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?
Another form on note taking the other day a family member was taking pictures of the patients vitals. and then the wife on one of the patients took a picture when I was putting on his id band which had mysteriously disappeared along with the ER band that everybody gets. She was raising such a stink I went and put another on the patient and then she clicked and took a picture whatever... I dont think that they are suppossed to take pictures. I have also heard that some patients leave their phones off the hook so that family members can listen when staff comes in. Society has gotten really strange if you ask me. I agree with the other poster who said makes you want to get out of nursing. I am sure it is worse in the ICU where the patients are really sick.
Taking pictures of you putting on the arm band?! That's just too much.
Overall, I think it's silly. If you want to make a list of questions to ask the doc next time he/she comes in -- that's GREAT. But to make a list of everything going on -- I mean -- I think it's a bit of overkill. What about the patient lying there? Isnt' there something pro-active they could do to help the person, rather than to sit there with a notebook documenting something that's already being documented elsewhere?
I personally can't stand it. I often see it with the guilty family member who hasn't taken care of the family member on a daily basis -- usually the one who "flew in" from across the country to "take control," etc, etc. If you want a list of meds, I can print that out for you. I have hundreds of educational handouts also on the medical condition -- but to "document" a play by play? I think it's ridiculous in light of the fact that we usually have 4-5 other patients we're caring for and can't get to every call bell within seconds .... I think it speaks to a very paranoid society, and sadly, a litigious one. All reasons why healthcare is so screwed up to begin with . . .
I had a patient like this one last week. Gobs of family members in round the clock, couldn't trust us to care for their 88 year old mom for 5 minutes, would complain if we took longer than 10 minutes to do anything. Never mind the other patient in the room who also needs us . ..never mind the other patients on the floor -- all that mattered was THEIR mom -- I know it's human nature, but it's selfish behavior.
i hate the whole notebook thing. i also hate when they stare at the tele monitor and come to the nurses station for every fluxuation. i understand being scared and concerned for your loved one, but like the op stated it really doesn't make you want to care for that person.
Specializes in private duty/home health, med/surg.
Wow, I guess you guys would really hate me. I'm probably the one who gave them the notebook.
Seriously, if my patients and their families haven't brought their own notebook I will give them paper and a pen to keep at the bedside. I encourage them to write questions that they think of throughout the day for their physician.
So many MDs breeze in and out in a few minutes that it leaves your head spinning. What about the poor saps who have multiple consulting doctors? Why not give the patients a tool to help keep track of the doctors?
I will write down pertienent labs for them -- for example, if you're my patient and you're in with a GI bleed you will know what the normal Hgb range is and be able to compare it to your latest serial Hgb drawn.
Seriously, I come from a "notebook" family myself. We're not looking to sue, but there are just so many of us and it helps us keep track of what is going on. It was very helpful when my dad had surgery a while back. He's getting up there in age and has STM deficit, especially when under stress. We were able to point to him when his last pain med, antibiotic, etc. was given. When I had my children my family kept track of my labor progress and I have the notes to this day. It's very special. When my daughter had a 2-week hospitalization for brain surgery we used notes we took to keep her CaringBridge blog updated for gobs of friends and family to follow along our progress.
I understand feeling unnerved if the family seems hostile or is monitoring your every move. But try looking at it from a positive point of view and assume that they have good motives.
Everyone of our patient's receive a pad and pen on admission to our hospital. It was intended as you mention to write down any questions they might have and want to remember. Or tests results if we haven't already given them a copy of them.
I was told by Risk Management that family members are NOT allowed to take pictures in the patient's room. I had a family member try and take a picture of me providing care and told them that I had NOT consented to having my picture taken, and neither had their intubated loved one.
Specializes in Emergency Dept. Trauma. Pediatrics.
I would go and alter a notebook for them and give it to them as a gift. Breaks the ice and doesn't make the situation seem so hostile anymore. Put some Medical stickers and stuff on it from the craft store. Than again I love to scrapbook and stuff so I am probably alone in this
I once worked in a LTC facility where I was warned by a CNA that one of the residents was using her tape recorder to record conversations when she goaded the caregivers into getting short with her. Her favorite activity was to wait until the CG got about four steps down the hallway, then get on the call light again. She did this incessantly. I got fed up with her snarky attitude and told her one night that I knew about her tape recorder and she could complain all she wanted to but there were three other ladies in the room that deserved care also. I then proceeded to care for the other three. From then on, I made a comment for her and her tape recorder and made sure that this person did not monopolize anyone's attention. She was angrier than all get out but the truth was that the others deserved care and it really was obvious that she tried to get people to get testy with her. I told her this. I have also worked in a home where the cameras and listening devices were set up. I conducted myself accordingly.
I don't like it. It hasn't happened very often where I work, but when it does it always put myself and colleagues on guard. These patients do get treated differently, they shouldn't but they do. If 2 patients ring the bell and one has a family that has complained it's likely theirs will get answered first.
we tend to joke on our ward, if someone says they are going to complain then show them our badge so they spell our name right.
When our son was two months old, he was hospitalized for three days with strep pneumo sepsis. Actually, he turned two months old in the hospital. I have never been more frightened in my life. He was admitted with temps >105 despite Tylenol, and was so dehydrated that his soft spot was sunk in about an inch deep. He went for over eight hours without urinating and was extremely lethargic. His WBC was over 40, and his 'lytes were all screwed up.
I was open about it with the staff though...I let them know that since his doc didn't come to that hospital, I was taking notes so when she called me throughout the day to check on him I could be sure that I was giving her accurate info. He had a bedside monitor; I let his nurses know that I did grown up tele and asked them what the norms for babies were so that I wouldn't be concerned unnecessarily. I was amazed at how very tachy a p!ssed off baby can get! I also had them leave extra electrodes and pulse-ox probes at the bedside so I could replace them as he got more energetic and started exploring the wires.
I wrote down all his feedings (we were breastfeeding) and how long they were in the same notebook, and handed it off to his nurses to copy out of. I figured, being a nurse myself, that openly sharing the notebook with them, and giving them the opportunity to see what I was documenting, would ease any feelings of fear that they had about it. I also kept track of his activity in it..."napped from 1300-1430, seems comfortable"..."wet diaper at 1500"...you get the idea.
It must not have bothered his main nurses very much, b/c they were willing to sit in his room with him for twenty minutes while I went and grabbed food on multiple occasions. One nurse even took her lunch breaks in our room while he was napping; she was wonderfully competent as well as being genuinely nice and got glowing reviews on our satisfaction survey.
I think that it totally depends on the vibe you get from the people writing in the notebooks. I've had several where the family mentioned "Oh, it's my shift, mom's gonna want to know how much dad ate" and that's totally cool. I'd rather have a continous written record for families to refer to as they swap shifts than have each new person who comes in tie me up for a run-down covering shifts that I was not even there for.
I tend to try and run with the assumption that they are writing for benign reasons until proven otherwise. I will gladly give VS, discuss assessments, etc. but tend to defer labs/EKG's/radiology etc. to the docs..."Well, I could tell you the results, but you really need to be able to understand the trend that is being established and view them in light of other results to get an accurate interpretation, which is what the doctor specializes in. So I'd rather you talked to him about it and he can give you the whole overview instead of worrying about one specific thing."
But those ones who say "What's your name? Dad was supposed to be turned five minutes ago, I want to know who you are and why you're late!" get on my everloving nerves. (I got in trouble with that one...I went in later to turn him, looked at the clock and said "oh, I'm ten minutes early, I'll be back!" NM did not appreciate the humor in that one.)
I too make sure that they spell my name right...I have a fairly common name with a uncommon spelling, like spelling "Jayne" instead of "Jane". Last names are a no-no though, we've had nurses stalked before.
I find it facinating that people complain if multiple family members ask questions about care and tell the family to communicate with each other. So the family members do - via the notebooks. And then the nurses complain about that.
I personally like seeing notebooks. It shows me that the family cares and is trying to keep each other up to date about things.
And don't be so quick to judge family members who live across the country and 'suddenly' show up at the bedside. You don't know the past hx of that family - maybe they were never informed of health problems until the pt ended up in hospital.
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NurseShelly
119 Posts
Taking pictures of you putting on the arm band?! That's just too much.