It is not a crime to ask a family member to leave the bedside. I have done it rarely in my career, but when I have done this it is because of what the patient needs. There are times that no matter how much you have explained to the family what is happening, how many questions you have answered or how much time you have spent with them, the family is not absorbing what is being said to them. And frankly there are many, many times that the family have not managed to realize that ultimately it is the patient who has to have their needs meant, not them.
When I worked in the neuro ICU years ago I had an 18 year old kid who had been in a bar on a false ID, who managed to pick a fight with the wrong set of people. He ended up with a severe head trauma. Family flew in from Chicago, mom and dad divorced. They would go to the nurse with, "tell my ex-husband this", "tell my ex-wife that" these two parents could not even manage to be decent when their son was hovering near death. The ultimate problem they simply could not manage to put aside their own needs to take a look at their son's needs. The mother would come into the room and rub his legs, and his arms. Crying or talking to him constantly. I would watch his ICP's hit 100 or more. For those of you who don't understand this, any intercanial pressure above 50 is causing damage to the brain. I repeatedly explained to her that she needed to be quiet, that she needed to please not rub his body at all. Educated her that she could sit quietly at the bedside and hold his hand as long as she wasn't rubbing his hand or making any type of repetative movement. But she just couldn't manage to do this. After a number of hours of dealing with this, I asked her to leave, and explained that her repeated disregard for the instructions I had given her was causing harm to her son. She refused. I called security and had her removed. Did this mean I could not understand that this woman was had fear? Or that I didn't understand that she simply needed to have a physical connection to her child? Or course not, I understood that well, I have children myself. But when it comes down to allowing a family member to do something that is obviously contraindicated for the PATIENT'S health regardless of the reasons or what the family member is feeling I fully believe it is up to the nurse who is EDUCATED to know what the patient needs and who has the ultimate responsiblity to protect that patient, to request that family members need to remove themselves away from the patient.
Talino, I am sorry about your own mom. Having lost my dad 2 and a half years ago after some terrible care and some things that should have been done that weren't, I think I understand your upset. Saying that however, what I see here is what in school we learned was transference. You feel that the family members were looked at as only a pain, perhaps the way you felt when no one was there for you when your mom was in ICU. Perhaps because of your experience in the ICU you are able to empathisize with family members in a way that other nurses do not. I know that because of the way things happened with my own dad I get angry pretty quickly when I see nurses who are not through with their own assessments on patients, it also led me to become vocal about what nurses need in order to do our job's appropriately. It may be that you have yet to run into a situation where you had to make a choice between the patient and the family needs, I don't know. I do however, know that this bb exists in part to allow a place for nurses to come in and vent, to ask advice, to ask for support etc... and while one can most certainly disagree with one another, it need not be done rudely. All of us learned how important family and the family dynamics for a patient is, and there are times I'm betting that each of us have dealt with families that we just don't understand where they are coming from. As long as what they are doing does not interfere with the ultimate responsiblity of taking care of the patient then there never needs to be a problem. But when that line is crossed, it is the nurses duty to step in and ensure that the patient is the center of care, not the family. Disagreeing with this is certainly your right, but again I say it need not be done rudely. And when a nurse is neglecting another patient in favor of spending time with a family that is not even the family of the neglected patient, than priorities need to be set. I agree with another poster, there are times when pastoral care should be brought in or social services to deal with these situations. As nurses we can't do it all, should not be expected to do it all. And no matter what our ultimate responsibilty is to the person who is ill and in our care. The ultimate responsibility is not to the family.
