Patient Families

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Ever feel like our jobs would be 10000x easier if families were not allowed in the ED?

I'm not a complete jerk, I'm very nice to family members, try to accommodate, make them comfortable, keep them in the loop, and always ask the family if there is anything I can do for them on the way out. I'd want a family member there if I was sick and I would definitely want to be there for my family member as well. But sometimes I want to rip my hair out when they don't understand that they're delaying my ability to do my job.

1) They are glued to the bedside. I politely ask them if they can scoot over so I can do my assessment or start my IV. They take a gazillion years to actually stand up, pick up their purse, jacket, and their 10,000 other personal belongings. Then they leave the chair sitting there in my way. Gee thanks. I move said chair out of my way and walk out for two seconds to retreive an item I need (i.e. gloves, patient labels, tubes, something I forgot) and they've parked themselves back in the chair. Oh lawd!

2) The patient is without complaint, but the family is giving me an ear full. Why haven't they gotten a bed assigned? They've been waiting 10 minutes for a transporter to take them to CT scan. They want a private room. My favorite? "My mom is in so much pain, did you even give her the 2nd dose of pain medication?" Um, well judging by the fact she's now asleep....I'd say the pain medication is working and I'm not going to wake her up to find out. ;)

3) They're babying the patient. 20-something young person with abdominal pain. Time to pop an IV in. Patient looks a little hesistant but I ensure them it will be quick! Mom or dad practically just across the stretcher to hold their hand (again, getting in my way) and completely over dramatic. "Oh honey, it's okay, I know how much you hate needles...nurse can't you use a smaller IV than that, like a butterfly?" *rubbing patient* Patient is now MORE anxious. Your son or daughter is my peer and not a child. Yeah, yeah, no one likes needles, I get it. I know what I'm doing so zip your lip and the deed will be done before the anxiety sets in. Cut the cord! :cheeky:

4) They answer questions FOR the patient. Sometimes the patient can't answer, in which case family is very helpful! But please don't talk over your loved one.... I appreciate additional input after the fact, but we're here for the patient so let's get their story first.

5) They don't want to stay any longer. Patient is going to be admitted for observation, all tests so far are negative. Or maybe we're waiting on a repeat troponin prior to discharge. Patient agrees with plan.... meanwhile the family member is furious because they're tired and they don't see the use of additional testing when nothing is wrong so far. Obviously you cared enough to bring them in the first place, so what's the issue?

6) They're hungry or have some other complaint. "I'm diabetic and I didn't eat anything all day, can you bring me a sandwich?" You're an adult. How do you survive on a daily basis? Go to the vending machine or find a nearby food place. I'll even tell you where there are some local spots. The patients come first. "I have a headache, can I have a tylenol?" Sure, if you'd like to register at the front desk!

7) "I have this rash on my foot, can you look at it?" Sure, you can register at the front desk. We'll get that checked out and take care of that headache, too! Maybe we can get you a mealtray as well.

8) It's a family reunion. You don't need the entire extended family and uncle leroy 2x removed at the bedside. Unless it's life or death you're going to have to take turns.

9) You're making suggestive comments or flirting with me. No, just no.

10) They decide to lay in the empty stretcher next door. Ugh, come on. What makes you think this is okay?

Any you'd like to add?

That brings end to my light-hearted post-shift rant :) Hurray, today is my "friday!"

*Disclaimer: Most of these fall to the wayside with very critical patients. I understand and advocate for family to be involved. It puts the patients at ease, gives the healthcare team more information, and just generally adds to the holistic care of the patient. I always try to accommodate when I can... I'll bring coffee if I have the spare time, try to keep family involved in the plan, and give them a business card with my name and contact info if they want to go home for the night and get a status update. Most families are very cool and understanding of whatever I ask them....even if I tell them they have too many visitors and they have to switch off in the waiting room. They're concerned for their loved ones and scared. But at the end of the day my focus is on the patient, so please let me give them the best care I can. I want you involved but not interfering. I promise, they're in good hands!

Specializes in Emergency Department; Neonatal ICU.

"Hey Mom/Dad, can we NOT give the child a McDonald's hash brown right now. As you know (because you called the ambulance), that she had a seizure and is just now coming around and becoming more alert. She doesn't need to eat right now, really she doesn't. And since we don't know what caused the seizure, we're not sure if it will happen again." Luckily, I had walked in the room before she had take more than a small bite. And might you be wondering if the child seized again? Why yes, she did, a short time later...

Specializes in ER, ICU.

My favorite is when I come into the room to do whatever, and the patient is on the phone. I let them make eye contact, and if they don't get off, I just say I'll come back later. They usually sign off immediately...

Specializes in Emergency Nursing.
My favorite is when I come into the room to do whatever, and the patient is on the phone. I let them make eye contact, and if they don't get off, I just say I'll come back later. They usually sign off immediately...

I was recently putting the heart monitor on a young female patient after she returned from the restroom. I thought she was lying with her head leaning to one side... then I realized she was on the phone. She rudely continued on the phone as I had to work around her weird positioning. I should mention this person is a reality television star... :sarcastic: I was probably the perfect nurse to be assigned this patient because I had no idea who she was and still didn't care after people made a big deal about it. And that my friends is why I don't watch reality TV!

Maybe I'm odd but I would rather NOT have family with me in the room when I'm checked at the ER or hospital....reason I like my privacy, and sometimes they sometimes add stress on me. I maybe disabled, in a wheelchair but I don't need someone to hold my hand while I get checked out. I can make my own medical decisions and can speak for myself and prefer to. Need to start an IV? Pick an arm and go to town, I have been told I have very nice veins so I'm an easy stick. I don't need my family to be called because you need to start one. You may want to hide my veins from the other nurses though I had a few nurses before asst. my nurse with tasks and see my veins and lightly tap them and say may I stick you?

I was 8 years old and in a body cast and vomiting so much I had to go to the ER for fluids and meds. My parents wanted to have dinner in shifts I told them they could go together, they were only going to the cafeteria, my nurse was shocked by this and said wow I wouldn't want my parents to leave me If I was in a body cast and as sick as you are and I'm 30. I told her I felt comfortable and safe with her.

I would NEVER stay on my cell phone while the nurse/doc was assessing me, starting an IV, it is rude to do that while you are at dinner with someone you know, so why should a stranger who's trying to fix you up be any different?

Maybe it's from everything I had to go through at such a young age medically but not too much bothers me and I have always trusted my care providers---Nurses in particular (They have never gave me a reason not to) So I'm comfortable without an entourage.

I don't know how all of you put up with all of the rudeness from family members you would think since you are trying to help a member of their family they would be MORE RESPECTFUL towards you. Oh well I try to break the "Disrespect The Nurse" cycle one nurse at a time.

I was recently putting the heart monitor on a young female patient after she returned from the restroom. I thought she was lying with her head leaning to one side... then I realized she was on the phone. She rudely continued on the phone as I had to work around her weird positioning. I should mention this person is a reality television star... :sarcastic: I was probably the perfect nurse to be assigned this patient because I had no idea who she was and still didn't care after people made a big deal about it. And that my friends is why I don't watch reality TV!

This is why I no longer have the patience to do bedside nursing. I would have politely said: Ma'am, your doctor wants you on telemetry. I'll come back to put the leads on when you're off the phone.

Now, if it was Barbra Streisand, or someone like that, that would be different. :)

This thread made me chuckle.

Completely universal!

We did have a non-written policy to make family wait in lobby for a few minutes while we got them settled. Of course, this causes some grief, as you've mentioned, the entire extended family must rush in for, say, a cough.

I enjoy the cell phones (sarcasm), especially during pelvic exams.

No one covered the 'are you going to keep them' the instant they come in, for say, a sore throat.

How about the awkwardness of a passing, and you give family say, 3 hours after passing. Then you approach them about funeral home/coroner and they tell you they are waiting until family comes in from 3 states away... They can't afford funeral home so they are trying to have a wake in your ER..

Specializes in Emergency.
I was 8 years old and in a body cast and vomiting so much I had to go to the ER for fluids and meds. My parents wanted to have dinner in shifts I told them they could go together they were only going to the cafeteria, my nurse was shocked by this and said wow I wouldn’t want my parents to leave me If I was in a body cast and as sick as you are and I’m 30. I told her I felt comfortable and safe with her. [/quote']

Sounds like you are a thoughtful patient and you had thoughtful parents. This reminders me of another though.

The "My kid is sick! Free babysitting!" Parent.

I always offer for Mom or dad to step out if we do something painful, suggesting it is a good time to go get a meal, some like to do this, others do not. I also feed parents of truly sick kids who are staying awhile. If it is an infant I will let them snuggle up in bed, if someone on staff has little extra time we will also ask if they want to go take a break, but some people are outrageous.

I was brand new the first time I patient came swooping out of a room, commanded "watch my baby, I need to go stretch my legs" (whatever they say it is code for 'smoke a cigarette') I had no idea what to say, and ended up sitting at my desk charting with a chunky 11 month old sitting on my knee until she returned 20 minutes later, good thing it was a slow night and I had no really sick patients.

Now I can't say no fast enough, a break from the ER while your tiny child cannot leave needs to be arranged with the nurse or another family member, not whenever the fancy strikes you.

The most egregious I ever had was a parent of a 7 year old who was admitted to the hospital, and actually very ill. She told me she was going for a smoke (which I discouraged due to her daughter's condition) and never came back. We finally contacted her at home "What do you want I'm trying to take a nap." We called social services on that one.

Specializes in Emergency Nursing.

No one covered the 'are you going to keep them' the instant they come in, for say, a sore throat.

This is great! See this one all the time. Bloodwork isn't even back and they family is already asking, "What time will they be sending him home?" Or once they're admitted they want to know every single detail of the care plan.... like I would know that.

Here's another one, patient JUST came in, "DID YOU CALL HIS DOCTOR!?"

:laugh:

This is great! See this one all the time. Bloodwork isn't even back and they family is already asking "What time will they be sending him home?" Or once they're admitted they want to know every single detail of the care plan.... like I would know that. Here's another one, patient JUST came in, "DID YOU CALL HIS DOCTOR!?" :laugh:[/quote']

Yes, I'm amazed at how many people are on a very intimate, personal level with their md.. That doc always tells them to demand a personal phone call, to be notified the instant they arrive..

I don't even say anything anymore.

I did, however, get a phone call from a doc who's pt was in waiting room, doc told me he sees an open bed, why isn't pt in it? Doc wasn't even in the hospital

Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

I always joke around with one of our doctors that I'm biding my time till I can work on the unit that serves only childless orphans without siblings, friends or significant others. :cool:

I did, however, get a phone call from a doc who's pt was in waiting room, doc told me he sees an open bed, why isn't pt in it? Doc wasn't even in the hospital

Maybe he has a crystal ball.

Specializes in ED.

11) The obnoxious aunt (who is an RN) of the two month old who triaged her own nephew with a skull fx and brain bleed, who then clocked out and drove three hours to be with him after he was flown out. And knows that CPS has been called in, KNOWS you are lying about it, and hears you talking to the CPS worked about how the family "has no idea what's going on, they just think they're being kept for observation". NOPE! They know exactly why they are having to stay an extra night, they know you are full of crap, especially since he's being kept for monitoring but I pulled his pulse ox monitor off of him three hours ago just to see what would happen and there has STILL been no one in the room to check his monitor. Yeah, I was a massive pain while my nephew was hospitalized. To be fair, the nurses and doctors flat out lied to us for the entire visit. My mother is a therapist, knew the head of DCBS in my region and had to call her to even get us discharged within a reasonable amount of time. On top of the fact that this hospital mixed up my nephew's CT results with another child, lied about hospital policy (tried to tell my sister that my nephew HAD to have a rectal temp upon admission and that it was not optional after having 5 rectal temps taken in the ED, I told that nurse she could get a rectal temp on him after I took her rectal temp). I was also operating on no sleep over three days and was DONE. I try to give professional courtesy but I was done being nice when this hospital pulled the above stunts and also never bothered to inform us of what procedures had been done to him while we were in route. My sister had no idea he had had additional labs done until I pointed out the blood bank band on him and then corralled a nurse to ask what had been done prior to us arriving. Moral of the story, you never know what profession the family members are in or what/who they know. Be open, honest, and listen when they are agitated. Sometimes it is just BS but sometimes they are well versed in these sorts of situations.

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