I am struggling with patient families lately.

[jennilynn]

I am fed up with patient families treating the hospital like a family reunion site. I am tired of the family members that insist on staying the night, why? In some cases I get it. But when your boyfriend has the flu or your nana needs her rest and she won't rest with a room full of visitors, please leave and go home. I am very capable of doing my job without you laying there with one eye opened making sure I do what you think I should. These are all things I wish I could say, but damn those customer satisfaction surveys.

[Guest343211]

I think there does need to be a limit. One family member at bedside overnight should suffice, except in rare instances. If they are truly interfering with the pt tx and plan of care, they need to be warned or go.

If they aren't, set appropriate limits, be as supportive as possible, do your job well, and don't take anything personally.

Most family members are not there to spy on you or to make your life difficult. Get used to working in a fishbowl. If you work in many critical care settings, you work in a fishbowl. If you work with peds, you will be watched. If not by families, then by other nurses, RTs, docs, you name it. It goes with the territory.

Be careful and confident, and get over it. The pt and family issues are not about us and our comfort level. It's about them. I've let parents look at their child's flow sheets and ask questions. Part of moving through the stages to expert level is in building humble confidence. If they aren't interfering with care, it really shouldn't bother you. Unless they are blocking treatment or are outside of appropriate limits, it's your problem, not theirs. So unless you have left out some important information, well, sorry. Sounds like the problem is with you. Hopefully you'll take my two cents as constructive and in the positive manner in which it was given. :) Sorry about any errors. I am typing on iPad screen.

[AngelfireRN, MSN, RN, APRN]

I deal with these idiots every day...even away from the bedside. I can tell you at a glance who are going to be my PITAs for the day, and it's those patients who come in with either Mommy or Sissy or a random friend in tow who have no business being there. Mommy will try to tell me that her precious dumpling needs more pain medicine or nerve medicine while Dumpling sits silently. Mommy will attempt to prove her case by telling me that she's had to supplement Dumpling's regime with her own nerve medicine. The dumpling in question is usually in better shape than I and has no real need of Mommy. This usually occurs after Doc refusing to up Dumpling's dose a few times.

Sissy is usually the same scenario... she's doing all the talking while my patient sits there. Sissy knows it all.

And friend is either angling to rat someone out and get them dismissed from the clinic (pain management practice) or my patient has brought friend along with the erroneous assumption that I won't say no to their face when they try to wheedle and beg an appointment. We aren't accepting new patients and the waiting list is closed.

Oh, and never forget the ones that try to run right over your head when you don't give them the answer they want.... they'll get another answer and act all smug. At least until the other party discovers that they're splitting staff.

Stopping now before I need a blood pressure pill.

[martymoose, BSN, RN]

maybe the OP works in an area where there is NO respect for the health care worker- families allowed to do what that want. It's not even about being scrutinized- it's about the fact that these people are loud, obnoxious, disrespectful to their fellow man(ie: the pt in the next bed)and could give two craps about other people. And management rewards them for this behavior.

Ive had many a pt ask me if i could ask me to ask the inconsiderate jerks (oops, other family members-customers)to go home( ie its 11 pm, pts should be sleeping), but noooooooo. We have no set visiting hours. They can come visit at 3 am if they like.

I will say though if families have legitimate questions, I will answer them. I don't mind when they actually are paying attention to my mere presence. That is fine with me.If they allow me to do my job, i do not mind their presence.There are some family member who are genuinly concerned for their sick one.

I just have a prob with the loud obnoxious ones that I can't do anything about-

[Daisy_08, BSN, RN]

My biggest pet peeve is when family will come and stand in front of the nurse's desk every 5 minutes, for water, blankets, etc., instead of just ringing their call-bell, and stare at you.

"you can find that down the hall and to the right"

[M/B-RN]

There have been too many times that I get up from the desk and instead go chart on a computer on wheels hiding somewhere because if you sit at the nurse's station, some family member will assume that you are not doing anything and will continuously bug you for every little darn thing. Water, pillow, food, more water, blanket, another pillow, another blanket, over and over again!

[DeBerham]

Gotta say, after working in this field after a while I value the families... and I have found that it all depends on how you interact with them (to an extent). If you're up front with them, explain what you're doing, and don't act like they are a burden they generally won't be. Instead of the patient being bored and staring at the wall through a shift the family generally keeps them busy. I generally don't mind the interaction and if you involve them so they not only know what you're doing but understand why you're doing it things tend to go pretty well (we're drawing two sets of blood cultures because...). I have, of course, dealt with difficult individuals and that will happen. Let it go. Seriously, you will drive yourself nuts if you don't.

[bobbe1025]

was the man her husband perhaps boyfriend etc. there are many reasons that you are unaware of why they are together like that. I don't feel that correcting them as you say was the appropriate thing to do right yet. Unless they were teenagers messing around and being stupid or some biker trying to make it with his chic sorta thing. I am not saying your wrong but going about your business or saying hey you two whats up i'll just be a few etc. woukld have made your life much more pleasant and them happy.Unless of course it got out of hand i would have called the supervisor to handle it. Number one your to busy to have to mess with it anyway . By correcting them that opened the door to defensiveness and the rest of your night will be dreadful. Try never to create a negative atmosphere for instance correcting a pts. behavior like what happened. you can correct that buy using the power of positive energy, if u can do that you will never have pt. relation problems. Like I said previously walk in say something like okay you two I need to check something give her a med and i'm out of here if u need anything just let me know thanks have a goodnight whatever. Every body walks away happy. I would almost bet next time you walk in he will be in the chair and you are their best friend. You set the stage and minded your own business, though of course you keep an eye if things got out of hand. but then call the supervisor thst keeps you out of harms way. Good luck to you and may the "force be with you"! Always keep a positive atmosphere and you will always have control.

[bobbe1025]

u know what those family members are displaying symptoms of guilt or showing nana that who is doing for her so when passes she will b remembered families r a trip. but slow down try looking at their behavior from a psychological aspect its very interesting it will also give you insight to why instead of making you crazy. Like they say reason for everything been ther done to many times and then some. check it out though and observe family behavior because it can get down right outrageous its not norma they are up to something or want something and asking for thi and that and scheduling nana meds etc is their way of showing u how much they care for nana its displaying their guilt cause they havent seen nana in years and could care less and they r after something. people are the most interesting creatures on Earth. Good Luck!

[mitral]

It depends entirely on the family. Often the family is difficult and critical. However, many times the family are actually very helpful to me, and especially to my PCA's- they do a lot of the little things that keep the patient comfortable or informed, or will talk the pt into doing things so I don't have to (i.e. incentive spirometer, c&db, ambulation) once i've taught them how. Sometimes if you give a difficult person one of these little jobs, they will focus on that instead of you for a little while

[Nurserton]

I have to agree with the OP as a former Neuro nurse in particular. Our neuro patients did NOT benefit from the increased stimuli of a room full of people, and I found that more often than not the patient got lost in the commotion of the reunion as opposed to being the center of it. I love when families constantly want to know why their loved one's pain or sleep meds aren't working, why they still have a headache, yet there's five family members in there with the brightest fluorescent lights possible ALL on. I think families can be helpful, but TO AN EXTENT. I think there does come a point where too much family takes AWAY from the patient and does not enhance care. I also think patients are very rarely going to flat out tell their family they want them to leave (although some do), and so they suffer even more with families talking and watching TV and making phone calls and all that. On more than one occasion I've had a patient say, "It was nice to see them for a little bit, but boy am I glad they're gone." Our patients DO need to rest to heal, they get worn out enough with us poking them and checking blood sugars and blood pressures every few hours.

Everything should be in proportion and there DOES come a point where PFCC must split because what's in the family's best interest may NOT always be the same as what is in the patient's best interest.

[Bringonthenight]

"you can find that down the hall and to the right"

Omgggg preach it! I'm not a waitress! Press your call light button and wait your turn!

[Vishwamitr]

Dear DoeRN,

I do not mean to harp on the matter or rekindle my ptsd-like memories, but no, they were not having sex. Nevertheless, a visitor is not supposed to be laying in patient's bed no matter what the relationship. It was visiting-hour, and not 'conjugal visitation hour'.

Luckily, it did not affect my view of nursing but that of nursing-administration. Whoever came up with the aphorism: 'the customer is always right' must've need the job very badly, 'cause I did not. (I quit).