Just yesterday, a new patient was admitted. As we transferred the patient from her wheelchair, weighed her , then started her physical assessment. Her daughter had her notebook in hand. Asking each of us our names and she would write it down as she also wrote down what was being done with her mother. Mind you their were 3 of us in the room assisting with the transfer, assessment and settling of the patient. The daughter was friendly. Internally, I was saying to myself, oh oh not another one of those....
I walked to the desk and casually mentioned to another co-worker. Don't families realize when they take those notebooks out and start writing how it makes us feel? To me it seems hostile. It does not make me feel like oh boy I want to go into that room more often. My internal side , warns me, this is a room to avoid, this is a family looking for trouble.
I do not believe this is the message families want to convey. I know they are trying to be proactive in the care their loved ones receive. None the less. I can not help how it makes me feel. It makes me feel somehow like the enemy.
How does it make you feel, when you witness those notebooks and the families writing, writing in them?
lpnflorida - Oh, this drives me NUTS!!!! I have had several family members over the years when I was working med surg or on a LTAC vent unit do this, and it wasn't stuff like vs, or questions they wanted to ask the MD when they made rounds, or dietary intake or questions regarding these things. That type of thing I would have no problem with whatsoever. I have had some family members actually write down part of my assessment (my auscultation of lung sounds, ect). They would be like, "Well, how did Mom's lungs sound to you?", then as soon as I started talking, they were busy scribbling on their pad and then say something like "Well, ___ (Insert Nancy nurse RN) said she heard _____ last night. Why didn't you hear the sounds that she did..." almost accusatory sounding like Nancy nurse did a better assessment or ....___.
We have had some family members go to the team leader's office with their little notebooks and complain about little things even a little difference in nurses uniforms or something nitpicky. It wouldn't be something pertinent (at least not in my opinion) but even stuff like that the nurse wouldn't get Mama 2 extra packs of mustard ...
I know I'm running off at the mouth here, but that kind of thing just makes me want to pull my hair out. Like I said, the stuff that needs to be addressed, no problem. But some of the other, please!
Anne, RNC
Oh my goodness! I was reading this post and felt my face get hot. I dealt with a family just like this. They even wrote down that she missed her prn meds at 0300 and complained to the NM. This patient was AO x 3, ambulatory, the whole deal. When it was explained to them for the 100th time that the patient should request prn's if needed and the nurse doesn't offer, they wrote that down too and wrote a nasty letter back to the unit about all the staff who had taken care of her. I try to be patient and understanding, I really do. I even encourage my own father to bring a notebook to his various MD appointments, just to keep track of which doc says what. I just wish that when a patients family did this, that they'd have some discussion about it instead of writing everytime someone comes in the room to round on the pt. or bring ice chips. I've had a family who explained to me that alway carry the notebook with them to just keep track, and even apologized if it made anyone feel uncomfortable. I thought it was really nice of them to acknowledge the staffs feelings.
I've seen a few family's with notebooks, usually they just ask me for vitals. Who knows what else they write, but discretion is key. At my old job (non-medical) I had a co-worker who didn't like me and one day she yelled at me,"I've been keeping a journal on you ever since you've started working here!" like I was supposed to be scared or something. ANYWAY, ever since that patient died on the roof at my hospital and the family has sued, all of a sudden everyone else wants to jump on the bandwagon and get a piece of the pie. I have covered up my middle and last name on my name badge. Patients and visitors don't need to know that.
I don't blame anyone for covering up their last name on their badge, good for you. Unless they're being referred to by their last name, what's the point? I for one don't think its very safe. I worked in a hospital where the ED nurses were encouraged to put something on the badges to hide their last name after a number of them had been threatened.
Specializes in OB, NICU, Nursing Education (academic).
When my mother was in the hospital for A-fib 1600 miles away from me a couple of months ago, I asked my very non-medical sister to keep a notebook so that she could let me know how Mom was doing.......yeah, lab results, meds, tests, everything! Long story, short: It could be that some neurotic nurse family member has asked that this be done.....I just wanted to know the scoop!
Specializes in Acute care, Community Med, SANE, ASC.
I have found that most families are not using their notebooks for "evil" but I do understand and agree that it can make me uncomfortable.
As for the nitpickers who say we didn't do this or that for their loved one or it wasn't on time, etc., I just wish they could see some of the stuff we do do for their family member, i.e. cleaning up the 4th or 5th liquid BM of the day, washing their family member who clearly has not taken care of themselves so I appear to be washing parts of their bodies that haven't seen soap in years, etc. People have no idea some of the really nasty things we do for their family members--I want to say to them, "write that in your notebook!"
Sometimes I will encourage my pts family members to do this. I work LTC and the ones that irritate you are the nit pickers..."call bell took 10 minutes to answer" "food was touching other food on the plate" those type of things.
I have both seen in done and done it myself. I'll tell you why I kept notes: because my dad was dying and I knew it. I wasn't looking for a lawsuit; I was trying to keep a record of his last days for my mother. We were taking turns staying with him round the clock. I can't tell you how much it meant to her to come in and read," Dad woke up at 7pm, commented that he could hear the rain. Wanted a diet Dr. Pepper and a little ice cream. I went to the cafeteria and got him the soda. No ice cream, however."
We certainly did not want to upset the staff. They probably would have been amused to see the "records." My dad has been gone 6 years now, but my mother still has those notes. I'm glad the nurses weren't threatened by my keeping them.
As a home health nurse the "notebook" often reflects an involved and caring family. I also am not "afraid" of them asking my name..1. It may or may not indicate a lawsuit BUT it may be the difference that You are the nurse who helped the patient and who the family can rely on. 2. Important historical information may be told from the book 3. Clarification of the patients meds, diagnosis etc. is helpful to the family.
Sadly, it is usually not the patient that has this bright idea, but an ignorant family member that hasn't seen this pt. in months. quote]
I am sooo glad you said this. It will be something I take with me: Aside from those who are just interested in tx, even if its someone looking for trouble, separate it from the patient. Thanks.
It reminded me of a relative we have that is clinically paranoid schizophrenic. She likes to come riding in on her high horse and make everything more complicated and drama filled than need be. While one of the family matriarchs was dying she was there to make the staff's life a living.... well you know. And she made it so for the rest of the family --who neither agreed nor appreciated her actions. But once that staff was treated horribly, we couldn't undo it. There was bad blood.
So chances are: those notebook wielding visitors/family have a notebook on the patient and their infarctions, too. It will not prevent me from being careful to cover my hiny, but it will remind me to have some extra compassion for the patient, who may not like this behavior either.
Specializes in Acute Care Cardiac, Education, Prof Practice.
It is funny how post likes these seem to show up right about the time the scenario happens to me. I guess we all share the same problems a lot more than we think about.
Anyway we had, what I like to say, "a family with lawsuit written all over them".
No clear PoA on the chart, but demands to recind DNR's, withhold meds until random other doctor's from outside the hopsital could be consulted, and of course, a notebook.
The funny thing is, the notebook doesn't scare me. I do my job the same as always, though sometimes it will make me a little more congnizant of covering every crack. I.e. consulting someone to clarify resucitation orders, and charting every bit of education I do.
This last "notebook family" was entertaining, because they were so busy writing, they rarely understood the information I was trying to give them.
The "notebook" is surely unnerving, even when used for benign reasons. I have only seen one family that obviously was thinking lawsuit. They kept demanding blood cultures and Tylenol for a comatose pt who had continual fevers from a serious brain injury, until the poor thing ended up with liver damage. This same family tried to video tape care, but risk management quashed that pronto. And of course the injury was related to illegal behavior to begin with.
I recommend openly recognizing the notes, inquiring the purpose, and even offering info and explanations of nursing care as time allows. I am a little hesistant about releasing lab and test info due to HIPAA unless I have the patient's permission.
A pet peeve I have is overhearing family passing on info that's not quite right: "they put a shunt in his vein", no, its a stent in an artery.
Last night the EKG tech told a pt with a new pacemaker and his family that he didn't see any paced beats on the 12 lead. Later I heard the son tell a phone caller that the pacer wasn't turned yet, "maybe somebody has to come in tomorrow and turn it on".
Specializes in Community Health, Med-Surg, Home Health.
I think that I would be suspicious because it is a litigious society. I also understand the need for writing down labs, results, medications, diet, even the names of the doctor and nursing team, but when they are walking around looking like reporters from the Daily Planet...well, it doesn't invite one to wish to do hourly checks. Hate to say it but most people doing that in my area are ones either looking for law suits or trying to track us down like we have no other patients to deal with.
NurseShelly
119 Posts
Oh my goodness! I was reading this post and felt my face get hot. I dealt with a family just like this. They even wrote down that she missed her prn meds at 0300 and complained to the NM. This patient was AO x 3, ambulatory, the whole deal. When it was explained to them for the 100th time that the patient should request prn's if needed and the nurse doesn't offer, they wrote that down too and wrote a nasty letter back to the unit about all the staff who had taken care of her. I try to be patient and understanding, I really do. I even encourage my own father to bring a notebook to his various MD appointments, just to keep track of which doc says what. I just wish that when a patients family did this, that they'd have some discussion about it instead of writing everytime someone comes in the room to round on the pt. or bring ice chips. I've had a family who explained to me that alway carry the notebook with them to just keep track, and even apologized if it made anyone feel uncomfortable. I thought it was really nice of them to acknowledge the staffs feelings.