Its all different when its your family...

[trolloc6340]

They say that it's all different when it's your family, and I can attest to that. Having been a nurse for the past 6 years, I have seen many things. But this one hit home for me. I will try to elaborate quickly.

Long story short, girlfriend's dad comes into town. Was not sure of his age, but looked 60ish. Went out to eat with her family, no biggie deal. Came back to families' house, and got a reality check.

So sitting next to him (GF's Dad) on the couch. Cannot help but notice his very audible expiratory wheezing. And like a mouse to cheese, so begins the covert assessment…

Expiratory wheezing when sitting, Respirs of 30 (thank you smartphone), use of accessory muscles to breath, shortness of breath. His color looked good, but this was all just at a glance. And as I get home later this morning, sleeping sitting up in front of the TV on the couch.

Now the bad news. Talked to GF, got in a fight over it. Her dad does not want to do anything. No going to the hospital, no Dr's apt. I tried to convince them to talk to him and make him go to the hospital, but he is not having it.

I realize that patient's need to make their own choices, but if that was my parent, I would drag them kicking and screaming to the hospital. I don't care if they were mad at me. Knowing what was happening and possibly being able to treat it vs dead parent is okay with me.

Thoughts??

[Emergent, RN]

At this point you need to back off. Let them know they can call you for assistance. Remind them to call 911 if needed.

[Elle23]

If you were my child, I would not be too happy if you "dragged me kicking and screaming to the hospital" if I did not want to go.

We seem to have forgotten that receiving medical care is always a choice (for a competent adult). It is not a requirement.

[sallyrnrrt, ADN, RN]

and the first patient bill of rights is.............yeah right to refuse treatment :)

[Been there,done that, ASN, RN]

What's his baseline? Does he have a history of COPD? This presentation might not seem unusual to the family.

That being said, my mother refused my recommendation, pleading, begging... to go to the hospital.

She didn't wake up in the morning. Certainly wish I would have just called the ambulance.

You are damned if you do , damned if you don't.

[nrsang97, BSN, RN]

You can't force anyone to accept treatment. Even if they really need it.

[Guest219794]

I realize that patient's need to make their own choices, but if that was my parent, I would drag them kicking and screaming to the hospital. I don't care if they were mad at me. Knowing what was happening and possibly being able to treat it vs dead parent is okay with me.

Thoughts??

Not sure what you mean by that. Often a patient's family badgers and cajoles them into coming in, which is different from dragging them in. I often hear "she made me come in". I usually point out that nobody made them do anything. They chose to come in.

In reality, you cannot drag somebody or force somebody to go to the hospital. I did once have to deal with the exception to this which resulted in a multi-person wrestling match somehow making it through the EMS doors and on to the floor of the ER.

People make choices. That is reality. If you are able to use your knowledge to influence those choices, that's great. Maybe your wining personality can be used to convince him.

From your description and the family's reaction, it sounds like this is a chronic problem, not an emergency. Presumably if dear old dad was a perfectly healthy guy who was tachypneic, wheezy, and unable to lay down, his family would be a bit concerned, as would he.

If he wants treatment his PCP is a great place to start. More important, if he has modifiable factors and motivation, he may do well. Does not sound like this is the case. If he doesn't want treatment, or to change his habits, an ER visit is a waste of time.