Pt/parents privacy, respecting it!

[Lorie P.]

of here goes my vent ,on 1-29-09 the monthly supervisor's visit was due, i don't have a problem with that. what i do have a problem is the nurse they sent not respecting the privacy of my client or parents.

my pt has a very irregular sleepiny pattern, there are nights she doesn't go to sleep unitl after 4am. this was the case on this day. the nurse shows up at 10 am and i tell her politely that the pt and parents are sleeping and are behind closed doors. she wants to know if she can just open the door and take a 'peep" so that at least she has seen the client. i tell her no! that is their private area and that i wouldn't want a stranger doing that to me.

this was the very first time that this nurse had been for a visit. the nurse that usally comes knows this and doesn't mind.

the nurse on this visit kept asking, just open the door and look, again i said no! after about 5x of asking and refusing her request, she calls the case manager ( another nurse) who is 2.5 hrs away and tells here she isn't allowed to see the pt cause i refuse to open the door to parents bedroom. the supervisor ask( i can hear her cause of speaker phone) if i have gotten a set of vs cause they must be done with in 2 hrs of arriving at client's home, i say no, the pt's care hasn't been turned over to me yet, cause the pt is with her parents behind closed doors and i am not going to invade their privacey!

anyway long story short, pt and family did wake up and she was able to see pt. the director of clinical services backed me 100% for being my pt's advocant and protecting the family's privacey.

anyone ever had this issue come up and how did you handle it?

thanks so much

[ArwenEvenstar]

I've not had anything exactly like this....but I think you did the right thing! If I was in bed with my husband and our baby was in the room with us, and the door closed, I would be LIVID, totally LIVID, if a nurse opened the door and peaked in at me!! What if we weren't actually sleeping but doing something else?! This is my home and the door is closed! Only thing I can think of is maybe you could have very softly knocked and seen if they responded... But if they didn't, let them be. I have had situations where I debated about whether to "bother" the family or not....it just depends.

It is so important to keep that professional boundary, and respect the privacy of the home. I always try to imagine what it would be like to always have a nurse in your home! Then, on top of it, imagine some nurse who lacks a professional boundary, invades privacy, and noses into business that is not hers. I have encountered two nurses in the past who failed to keep a professional boundary and essentially socially integrated into the family. It created SO MANY problems. (I could type a 5,000 word post! haha) The family is not your friend, they are a client! A nurse who had socially integrated into the family likely would have barged right into the room without even thinking about it.

Private duty does create unique situations....where nurses must balance the family's rights vs. the nurse's responsibilities. You are in a private home, and the family can really do whatever they choose to do in regards to the patient's care. As the nurse, we do have to follow MD orders and we must make sure that the patient is being cared for properly...but there are sometimes shades of gray in the home. This is another reason to keep a professional boundary...only then will we be able to make OBJECTIVE decisions about the patient's care.

I think you did the right thing nurse hobbit! It is great the Director of Clinical Services backed you! I am sure that was re-assuring. Continue to keep a professional boundary and respect the privacy of the family! I was once accused by another PD nurse of being cold-hearted and cruel because of the firm professional boundary I maintained with a particular family. It is often rare in life to see justice done, but justice was eventually done...the situation went bad and the nurse was fired. She did it to herself by being a "friend" to the family instead of their nurse.

[Lorie P.]

usually you can hear if the family is up and moving around and they weren't at this time.

i explained just that to the other nurse, saying, look i am in this family's house 5 days a week up to 12 hrs a day, i am in every room except their bedroom. that is their private area and no way am i about to open the door and peek in.

i would be highly ticked off if a stranger opened my closed door and peeked in. guess some people just don't get it.

yea it was great having support form the doc on this one.

i try my best to keep that professional boundry and the family keeps theirs' too.

it is much better this way, plus it makes the job easier and no room for over stepping into that "friendship" area.

by the way, everyone is still sleeping behind closed doors this morning and the door will stay closed until they open it.

[caliotter3]

Any nurse who wants to open the bedroom door of a client's family just to "peek" is asking to be thrown out of the house and to be fired. I am surprised that this person is a supervisor. Besides, "peeking" does not cut it for a supervisor's visit. They are supposed to assess the patient.

[Elektra6, ASN, BSN, RN]

I'm guessing that your patient is a baby or toddler but I had a similar situation yesterday. My client sleeps VERY late and was also sick this week. The supervisor bypasses the front and kitchen door and looks into his bedroom while Im dressing him! Crazy! Plus scared me too. She is familiar with his pattern so why doesn't she shedule her visit for later or call us to see if he's up? I pointed for her to go to the front door and met her there so I think I handled it well.