Is it okay to treat a family member?

Published

My daughter, a 25 yr type I diabetic who is in CHF, recently had her Pacemaker/ICD moved to a new location. She has since developed an infection in the site and now has a PICC. She has been discharged to home after 4 days in the hospital and will be on IV Vanco TID for 6 weeks. My dilemma: I want to make sure her PICC dressing changes are done correctly and that her vanco is hung correctly. I prefer to avoid the use of a home health nurse because I am capable of taking care of her myself. Is it ethical to treat my own daughter? Any input would be appreciated!

Specializes in ER, ICU, Infusion, peds, informatics.
wait, guys....she said she doesn't want home health out at all. all the cases that have been cited had home health looking in periodically. she's talking about doing it all herself, in the home health nurse role. not good.

no, our patients often have no home health involvement at all. sometimes they get a few visits on the front-end to do the teaching (and she may still get one of those, since home health methods of giving iv infusions are very different than hospital methods. much easier, but still different.)

our patients are frequently ambulatory, not home-bound, still working, and we often can't find a home health company to take these types of patients.

i work for an infusion pharmacy, and she will have to have one of those (can't make the abx herself ;) )

between the nurses at the doctors office and at the pharmacy (i bet the company that is supplying her abx has at least one rn, probably more, on staff to answer questions), she should be fine.

plus, depending on the med, home iv abx admin can be amazingly simple. very tough to mess up. i think the op mentioned vanc, and that is one of the easiest, because it is stable once mixed for several days in the refrigerator.

to the op: your daughter is most likely going to need weekly labs; at the least, a vanc trough, creat, bun, and cbc. while you can get the last three from the picc, it is a very, very, very bad idea to draw drug levels out of the iv line in home care due to the long turn-around time and potential for very long interruption in therapy should the draw get contaminated. how do you (and your daughter) feel about you doing vp's on her? you might want to consider have lab draws arranged at a local lab.

Up Vote Up Vote ×
Wait, guys....she said she doesn't want home health out at all. All the cases that have been cited had home health looking in periodically. She's talking about doing it all herself, in the home health nurse role. Not good.

This is not a neighbor she is treating. If it were there would be a real problem with advise/help being a professional and not in a professional role. This however is a mother taking care of a daughter who is a type 1 diabetic. Do you also think she should never have given her daughter insulin shots because she didn't have home health? Mother should go for it. We need a reality check when professionals think a family members cannot take care of each other.

Up Vote Up Vote ×

With your adult daughter's permission I don't see how this differs from treating oneself. I did my own central line Vanco administration aand dressing changes when being treated for a severe post-mastectomy wound infection. This went on for weeks and weeks. The VNA nurse came just the first time and then I never saw her again. Good luck.

Up Vote Up Vote ×
Specializes in Med-Surg, Wound Care.
In this case I would say no.....there is a med involved. There is a reason why medical personnel are discouraged from caring for their family members. Dressing changes are one thing, meds are another. If you allowed home health to come in in a supervisory position, sure.

Home health will NOT administer every dose of home IV meds. They teach the family to do it and then check in once a week.They are available by phone if needed. The family will be responsible for administering the meds. Dressing changes/blood draws will be done by home care, but I've done those too when a dressing is soiled.

I've had my husband home on IV antibiotics three times this year. He's currently on for 30 days. I do what is needed with the "oversight" of the home care agency. My actual contact with them is minimal. They provide the antibiotics and draw blood..not a big deal.

I'm also doing a vac with no home care involved. His doctor is following it up, but I'm in charge of that one!!

Up Vote Up Vote ×

You're alll worried about this - how do you feel about a doc treating his own mother? He'd come in every day and go thru her chart, look up her labs, write orders, change her meds around...he ordered IVIG and blood and all kinds of stuff on her. He's very nice and so is the pt, but I don't know how I feel about that...

Up Vote Up Vote ×

Why the heck not? As a mom you spend your life taking care of your kids. Why should this be different? You're certainly qualified to administer her antibiotics and you'll be more attentive than any stranger would be, right?

Up Vote Up Vote ×
Specializes in Perioperative; Gyn-Onc.

In answer to some of the questions... yes, my daughter would rather I take care of her than home health. And yes, home health will still be out to draw labs twice weekly. And finally, my daughter's husband will help her hang the last dose each day because I'll be at work.

Up Vote Up Vote ×

I think some of this depends on your comfort level...and also confidence in your abilities.

Up Vote Up Vote ×
+ Join the Discussion