"It's a Family Affair....."

[patrice meursault]

Anyone else noting a trend of the last say 5-10 years of folks bringing in the extended family, or even the whole block while visiting the ER? And it is usually goes, the more silly or stupid the reason of the visit, the more visitors in attendance. It's a freakin family outing.

Last week I had a 3 yr old boy brought in by eight other family members for a rash to the scalp for three months!!!! And it was the size of a single pimple.

They had four generations!!! Great GMA, G-Ma, Mother, and siblings, cousins, neighbor.

Then they had the audacity to ask for food and beverage. They even complained that their room had no TV.

I'm not making this up either!!!! And trying to enforce the visitor rules are a joke as they just sneak in the locked door whenever it opens.

Or you get the patient who has to call every person they know once they arrive, then the trickle effect as the dozen or more people come to visit as word in the neighborhood spreads that so and so is in the ER.

I just keep singing the song (In the tune of "He's Got The WHole World in His Hands)

"We got the whole family, in my ER, we got the whole family in my ER...."

[PatricksRNMommy]

I don't work in the ER, but on the floor this happens all too often, I understand wanting to visit your ill loved one, but I am THEIR nurse, not yours. There is a cafeteria and a coffee shop downstairs. I am pretty accomodating to a point (and if people ask nicely) but when they start snapping their fingers and ordering me around like their maid (Yes, someone did this to me yesterday "Fetch me a water, I'm parched - light ice and a straw."), I direct them to the cafeteria. The visitors get so out of control sometimes, I am forced to tell some of them to leave (if they are a disruption to other patients or to tasks that need to be completed with the patient).

[delilas]

It also depends on where you live, and the communities nearby. One of our NPs is fond of recalling her times in Chicago in an area with a large gypsy population who would literally cram 20 people in a labor and delivery room, and more would be in the hallway and waiting room. For me, the most I usually see is four. Some cultures really lend themselves to everything being a family affair and every decision being the family's.

[lilbearzmom]

OK, I'm a pre-healthcare student, but I used to work for the courts. It's not just the ER. People would bring their entire extended family plus neighbors for their traffic ticket. We had really limited seating in our waiting area, and it always irked me when on busy days, people who were there on legitimate business could not find seats. I think people are really bored and have nothing better to do, just my honest opinion. It's annoying, to say the least.

[CNM 26.2]

My general rule of thumb is if the family is there for support for the patient and they are not causing problems they are welcome. I do have a problem with people that think they are "entitled" to view the birth just because they are related or friends with the patient. I usually talk with the patient well ahead of time and find out who she wants in the room-and I tell her that they must be supportive and I WILL put them to work doing counter pressures, getting her water, ice, juice, etc...it's not a spectator sport! ; ) I am more than willing to be the bad guy and kick out those people that the mom doesn't want in the room. I must admit, however, that I am surprised sometimes at how many people women actually want in the room during their birth.

[Ruby Vee, BSN]

i don't work in er, have never worked in er and have been a patient. when i was sitting in the waiting room with the nausea, projectile vomiting and headache that go with a csf leak i was not appreciative of the large family (17 people plus two or three infants) eating their take-out and stridently "conversing" next to me. nor did i appreciate the family letting their toddlers run, scream and put their sticky, dirty fingers on me, on my bag and on the bucket i was barfing into. i have to agree that it seemed as if the er waiting room was the cool place to hang out. ems brought in a drunken teenager and all her friends congregated in the waiting room -- none too sober themselves -- and ordered pizza. i waited four hours. i'm not saying that's an unreasonable amount of time to wait, but when you're truly miserable, you really don't want to deal with the food smells, the screaming, the toddlers, etc. plus every time i got up to go empty my barf bucket in the restroom, one of the visitors would take my chair and i'd have to stand for awhile.

we get the same thing in the icu with certain cultures. we only allow two visitors at a time, so the rest of the extended family hangs out in the waiting room. one time a family brought in a hibachi and were cooking their meals! they spoke ok english until our manager tried to explain to them that they couldn't cook in the waiting room . . . we ended up having to call security who called the police.

i've had 8 or 9 of a patient's closest friends show up at 2am -- probably not so coincidental that the bars closed right about then -- to visit. that's a fairly common occurance with certain groups.

i guess i shouldn't say anything, though. when my father was in the icu post mi in the 90s, all of my aunts and uncles showed up to "visit." they weren't allowed into the icu, so mom held court in the waiting room. she attempted to draft me into entertaining the visitors "because they drove so far to visit", but i wasn't having any of that. i don't understand it. it's my own family, and i still don't understand it.

[iluvivt, BSN, RN]

Here is my rule......IF the family or any person for that matter impedes my ability to provide safe and good nursing care then out they go!!!! I personally can not stand when 10 people want to watch me start an IV b/c they start talking about their veins and how no one can get them or worse yet they say things like "you will never get it" . So now I just say "please step out ....I will need 10 min or if it is a PICC placement....I will have to ask you to all step out now as this a sterile procedure". I do sometimes allow a family member to stay in if I have a language barrier or I beleive their presence will calm the patient and make it easier for them

[Freedom42]

I'm new to ER. Not only do they bring the whole freakin' entourage, they are utterly clueless to the nurse's need to work. Our patients are in small private rooms, and with one patient, one nurse and just two visitors, it's tough to move around equipment. Yet they pack themselves in like sardines, and when I ask if them to step outside for a few minutes to give me time to settle the patient or rearrange gear, it doesn't always register. I've had a few freak out when the patient started to vomit. They ran out of the room so fast that they nearly caused accidents. Then there are the ever-so-helpful ones who offer running commentaries, including, "Oh, no, you're not going to put an IV there, are you? Why? That's really going to hurt," or some variation of that. Sometimes the best thing family members can do for patients is to stay home.

[steelydanfan]

I'm new to ER. Not only do they bring the whole freakin' entourage, they are utterly clueless to the nurse's need to work. Our patients are in small private rooms, and with one patient, one nurse and just two visitors, it's tough to move around equipment. Yet they pack themselves in like sardines, and when I ask if them to step outside for a few minutes to give me time to settle the patient or rearrange gear, it doesn't always register. I've had a few freak out when the patient started to vomit. They ran out of the room so fast that they nearly caused accidents. Then there are the ever-so-helpful ones who offer running commentaries, including, "Oh, no, you're not going to put an IV there, are you? Why? That's really going to hurt," or some variation of that. Sometimes the best thing family members can do for patients is to stay home.

And I love the busybody friends and neighbors who have to call for updates, offer (usually) bad advice, and otherwise feel have to insert themseves into a place they have no business in.

I loved the friend who kept calling with the "crisis" of having to deliver a piano to the pt. (because HE thought she needed one to recover) who had just undergone major surgery and whom I was trying to get discharged, and instruct on wound care.

I loved the out of state daughter who's response to her mother's placement in an ECF for PT was "I heard the nurses were mean there". Therapeutic and caring, no?

I think that nursing schools need a new requirement, "Morons, and how to deal with them," 101.