Notifying the family when a patient arrives on your unit/transferred out?

K+MgSO4, BSN · Apr 24, 2020

Of course.

The surgeon does not know when the pt leaves PACU for a ward. Also, while the pt should go to a specific ward if there are no beds the bed manager may allocate them to another ward. How does the surgeon know this?

With regard to discharging or transferring same. The discharge coordinator may have set everything up but does not know when transport is going to arrive. Pre COVID we would often have told families that we were transferring to our subacute campus with transport booked for 10. However due to traffic, roadworks and other issues it could have been 1 PM before the pt left. If the family was waiting for the pt they would be freaking out.

We have a nice piece of tech that helps. A NoK text messenger. We can choose a pre written format to send to the NoK. Very useful.

Can you imagine, especially in the current climate waiting at home for your dad to get out of surgery and not hearing when he was settled on a ward. Health background or not your imagination would be in overdrive. Is he dead? Did the surgery have complications? Is he in ICU? People worry and part of the role of the nurse is the care of the family as well as the patient.

Closed Account 12345 · Apr 24, 2020

I fully agree with the previous post, BUT...

Never, ever allow someone to scream at you on the phone for 25 minutes. Not a family member, or doctor, or manager. It's OK to say "I am sorry about XYZ situation, but I need to end this phone call if we're unable to speak calmly."

In this case, "I sincerely apologize that I didn't contact you about your father. There must have been a miscommunication on our end because I wasn't aware you wanted a call, but I can certainly understand why you're upset. How can I ease your concerns now?" Beyond that, if literal screaming continues, you end the call. Nurses don't have to accept screaming, berating, belittling, disrespect, etc. as part of the job description.

Also, who has 25 minutes for any phone call an hour before shift change? If a phone call is keeping you from necessary patient care, it's OK to excuse yourself politely. Family communication is so important, but patient care wins out, and you need to be prepared for shift change. You can always say "I'll pass along your concerns to the oncoming shift and ask the nurse to call you when she is able to more fully address your concerns. It may be a few hours before she can call because she'll need to get report and round on all patients first." Set realistic expectations, and make sure you really do pass the call request along.

Swellz · Apr 25, 2020

It really depends on how your health system is set up. Our CMs speak to families when someone is going to a facility, and I don't have to call unless there is a significant delay in transport that is after the CM leaves for the day. If someone goes to a higher level of care, I call (unless the patient is AAOx3 and specifically tells me not to). If someone is going to a lower level of care, I only call if the patient is confused.

While people are not allowed to have visitors, I ask my patients if there is anyone they would like me to update about their care. Most of them don't want me to call anyone but are happy to let me update family members who call me.

Sour Lemon · Apr 25, 2020

On 4/24/2020 at 9:06 AM, Adrian007 said:
Does anyone here notify the family when the patient arrives on your unit or when they are discharged to a facility? Lately I’m getting calls from angry family members saying they had no idea where the patient was. We have staff specifically who plans the discharges, so I was under the impression she is to call the family and keep them in the loop. Then yesterday I got a post op patient at 3 and listened to the daughter screaming at me my on the phone for 25 minutes at 6pm wondering why I didn’t call her when the patient arrived on the unit, results of her surgery, etc. She claims she told the surgeon to have me call her when she arrived, but there were no notes, orders, and no report from the OR nurse that I had to do that. And during my training my preceptor never did any of those things. I get things are different right now with covid, but I feel like a lot of contacting the family is the doctors job? Does anyone here find the time in the day to contact the family when they arrive/are discharged?

I have never called family when a patient returned from surgery. I do keep them updated if they're waiting on the unit or elsewhere in the hospital, though.

I do notify involved family when a patient is discharged or transfers to another unit.

Here.I.Stand, BSN, RN · Apr 26, 2020

The surgeon absolutely should update the family after surgery is over, to let them know how it went, findings, etc. Sometimes I know the answers to their specific follow up questions, but sometimes I don’t... I wasn’t present in the OR. And I shouldn’t have to be the middle man and track down the surgeon, ask the questions, and call the family back, when this conversation REALLY should be had between the physician and family.

If that discussion did NOT happen for whatever reason I do page the surgeon and say the family has questions—please call them when you have a moment.

I also agree that you don’t have to wait for family member is done screaming at you. In the words of the venerable Sweet Brown, “ain’t nobody got time for that!”

I do call families when their loved one transfers out of the ICU as a courtesy, because my hospital is really difficult to navigate. I will let them know what unit they’ve gone to and how to get there via the main entrance.

Adrian007 · Apr 26, 2020

5 hours ago, Here.I.Stand said:
The surgeon absolutely should update the family after surgery is over, to let them know how it went, findings, etc. Sometimes I know the answers to their specific follow up questions, but sometimes I don’t... I wasn’t present in the OR. And I shouldn’t have to be the middle man and track down the surgeon, ask the questions, and call the family back, when this conversation REALLY should be had between the physician and family.

If that discussion did NOT happen for whatever reason I do page the surgeon and say the family has questions—please call them when you have a moment.

I also agree that you don’t have to wait for family member is done screaming at you. In the words of the venerable Sweet Brown, “ain’t nobody got time for that!”
I do call families when their loved one transfers out of the ICU as a courtesy, because my hospital is really difficult to navigate. I will let them know what unit they’ve gone to and how to get there via the main entrance.

I don’t work on a medsurg floor but we’ve been taking them as overflow so I’m not familiar with any of the surgical procedures/guidelines