Should family members insist on being present for procedures?

[MG-NotANurse]

I don't post often on this site, but when I do I always receive thoughtful and helpful answers.

My mother had cataract surgery recently; the procedure went very well. Mom is very independent and told me that she would make her own arrangements to get to the hospital; I picked her up and took her home afterwards.

Here's the question. Just about everybody I know was shocked that I didn't bring Mom to the hospital, remain in the waiting room throughout the procedure, and let all of the staff know I was there. The consensus was that, unless a family member is at the hospital constantly, the patient will not receive the best possible care.

This just doesn't sound right. Do your patients feel the same way? Or, to rephrase the question, if you had an A & O family member who asked you not to wait during her procedure, would you insist on doing so?

Thanks for your help.

MG

[CHATSDALE]

my adult son had a daysurgery on a rotar cuff...they required that someone drop them off and that they not have access to car on discharge

sooo, i was going to drop him off but the nurses called me when i had driven away and said that the surgery was not going to be started unless he had family member in waiting room

i really don't know why, he is an independent adult and i would have no right to sign any consent if something bad had happen during the surgery

[Xbox Live Addict]

my adult son had a daysurgery on a rotar cuff...they required that someone drop them off and that they not have access to car on discharge

sooo, i was going to drop him off but the nurses called me when i had driven away and said that the surgery was not going to be started unless he had family member in waiting room

i really don't know why, he is an independent adult and i would have no right to sign any consent if something bad had happen during the surgery

And that's screwed up. Some people have no family. Are they going to refuse care to these people just because no one can be there?

[Altra, BSN, RN]

Or, to rephrase the question, if you had an A & O family member who asked you not to wait during her procedure, would you insist on doing so?

If I went against my A & O family member's wishes on this, it would be just as disrespectful as if I had ignored their expressed wishes on any other situation or topic.

[MG-NotANurse]

Thanks, everyone, for your responses.

Lpnflorida, I didn't question myself at the time. But almost everybody I know seemed to believe that Mom would absolutely not receive proper care unless I was making a pest of myself in the waiting room, and that just seemed wrong.

Mama-d, I am a lawyer, and you might be surprised how many times I've been asked "didn't you threaten to sue?" People are usually shocked when I say no: I never tell people what I do unless asked directly.

So it seems, as Sharrie and SmilingBlueEyes say, that the situation depends on the patient's wishes and the family member's own best instincts. All I know is that Mom was the only one NOT critical afterwards.

MG

[RN1982]

Well, we're glad you don't threaten to sue. I hate when people try to pull rank and start making threats. Just makes any situation ten times worse.

[rita359]

We are talking about an outpatient procedure here. If you were there you would be in the waiting room until she woke up anyway. It isn't like they are going to let you watch the surgery. I see nothing wrong with what you did. I've had a colonoscopy. My husband dropped me off, went to work, came back and picked me up. If we were talking about a major inpatient surgery it might be different.

[ERER]

Interesting Question! On the one hand there are Family Members who might prove too emotional upsetting the patient and/or interfear with staff trying to do their job correctly. On the other hand, their are Family Members who actually take the time to review and learn about the test/procedure to be performed on their loved one and can offer genuine, emotional support while being present to the patient without interfearing with Staff. So I'd say it would be helpful to treat each case and request on an individual basis and delve into reasons for Family wishing to be present esp when the patient ask! After all, a patient can refuse a procedure/test if a misunderstanding develops by not allowing a family member and you are pretty much a fish outta water at that point as you cannot "force" or "physically make" a patient refusing to be subjected to a medical test anyway for obvious reasons! I've known Husbands that have requested being present with wives and vice versa where the parties are genuinely concerned about each other; have a genuine interest and have taken time to learn about the test/procedure involved; fully understand the OR is NOT a place to be asking to be present; and actually enhance the experience of the patient during procedure with just a simple reassuring smile! Don't see anything wrong with this at all!

[hiddencatRN, BSN, RN]

I don't post often on this site, but when I do I always receive thoughtful and helpful answers.

My mother had cataract surgery recently; the procedure went very well. Mom is very independent and told me that she would make her own arrangements to get to the hospital; I picked her up and took her home afterwards.

Here's the question. Just about everybody I know was shocked that I didn't bring Mom to the hospital, remain in the waiting room throughout the procedure, and let all of the staff know I was there. The consensus was that, unless a family member is at the hospital constantly, the patient will not receive the best possible care.

This just doesn't sound right. Do your patients feel the same way? Or, to rephrase the question, if you had an A & O family member who asked you not to wait during her procedure, would you insist on doing so?

Thanks for your help.

MG

When my dad had surgery, I went to the hospital and waited in the surgical waiting room, and then spent the next few days in the hospital with him. I kept him company, listened to what the doctors were saying (I was pre-nursing school at that point so was FAR from an expert), got him ice water and walked with him. I think the hospital staff would have taken good care of him if he wasn't there, but I think family presence was helpful for moral support and I was able to take notes on what the plan of care was so we could all remember it.

If it had just been a minor procedure and he didn't want help, I would have stayed home and I'm sure he would have been fine. I'm a drama queen with health care stuff so I go to the dentist and I want family waiting there with me but I think it's really about what the patient wants and needs to feel supported.

[kids]

I don't see how a family members presence or absence in the waiting room would have any impact on care during a presumably minor outpatient surgery.

For that matter I don't see where they would have any impact (from the waiting room) on care during a major or inpatient surgery.

On the floor, during an inpatient stay is another thing all together. Family presence then can definitely impact patient care, both for the good and bad.

Of course I'm the wife who tried to convince my husband to drop me off and go to work while I had a 12+ hour spine surgery (he didn't go for it). I did appreciate all the time he spent camping out at the hospital for the following week, he was the only person who could move and reposition me comfortably.

[Fiona59]

Uhm, 99% of cataracts are done under local anaesthesia under the outpatients/daysurgery unit. The other 1% are a totally different topic.

My friend works in a cataract unit. They permit one patient to wait in the pre-op area if the patient permits it. Usually, the family just walks Dad or whoever to the chair, look around and leave. There is absolutely nothing for them to do there. No cell phones, no food permitted.

The memorable one is the guy who insisted on going into the OR with his wife. The surgeon flat out told him to take a hike or the surgery wouldn't be done.

Legally, the patient is responsible for their consent and marking of the surgical site. So what the family's job really is, is moral support and a ride home after it's over.

Oh, and the Reader's Digest and their constant stream of "watch those nurses like hawks" articles are getting old real fast.

[notjustanurse]

I would like to answer your question by sharing an experience of mine.

I broke my ankle badly and needed surgery to repair it. My husband needed to stay home to care for our 9 month old daughter so he was unable to stay with me after my surgery. I remember nothing of my PACU time, and my memory after I returned to my room is sketchy for HOURS, which can be chalked up to the meds. What sucked was that I kept trying to tell my nurse something was wrong, at least that's what I think I said, I don't really know what I actually said. I was so confused and I do remember not knowing where I was. At some point I got a hold of my cell phone and called a friend who recognized how "off" I was and phoned the nursing desk immediately, demanding vital signs, etc. My pulse ox was 74%. They gave me narcan 3 times. I really think that if someone had been able to stay with me the inept nurse assigned to my room would have been forced to intervene sooner.

[notjustanurse]

And because of that situation I will always have someone with me if I possibly can any time I have a procedure that could potentially alter my LOC.