Due to a few people, including myself that thought that the hemophobic thread was homophobic and stated such...here is a homophobic thread...lets keep it nice now :).
I too (as one person stated) had a male homosexual whos partner was his MPOA. Sadly, most of the information was told to the patient and not his partner. His partner was so confused about the pts care, what the plans were, and was trying so hard to arrange after care that would fit their needs. No one really would discuss it with him, even though he proved he was a MPOA.
TILL I came along! I got everyone involved together and we discussed our short term and long term goals in a way both patient and partner could understand. There was quite a family dynamic involved with the pts family (against the pt being homosexual with a partner..they treated the partner like slime!), but the partner was the LEGAL MPOA! So I got in there and made it clear to everyone :).
It all worked out great, all sides were happy...(the patient was suicidal and depressed when he came in, so he wished to go to a psych inpatient to get better...bless his heart! He was so saddened by this family/partner fight he was just so sad looking and you can tell he just couldn't take it anymore!!!). And the MD's and RN's felt that they did actually get the info to the right persons involved and felt good about it. It was just that no one really got into that situation deep enough to figure out whom they should be talking with r/t the dynamics and fragile nature of the patients mind (we didn't want him to kill himself over his family and partner fighting!!!).
But would this have been the same if this was a married hetrosexual couple???? Would the wife or hubby automatically get the info with no question???
I think there are a lot of people out there who judge people ALL the time. I think that to some extent we never completely get out of our prejudices. I think that sometimes we are so immersed in our own perception of people that we forget that there are other realities.
I try very hard at work to leave my personal feelings to the side and just take each person, family and issue as it comes. Most of the time I succeed, sometimes I fail.
Thanks to all of you who are posting here for helping me get a better understanding of the issues that face same sex couples and patients in general with the new HIPPA regulations.
Why not let his parents make the decisions since they gave him life why not let them decide on events that could help save it they don't stop being parents just because their child is over 21. If health care is totally relying on family court systems to fix these issues we are in sad shape. Did Terri Shivo teach us nothing?
That's a big old can of worms. There are cases where it doesn't work, like the case you mention. But there has to be some rules, and having the parents out rank spouses isn't the right thing to do in my opinoin.
I've seen many cases where parents have disowned their gay kids, only to come back at the end of their life to take their homes and life insurance policies from their life partner. So not everyone who gives birth to someone deserves to make decisions anymore than an estranged spouse. There's always going to be cracks in the system.
That's a big old can of worms. There are cases where it doesn't work, like the case you mention. But there has to be some rules, and having the parents out rank spouses isn't the right thing to do in my opinoin.
I've seen many cases where parents have disowned their gay kids, only to come back at the end of their life to take their homes and life insurance policies from their life partner. So not everyone who gives birth to someone deserves to make decisions anymore than an estranged spouse. There's always going to be cracks in the system.
Good point - this happens in families all the time, sad to say. My grandmother fell and broke her hip, my uncle was able to get her to sign over all rights to him, he sold her house, put her in LTC where she died of a broken heart (I'm positive of this). He ended up with all the money and made a video tape to his sister and brother that he hated them and would pi$$ on their graves one day.
I respect and sympathsize with the problems homosexual couples face when entering into the hospital and not to minimize their pain but many heterosexual couples face similar night mares. For instance I am caring for a 49 year old man who is on vent and full life support in multi system failure and ruling out HIV. His wife has left him and moved to another state several months ago and no comes back and is made his medical surrogate because they were not legally divorced yet. He had living parents and children that could have been appointed why not one of them? Why not let his parents make the decisions since they gave him life why not let them decide on events that could help save it they don't stop being parents just because their child is over 21. If health care is totally relying on family court systems to fix these issues we are in sad shape. Did Terri Shivo teach us nothing?
I don't think this is the same as the problems faced by OP's patient. The OP's patient had appointed a MPOA and no one on the healthcare team was acknowledging this. That is both ethically and legally wrong.
In your pt's case it is a matter of your pt. never appointing anyone and then it goes to family law. If something happened to me I absolutely trust my husband over anyone else to make the best decisions for me and my daughter. He knows my wishes. If I didn't feel comfortable with him making these decisions, I wouls appoint someone else. I just hope that I wouldn't run into the same situation as the OP's patient. It is unbelievable that in this day and age healthcare "Professionals" would so blatantly ignore a legal document. I'm glad OP set everyone straight and advocated for her patient.
I'm proud to say that this would not happen on my floor. The sad thing though is I've seen many techs and a few nurses afraid to take care of na HIV patient. I mean standard precautions should take care of all. I suppose there will always be ignorance no matter how educated we are.
Yes, I feel the same way. I'm her MOTHER, I gave birth to her, I have some rights over what happens to my 12 year old daughter.
Making a rule or law for the small percentage of parents who might beat the crap out of their child for getting pregnant, makes no sense. I shouldn't be punished because of someone's else's reaction.
We live 70+ miles from the nearest city that does abortions. Someone would have to take my daughter from her school, drive her to this city and drive her home all without my knowledge. What happens if that someone gets into a car accident on the way? Who is liable then? Can I sue that person for injuries caused to my daughter in the accident?
It just seems nuts that I have to give the school my permission to give my daughter a Tylenol for a headache -yet they can whisk her off to an abortion and I would know nothing about it.
Nuts and screwy . . .
steph
I worked in a clinic in an urban high school and we had patients from 7th grade thru 12th grade and had all the confidentiality issues. We as a group ALWAYS tried to help the patient identify a family memeber or close family friend that they could talk to if any of these types of issues came up. Sadly, it wasn't always possible. We offered mental health counseling, reproductive counseling, hcg testing, std testing/treatment, and we could prescribe birth control but they had to obtain it from a local teen clinic since schools can't dispense. We helped many, many kids. Legally, kids cannot be transferred off schoool grounds without parent permission, so the school really can't send them off for an abortion. We could tell them where to go and assist with the appointment should they choose to go that route . We also helped them get set up with the teen maternity clinic if they chose that route. And helped with setting up appointments for adoption counseling should they choose that route.
Parents would get REALLY upset with us sometimes when we said that "HIPPA prevents me from sharing that information". But we did stress family communication, would have family meetings on site so that if the kid wanted to tell their parent something touchy but was scared, they could do it in our office as a safe place.
As a parent of an 18 year old (M) and a 12 year old (F), I pray that if my kids had a problem that they couldn't tell me, they would have someone, somewhere, to help them. I have told them both, if you have something going on, tell your doctor. They won't tell me if you don't want them too, but they will help you.
I worked in a clinic in an urban high school and we had patients from 7th grade thru 12th grade and had all the confidentiality issues. We as a group ALWAYS tried to help the patient identify a family memeber or close family friend that they could talk to if any of these types of issues came up. Sadly, it wasn't always possible. We offered mental health counseling, reproductive counseling, hcg testing, std testing/treatment, and we could prescribe birth control but they had to obtain it from a local teen clinic since schools can't dispense. We helped many, many kids. Legally, kids cannot be transferred off schoool grounds without parent permission, so the school really can't send them off for an abortion. We could tell them where to go and assist with the appointment should they choose to go that route . We also helped them get set up with the teen maternity clinic if they chose that route. And helped with setting up appointments for adoption counseling should they choose that route.
Parents would get REALLY upset with us sometimes when we said that "HIPPA prevents me from sharing that information". But we did stress family communication, would have family meetings on site so that if the kid wanted to tell their parent something touchy but was scared, they could do it in our office as a safe place.
As a parent of an 18 year old (M) and a 12 year old (F), I pray that if my kids had a problem that they couldn't tell me, they would have someone, somewhere, to help them. I have told them both, if you have something going on, tell your doctor. They won't tell me if you don't want them too, but they will help you.
Actually there was a case of a school nurse taking two students off campus for a medical appt - it was hotly debated here on allnurses. I will try to link it below:
That's a big old can of worms. There are cases where it doesn't work, like the case you mention. But there has to be some rules, and having the parents out rank spouses isn't the right thing to do in my opinoin.
I've seen many cases where parents have disowned their gay kids, only to come back at the end of their life to take their homes and life insurance policies from their life partner. So not everyone who gives birth to someone deserves to make decisions anymore than an estranged spouse. There's always going to be cracks in the system.
I've been lurking for a long time and finally signed up today so this is my first post:
I probably should have picked a less controversial topic to comment on but this one interests me.
Like the poster "Tweety" stated, I too, have seen parents who basically disowned their children because they're gay only to show up at the funeral like vultures once their child dies to take over their assets and kick their partners to the curb simply because the law is on their side at this point in time.
My partner and I both enjoy good relationships with our parents but we have taken every possible measure nonetheless to ensure our futures (since we still can't get married) the day one of us dies because we know the reality in many cases.
As it stands right now, both our parents state that they would never interfere with health decisions or try to get greedy in the event that one of us ended up comatose on a vent or dead, but we all know as nurses that people can, and often do, change when something like this happens.
Promises can quickly become broken once emotion and greed sets in.
That's a big old can of worms. There are cases where it doesn't work, like the case you mention. But there has to be some rules, and having the parents out rank spouses isn't the right thing to do in my opinoin.
I've seen many cases where parents have disowned their gay kids, only to come back at the end of their life to take their homes and life insurance policies from their life partner. So not everyone who gives birth to someone deserves to make decisions anymore than an estranged spouse. There's always going to be cracks in the system.
I, also, saw this so many times when I worked as a volunteer with an AID's advocacy agency in Philadelphia years ago. But, then you have parents who initially had trouble with their child's sexual orientation, only to make a complete turn around when faced with end of life care, being totally there for them. That's my mom, BTW (my brother died in 1988 after his best friend deserted him). You never know.
I, also, saw this so many times when I worked as a volunteer with an AID's advocacy agency in Philadelphia years ago. But, then you have parents who initially had trouble with their child's sexual orientation, only to make a complete turn around when faced with end of life care, being totallly there for them. That's my mom, BTW (my brother died in 1988 after his best friend deserted him). You never know.
That's the thing about making blanket statements in this situation. Sometimes the "spouse" isn't the best person, sometimes the parents aren't.
Any person is capable of great evil or great good.
I wasn't saying that a parents right should supercede the rights of the spouse, I am trying to say that I don't think that a persons medical power
of attorney should automatically unquestionablely go to the person listed on the marriage certificate..not if there is someone else closer to the person and usually a doctor , nurse knows who that person is (usually the one sitting at the bedside) . Why must we be obligated to make the "spouse" the medical power of attorney? For instance if a spouse did not have to be made mpoa and the closest person listed is the patients
partner ,then that person should be given the mpoa . It would not matter if there was a legal marriage document or not.
That's the thing about making blanket statements in this situation. Sometimes the "spouse" isn't the best person, sometimes the parents aren't.
Any person is capable of great evil or great good.
steph
I agree, and this is why surgeons aren't supposed to be operating on their own family members.
Yet we allow designation of health care decisions to be made by people who are heavily emotionally involved with the patient, and/or have alterior motives and strings attached when making these decisions.
All of the nursing or medical education in the world isn't going to make someone rational when things go wrong for their own loved one.
Personally, I don't think that either my parents or my partner should be making my healthcare decisions. I think that we all should have someone who would be more rational to do this but that's another story.
Earlier I was talking about protecting my partner from getting kicked to the curb from a financial standpoint, but as far as healthcare decisions go, I really don't trust that my partner would know when it is the right time to pull the plug on me either, simply because he would be too emotionally involved to make a rational decision. Same goes for my parents.
I've seen way too many hopeless 103 year old people who remain on vents while I pump yet another blood transfusion into them because the family hopes that the patient will somehow turn around and come back to life in the way that they remember them.
weirdRN, RN
586 Posts
I think there are a lot of people out there who judge people ALL the time. I think that to some extent we never completely get out of our prejudices. I think that sometimes we are so immersed in our own perception of people that we forget that there are other realities.
I try very hard at work to leave my personal feelings to the side and just take each person, family and issue as it comes. Most of the time I succeed, sometimes I fail.
Thanks to all of you who are posting here for helping me get a better understanding of the issues that face same sex couples and patients in general with the new HIPPA regulations.