"I want him extubated NOW...I dont care if he's not ready"

Nurses General Nursing

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So here is my new horror story from my unit:

We have this CRAZY family member (the POA), who has barely enough medical knowledge to make her dangerous...we all know the type :)

Background: patient is in severe heart failure, pulmonary edema, intubated on high peep/Fio2, inotropes, awful Swan #'s, not a candidate for LVAD or transplant. We are just trying to stabilize and dry him out, basically.

The POA is aware of this, doesnt care, but wants him extubated bc she read "somewhere" that being on a vent can cause VAP, etc. Ugh.

Here is her list of "demands":

1. That we turn off his sedation, skip weaning, and just immediately extubate (bc of the risk of VAP). She has come into our unit in the middle of the night (thank you, open visitation!) and tried this several times in a row. She doesnt listen to reason from the nurses or MD's (she demands to speak with the MD's at 4 am on the phone btw).

2. After trying to get #1 and failing, she changed #1 to: "well if you have to reintubate him, then thats ok I guess, but I want his ET tube changed out. I think there's some bacteria growing on it":banghead:

3. When we DO extubate him (not like we are going to in his present condition), she wants us to d/c the sedation, then immediately attempt to stand this 350 lb patient up on his feet, wean him standing up in that position hooked to the ventilator, and then d/c the ET tube....all bc she says "at home, he has to be in a high position to breathe". LOL:yeah:

4. She demands to read his chart/lab values/look at his chest xray every day... ok I know she is the POA, but there is still a formal process to view PHI at my hospital, and she hasnt gone through it :nono:

The other day, a nurse caught her smuggling out a urine sample from the patient's foley bag!! When she was stopped and asked what the _____ she was doing, she replied "Dont you worry about it, mind your business." Presumably, she wants to get his urine analyzed somewhere else...who the heck knows for what. It is unreal the kinds of things she has done/demanded.

The whole situation has gotten completely out of hand. Numerous incident reports have been filed, but nothing has been done. My manager seems to be turning a blind eye. We all believe she is setting up to sue (but doubt anything will become of it d/t her crazy behavior--- I mean, obtaining a urine specimen and putting it in her purse?? OMG). The nurses that care for this pt are charting to a "t", noting all her actions, RN responses/actions, and charting the constant phone calls to the MD and unit manger. Every time she comes in, the nurses watch the IV pumps and ventilator like hawks to make sure she doesnt do something really stupid and harm the pt, but they cant police her 24/7.

My question is: what will it take to get this lady REMOVED FROM THE HOSPITAL ?!! Press Ganey can take a leap off a cliff!!

Specializes in Med/Surg.

Just wondering, did this POA really know what was wrong with pt, the treatments needed? Maybe have a conference with her and caregivers going over the care plan ,the interventions and goals. This generally helps alot when there is a demanding family who don't really understand the treatment . And maybe the lady needed that clean UA to have tested for herself ! No , I guess not, if he was sedated it was sure to be positive for something!!

Specializes in Med/Surg/Oncology.

I hate it when you have family members who think they know better, we had a patient with an NGT hooked up to LWS, but the family member thought that it was too low and was asking to put suction onto high! We don't want the patient's intestines being sucked out with it!!!

In that case: I would coat the foley bag and tube in a layer of vaseline, so that the next time she tries to steal a urine sample, she'll get it all over her hands. When she asks you about it, get really excited and go, "Oh my God! What is that?! You should go get checked out in the ER right away!"

If you do this, do it anonymously---so that the ER nurses won't try to meet you out in the parking lot.:chuckle:chuckle:chuckle:chuckle

I truly feel sorry for the ER nurses that ever have to put up with her.

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