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! 
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!
DayDreamin ER CRNP
640 Posts
The wife of the sickest patient in the ED (art line, central line, tubed, pressers, etc) comes out to the desk stating to me, the pt's nurse, "When you get a fresh pot of coffee made, I'll need a cup. And can we clean up some of this mess?"
Keeping in mind that I have otherwise been in the patient's room for the past four hours and only walked out to the desk ten steps across the room to use the bathroom and to get another pump for the fifth medication I'll be hanging.
Then said patient's child is an outpatient OR recovery nurse and is complaining about the tube placement tape that is "pulling on his lip." Stating, "We just don't DO that in the OR." Me? I'm looking in the room with the 3 used Bougies on the floor and the Glidescope at BS, and thinking, "are you freaking kidding me?" Instead I politely tell the family members, "based on the supplies I see in the room and on this floor, I'm guessing this was a very difficult intubation and we are doing all we can to keep him tubed and stable at the moment. So sorry I haven't had time to clean up the mess." ::eye roll::
Also love the patient that tries to lie to me and tells me "that doctor said I could have some pain medicine and you need to give it to me." Knowing that doc is NOT giving you anything. I still have to have a WRITTEN order for it.
Or that other patient that was already given some dilaudid by my co-worker but tries to tell me she didn't. Yeah, buddy. Try again.
I really do appreciate the family members that are knowledgeable about the patient's history, etc but still knows his/her boundaries and is actually appreciative of what we do as a profession. It actually drives me and pushes me to do my very best for your family member.