaller needle on the syringe for the doctor to inject that lido and I'm NOT going to remove that filter needle without a cap.

Yup, I recap blunt filler needles all the time, without using the one handed scoop method. Our injection needles have the little cover you slide up after it's been used, so no need to recap them. I think the poster was referring to recapping dirty needles, though.

Lacie, BSN, RN · Nov 5, 2009

Nurse or not I always ask family members to leave the room during any procedure particularly if changing a bed or bathing, peri-care, ng care, etc. During that time you wont feel there is someone looking over your shoulder constantly. Also stick to the visiting times and only permitting the amount of visitors permitted by the facility in the room at the same time. Even though they are family members a pt is entitled to his/her dignity and personal privacy. Something as simple as "I need to do my VS and assessment on your father, would you mind stepping out and you may return as soon as I've completed". I never allow visitors to stay in room during my procedures or tasks. I use the "it's hospital policy" alot!

classicdame, MSN, EdD · Nov 5, 2009

stressed or not, some people just like to boss others around. It is hard to draw the line between customer service and dealing with people who actually make your work more difficult. I think you did well and in no way do you need to apologize for not being in the room 100% of time or giving him 1:1 care.

This family reminded me of the grandma who insisted I give baby IV Tylenol so as not to wake him up again (first time being when CNA took temp and it was 103). I know she was concerned, and I had to spend precious time with her that could have been more productive elsewhere. ARGGGGGGGGGGGGG

Katie5 · Nov 5, 2009

Anybody could wear scrubs. I'm not sure that is a criteria.

I also loved something someone else said that true nurses are always

relunctant to admit so- I've found a few who were not so eager. Probably think it gives them away

Ruby Vee, BSN · Nov 6, 2009

we just had a big discussion thread on this same topic. it's really not a matter of the family member's background - it's usually a matter of loss of control. if there are actual visiting hours, you can ask security to enforce them when they get difficult.
i always tell the staff that i am a nurse; my family member has probably already told them. my nursing knowledge has literally saved the lives of two of my family. when my then-fiance' was getting levaquin and kept getting red all over, i begged them to stop giving it to him. they wouldn't listen, and the next time he got it, his bp dropped - and i turned off the drip and demanded a doctor. they stopped the med.
when my dad was desatting, and sob, i noticed that he had only 10cc - tencc's of urine output in 20 hours. i loudly demanded a doc immediately - and a few hrs later he was back on a respirator and the balloon pump.
he hadn't been able to cough up a huge mucus plug, and went into near-total organ failure.
there are other stories i could tell you - too many, unfortunately - and it makes me so sad that i feel i have to be so watchful for my loved ones.
when i was just recently in the er for my own issues, i overheard a nurse giving blatantly wrong information to a patient in order to get her to agree to a test. i piped up with a question. i saw a nurse recap a needle in the air - no one-handed scoop kind of thing. i should have called for a supe, but i was too tired to intervene.
i hope i have been a better nurse than the examples i have given here. the er things were in the past 3 months, by the way.

i'll give you the benefit of the doubt and allow as how you were under stress when your loved ones were in the hospital -- but it's not up to you to intervene between a patient who is a stranger to you and the patient's nurse. in fact -- and i'm sure you already know this -- it's a hipaa violation. as for the needle recapping incident, grow up and get over yourself. you don't have to be so watchful for "your loved ones." sounds as if you simply like being in control.