pt husband keeps moving the toco!

  1. What is wrong with some people? I would NEVER touch any equipment being used on a family member or in their room, even as a nurse! Last week I had a pt coming in for an induction. Her husband kept moving the toco around saying " this isn't working - she's having contractions but the monitor isn't picking it up so I moved it." This happened more than once. WTH? He's watched us place the monitor a few times and he's suddenly an expert? He thinks he can just place it anywhere.... and do a better job than the nurse? (my preceptor has 27 years of OB experience!) I have also walked into the pt room before and seen family members trying to get on the computer (where we chart), changing settings on pumps, you name it. How do you handle patients and family members who think it's OK to touch the medical equipment and settings? Do we need signs on everything saying DO NOT TOUCH?
  2. Visit lannisz profile page

    About lannisz

    Joined: Nov '05; Posts: 265; Likes: 18
    Family Nurse Practitioner/Registered Nurse; from US
    Specialty: 8 year(s) of experience in primary care, pediatrics, OB/GYN, NICU


  3. by   babynurselsa
    I outright tell them that they are not to touch these things. I let them know that that is my job to do so. I also let them know that if something untowards happens to their loved one they will be responsible for it.
    I also document this all very clearly, them "adjusting" equipment, my instructing them not to do so etc.
  4. by   meownsmile
    Thats why i use the lockouts on our new pumps. Scares the begeebers out of them when the things alarms go off and they cant shut it off. They learn real quick if they want a nurse in there just try and mess with the pump.
  5. by   PANurseRN1
    "If you cannot comply with our requests to not touch the equipment, you will be asked to leave. If necessary, the security department will escort you off the unit.

    Any questions?"

    I have no patience for people like that. It's one thing to be curious and ask questions about equipment; quite another to meddle with it.

    "Oh yeah, one more break it, you bought it." (For the record, I have indeed said that.)
  6. by   babynurselsa
    Yes, many IV pumps do have a little button on the back to lock out anyone messing with them. I try to be real casual about activating it so that they do not know that is what I am doing.
    Unfortuanately everything cannot be locked out.
    Again, document everything to CYA
  7. by   traumaRUs
    I totally agree that documentation is the key. That's what will keep you out court later on down the road.
  8. by   lannisz
    I have seen family members do the same. I think it shows an utter disrespect - the gall! I do document...but I am so irritated by their behavior. I would like to hear if any of you have come up with a good way of communicating the hands off policy?
  9. by   KellNY
    Tell him how much it costs if it breaks while he's touching it.
  10. by   CaLLaCoDe
    [BANANA]Tell him that the device is designed to give an electrical shock to anyone else in the room who messes with it besides the RN[/BANANA]
  11. by   LDRNMOMMY
    Quote from babynurselsa
    Yes, many IV pumps do have a little button on the back to lock out anyone messing with them. I try to be real casual about activating it so that they do not know that is what I am doing.
    Unfortuanately everything cannot be locked out.
    Again, document everything to CYA
    I love the lock button! I use it all the time, and not just for family members. We have a doc that will go into a patients room and turn up the pit willy nilly without telling you he did it!
  12. by   txspadequeenRN
    Good funny this should come up. Today while I was in the Ob office getting my weekly NST, my husband kept thumping and moving my toco. I ended up telling him I was gonna kick him across the room if he didn't stop it. I would never move or mess with the equipment....GGGGEEEZZZZ
  13. by   TrudyRN
    I think I might take a moment and ask him why he is doing that. I would let him know that it makes me very uncomfortable, as I don't know what is happening with my patient if he is going to be altering things. And I would say that I can't be responsible for the wife if something bad happens as a result of him changing settings. Find out if it's a matter of trust (or lack of it) or does he have a need to be in control or what?

    Absolutely chart everything in a non-adversarial, factual way (say hunsband move the toco, explained to him why it needs to be where it was placed, asked him why he moved it, he said ____, informed him that patient's safety depends on nurse knowing what is happenig with patient and nurse cannot be responsible for any changes he makes; He does not express agreement. Sas is nervous about wife's well-being. Supervisor and Dr. Smith notified and asked that they come talk to spouse; )

    On the other hand, make sure you are responsive to their questions and concerns, that you see them often enough, that you keep the communication/teaching going.
    I think you'd be within your rights to refuse to care for a patient if the family is going to do this sort of thing. What does your Risk Management dept or DON say? Your Med Chief of Staff? The patient's physician?
  14. by   NurseNora
    All very good responses about the charting angle. Had you been in the room palpating contractions? Were they recording? Did you feel anything when the patient reported feeling a contraction?

    Sometimes (especially with the "fluffy" patient) you have to sit (or stand--I tell my patients that since I'm old and fat, I sit as much as possible as I claim the doctor's stool for myself) at the bedside with your hand on the fundus for a long time, moving the toco after each contraction you feel that doesn't record. When the family sees what I'm doing and how long it took to get it adjusted properly, they don't tend to move it. I also explain to them during this time how the toco works, that the height of contractions on the monitor doesn't tell us anything about the strength of the contractions in the woman.

    The only time I have a problem with someone messing with the toco is when I have a woman who so desperately to be in labor that she pushes on the toco to "make" a contraction show up. But you can tell them because when you sit with them for 20 min, they don't have any contractions. Then when you leave they start "contracting" again q2m.