We have this pt whose just a royal pain. She refuses tx and tells her daughter shes not being taken care of, so there's a lot of manipulating going on their. But today, I was working a double 7a - 11:30p. Early this moring, the daughter asked the primary nurse how mom was during the night. Nurse told her she didn't get anything significant in report, but when she was done with her meds (we're in LTC) she'd double check. Well, this daughter then came up to me and the other nurse (rudely I might add) and asked the same thing. We told her that while we did not recieve any report on the pt, since she wasn't ours we would check the written report on the floor. The daughter requested we read it word for word. We explained that it was not open for her reveiw, but that we can honestly tell her that the mom had little problems last night. The daughter wanted to read this report, but it has every pt from the floor on there with info on each pt and that we can't show it to her. She really thought we were all hiding something, and we assured her that this wasn't the case.
Well, she left and came back at like 5pm. I was in with another pt. She cornered another (new) nurse and asked her to read from the floor report. (I don't even know how this lady came to find out we have this floor report, I guess from hovering over the nurses station so much) This nurse was flipping through and I walked up as the daughter was commenting on what she wanted to know. The daughter looked at me, and HER LOOK WAS PRICELESS. The shock that I was STILL their from the day shift. At that point she goes, "Oh I forget if I asked" and I couldn't resist, I said "you meant the same question you asked this morning?" :nono:at that point I told the other nurse that we had already been through this earlier today. BTW, this daughter can recall every and any detail, she DID NOT FORGET. She just didn't think I'd be there...:angryfire:angryfire:angryfire:angryfire:angryfire:angryfire
Little problems at night? I also would want to know what they had been. Sorry but it sounds like you guys could have done a better job addressing her concerns. Hard to say since I am only seeing your side of things and don't know what it's like with her all the time. It does get old when people hound you. It's her mom, though.
Sorry, I read it as "few" problems, not little as in small. And if the daughter had an "I'm dead meat" look on her face when she was caught, I'm willing to bet it's safe to side with the OP. Otherwise the daughter would have been justified in her actions.
mama; That's always the best reaction. She'll probably worry for weeks when she'll be called on the carpet.Had you said anything ,she'd use that against you to management( difficult family member, crazy lady,'" I didn't mock her!!!")
sadly, the nurse that let him read the chart should be turned in for the hippa violation; the boyfriend has no legal right to read the chart. as for the husband with the gun - the hospital should have never permitted him back in the hospital - he may not have a gun but he could have a knife! what were they thinking?:cheers::lol_hitti
the handful of "boyfriends" i have met who wanted to read the chart were usually the same ones we suspected of putting the patient in the coma in the first place.
Specializes in Alzheimer's, Geriatrics, Chem. Dep..
She just didn't think I'd be there...:angryfire:angryfire:angryfire:angryfire:angryfire:angryfire
This is her way of saying "I'm scared and I think you might not be telling me everything" - manipulative yes - but what if she said that directly? You might spend 5 minutes w/ her letting her voice her concerns and then giving her what assurance you can - w/o of course letting her read/hear the report read... She just needs a little bit o lovin' lol
Doesn't make ya less crazy but it might get her to stop the behavior if we anticipate her need and try to meet it. Obviously she doesn't know how to ask for it in a healthy way. She needs time and reassurance.
I know, we don't have an extra 5 minutes do we? lol - but this lady is going to "take it" one way or another - might as well give it to her.
If this is a daily occurance however we would definitely need to set the boundary that "look, we are not allowed to read the report. However I promise you that if there are changes you should know about we will keep you informed. Meanwhile I need to spend time taking care of your daughter and others who need my attention. It will be ok" (or something like that)
I don't know why I am saying "we", ha ha! but - you get the gist of it right?
Specializes in Alzheimer's, Geriatrics, Chem. Dep..
Husband came back with a handgun to "put her out of her misery." (He also threatened to put nursing staff out of THEIR misery.) He was arrested at midnight and carted off to jail, but was back on the unit visiting at 0600. When we called our manager, her response was, and I quote: "He's from Montana. Everyone carries a gun in Montana"
HOLY ...
... caught the nurse who had just left his room mocking me (I had asked for pain meds for him.)
(Mouth wide open!)
The handful of "boyfriends" I have met who wanted to read the chart were usually the same ones we suspected of putting the patient in the coma in the first place.
i was taking care of a chronic patient in our icu one weekend. after i'd done my assessment and started my charting on the computer, visiting hours commenced. her boyfriend came in and chatted with me for a bit (patient was intubated and comatose) and then casually commented, "i'll look at her chart now."
***** "i'll look at her chart now"? i explained hipaa policies to him and his response was "all the other nurses let me read her chart." once again, i explained the hipaa policies. he seemed to accept this, and since i couldn't believe that anyone else let him read the chart, i concluded that it was just an attempt at manipulation.
when i came back from lunch, the patient's boyfriend was sitting at the nurse's station, reading her chart. (and no, he was not the poa.) another nurse was sitting next to him, chatting on her cell phone, and when i commented about hipaa, she said "oh, i gave him the chart." explained hipaa to her, and explained the hospital's policy that if the patient, next of kin or poa wanted to read the chart, they would be given a chance to do so in the medical records department with an md at their side to answer questions. "oh, that's too much bother," she said. "he reads the chart every night.":banghead:
having a clueless manager does not end this situation. if the patient wakes up and is unhappy that her privacy rights have been willingly violated, she can file a complaint with the feds and the hospital can be fined. the proper action to take is to let both risk management and the chief nursing officer know about it--they will definitely want to know about this. if you don't want to identify youself, send an anonymous note through an interoffice envelope, or mail it to them, and state all the facts.
sadly, the nurse that let him read the chart should be turned in for the hippa violation; the boyfriend has no legal right to read the chart. as for the husband with the gun - the hospital should have never permitted him back in the hospital - he may not have a gun but he could have a knife! what were they thinking?:cheers::lol_hitti
they were thinking that the nursing staff, other employees, patients, visitors, and other staff, were not important enough to protect. they are more concerned with their "image" and press-gainey" reports, than anything else.
i would make alot of noise to administrtration, risk management, and yes, as i have advised previously, contact the senior partner of the law firm who respresents/defends, the hospital. get your ducks in a row with documentation, take someone with you to as a witness to the meeting, and have a nice "chat" with mr. senior partner, and the legal and ethical ramifications of the above scenarios. i guarantee that you will get results.
a call to local law inforcement and the local newspaper as to the unsafe goings on in a local hospital should also garner some action. the public expects to be safe when they visit grandma in the hospital. jcaho would also be another place to get action, along with the state department of health. jmho and my ny $0.02.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
having a clueless manager does not end this situation. if the patient wakes up and is unhappy that her privacy rights have been willingly violated, she can file a complaint with the feds and the hospital can be fined. the proper action to take is to let both risk management and the chief nursing officer know about it--they will definitely want to know about this. if you don't want to identify youself, send an anonymous note through an interoffice envelope, or mail it to them, and state all the facts.
hollyvk, rn, bsn, jd
i appreciate your concern, and would have handled it as you suggest if not for two things: the patients legal power of attorney was more upset about me putting a stop to the chart reading than he was about the chart reading itself. (another story, that!) and secondly, the patient died on the next shift.
Little problems at night? I also would want to know what they had been. Sorry but it sounds like you guys could have done a better job addressing her concerns. Hard to say since I am only seeing your side of things and don't know what it's like with her all the time. It does get old when people hound you. It's her mom, though.
Maybe I should have gone into more detail and typed even more paragraphs...The daughter got her answer CLEARLY from the primary nurse, and really wanted to read through these reports AND has been continuing the same behavior since my OP. She asks any and all staff the same questions and recently I spoke with her about addressing the primary care nurse only.
I came on here to vent about the fact that this women is being so manipulative with staff that a family meeting is in the works (since the OP). I really don't appreciate you telling me that it sounds like we could have done more.
Daughter asked me how many times a day mom is getting her ABTs.
No big deal, easy question to answer, right?
However her PRIMARY nurse has the chart, and she's about 10 feet away. I said, lets go over to so-and-so and we'll look.
Daughter tells me she just asked so-and-so and she told her 2x.
Ok, I say, so-and-so checked the chart, which is what I'm going to do because your mom is not my pt, is there any reason why you want me to check?
Because when I asked that nurse (as she points to another nurse down the hall) she said she thinks it was 1x.
I told her that that nurse should not have tried to answer, that she may have been trying to remember from other days that she had you mom, but w/o the chart and since she was not the primary nurse, the other nurse should have sent you to so-and-so, the PRIMARY nurse.
oh, says the daughter, she did. And after the PRIMARY nurse answered me, I went back to her anyway...
(I check with the other nurse who tells me the daughter says the primary nurse did not answer her, and the other nurse says that she told the daughter that she hasn't been her moms primary nurse in over a week, but last she remembers the ABTs were 1x a day, but she should check with the primary nurse to be sure because in a week, her mom's care could have changed)
Now remember I'm the third nurse she's asked...
I explained the the daughter that she must communicate with the primary nurse. When the nurse gives her answers from the pts chart that is the most up to date info we have. It seemed as though the daughter was trying the test everyone.
I assured her that random nurses do not care for her mom and that her care and meds are of course given properly, by the nurse that is caring for her that day.
However, this behavior has continued. No matter how much time you take with her, or how much attention, or how much you address her needs. She walks up to the next nurse and acts like she knows nothing. And this happens shift after shift.
If she has that much distrust of staff, she needs to move mom somewhere else.
Daughter asked me how many times a day mom is getting her ABTs.
No big deal, easy question to answer, right?
However her PRIMARY nurse has the chart, and she's about 10 feet away. I said, lets go over to so-and-so and we'll look.
Daughter tells me she just asked so-and-so and she told her 2x.
Ok, I say, so-and-so checked the chart, which is what I'm going to do because your mom is not my pt, is there any reason why you want me to check?
Because when I asked that nurse (as she points to another nurse down the hall) she said she thinks it was 1x.
I told her that that nurse should not have tried to answer, that she may have been trying to remember from other days that she had you mom, but w/o the chart and since she was not the primary nurse, the other nurse should have sent you to so-and-so, the PRIMARY nurse.
oh, says the daughter, she did. And after the PRIMARY nurse answered me, I went back to her anyway...
(I check with the other nurse who tells me the daughter says the primary nurse did not answer her, and the other nurse says that she told the daughter that she hasn't been her moms primary nurse in over a week, but last she remembers the ABTs were 1x a day, but she should check with the primary nurse to be sure because in a week, her mom's care could have changed)
Now remember I'm the third nurse she's asked...
I explained the the daughter that she must communicate with the primary nurse. When the nurse gives her answers from the pts chart that is the most up to date info we have. It seemed as though the daughter was trying the test everyone.
I assured her that random nurses do not care for her mom and that her care and meds are of course given properly, by the nurse that is caring for her that day.
However, this behavior has continued. No matter how much time you take with her, or how much attention, or how much you address her needs. She walks up to the next nurse and acts like she knows nothing. And this happens shift after shift.
If she has that much distrust of staff, she needs to move mom somewhere else.
Is that clear now?
This is a visitor who clearly needs limits set. As long as everyone accomodates her repeated requests for the same information, she will continue to pester everyone and anyone who will pay attention to her. Have the primary nurse give her ONE update. Have set time when she can ask questions. And then let her be. If she complains, bring her to the nurse manager, or better yet, administration. Let them understand EXACTLY WHAT "CUSTOMER SERVICE" REALLY MEANS. JMHO and my NY $0.02.
sadly, the nurse that let him read the chart should be turned in for the hippa violation; the boyfriend has no legal right to read the chart. as for the husband with the gun - the hospital should have never permitted him back in the hospital - he may not have a gun but he could have a knife! what were they thinking?:cheers::lol_hitti
At that point she goes, "Oh I forget if I asked" and I couldn't resist, I said "you meant the same question you asked this morning?" :nono:at that point I told the other nurse that we had already been through this earlier today. BTW, this daughter can recall every and any detail, she DID NOT FORGET. She just didn't think I'd be there...:angryfire:angryfire:angryfire:angryfire:angryfire:angryfire
:banghead:
TazziRN, RN
6,487 Posts
Sorry, I read it as "few" problems, not little as in small. And if the daughter had an "I'm dead meat" look on her face when she was caught, I'm willing to bet it's safe to side with the OP. Otherwise the daughter would have been justified in her actions.