Members are discussing the role of family members in providing medical information for hospitalized patients. Some members argue that spouses should be allowed to answer questions on behalf of the patient, while others emphasize the importance of obtaining information directly from the patient. The debate revolves around the balance between respecting the patient's autonomy and ensuring accurate medical history.
I'm not a nurse, but I'm hoping someone can clear something up for me.
I accompanied my husband to hospital several times over the past few weeks, and a couple of things have really puzzled and slightly annoyed me.
First off, we went to see a consultant, who had to examine my husband's abdomen. The consultant asked my husband to remove his shirt and lie on the bed, so my husband started taking his shirt off as he was walking to the bed. The consultant hurriedly ushered my husband towards the bed, and closed the curtain as if trying to protect my husband's privacy (from me - his wife?!). I found that a bit odd, especially as he only had to remove his shirt. Does he not think I've seen my husband's chest before?
Secondly, when my husband went into the same hospital for a procedure, the porter asked me to leave the room whilst they (four people including two females) transferred my husband from the trolley to the bed.
In both these situations it struck me as a little odd that a spouse would be asked to leave, and I felt a bit annoyed that the staff wanted to shield him from me, as if me being there would upset him somehow. When in fact he would feel no loss of dignity or privacy if I saw any part of his body at any time.
He is more comfortable with me seeing his body than anyone else in the world, especially female hospial staff. If he was going to suffer any loss of dignity, it would be from them seeing him, not me.
I should think that would be the case for most couples (except perhaps the odd vicar / nun combination).
Shouldn't the patient be asked?
All staff knew we were married, because he introduced me as his wife to all staff members who assisted him.
I realise I'm taking this way too personally, andpeople will think I'm getting upset over nothing. I've tried to put this out of my mind, but unfortunately it's not going anywhere, and I'm hoping someone can enlighten me as to the rationale behing asking spouses to leave in the situations described above. It might help me feel a bit better.
I don't want to ask the hospital, because they might think I'm neurotic and paranoid, which I am due to a couple of mental health conditions.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Susie2310 said:
I recognize how a wife who wants to do all the talking for the patient can be a problem, and I recognize the necessity for patients to be able, if they wish, to disclose information without a spouse/family member present. But please consider this particular situation, which I'm certain is quite common: When my husband has been hospitalized, and I have answered questions posed to him, I.e. admission assessment; it has been because even though my husband may be alert and oriented, he is also very sick, and I can at this moment in time answer more accurately and completely for him. It is that simple, and it takes the burden off him, when he is using all his energy just trying to stay alive. I want him to get the best care possible, and if I can contribute by recalling important health information for him, I'm going to do so. Just because someone is alert and oriented doesn't mean that they will easily recall important information, especially when they are very sick (as people usually have to be to get admitted to hospital). I am actually more interested in remembering the details than my husband is; surely what one wants as a nurse is an accurate database, regardless of whether the wife does more or even most of the talking. As a nurse, if the patient was willing for the spouse to be present, I would be more concerned about obtaining correct information about the patient's medical problems, past illnesses/surgeries, allergies, medications etc. so that I could give appropriate care, than I would be worrying about whether the patient personally relayed what they could recall of that information to me.
You make a very good point about the importance of asking the spouse to step out of the room while a history is being taken. Taking the very best care of your husband involves an assessment of his knowledge base about his illness, his ability to answer questions, his ability to communicate. It is also a very good time for us to ask HIS preferences for visiting. Maybe he's not quite as eager to have you at the bedside 24/7 as you might think. Maybe he is. But we need to hear that from HIM rather than from YOU. And he's not going to verbalize his need for time away from you in front of you.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Susie2310 said:
Altra, I'm afraid your explanation doesn't address a situation such as mine and my husband's, although it does address a textbook situation. I hope both my husband and myself continue to encounter nurses who have some compassion, flexibility and common sense in dealing with life and death.
You aren't getting it. You seem to think that your situation is somehow special.
You make a very good point about the importance of asking the spouse to step out of the room while a history is being taken. Taking the very best care of your husband involves an assessment of his knowledge base about his illness, his ability to answer questions, his ability to communicate. It is also a very good time for us to ask HIS preferences for visiting. Maybe he's not quite as eager to have you at the bedside 24/7 as you might think. Maybe he is. But we need to hear that from HIM rather than from YOU. And he's not going to verbalize his need for time away from you in front of you.
Interesting that you choose to reply to an old post from 2012. My post stands, and it is now 2017, soon to be 2018.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Kooky Korky said:
I think this is a no-win situation. Some like it hot, some like it cold, some like it in the pot 9 days old.
Ruby Vee - You make a good point from the nurse's POV. But from the patient's side, and from the
spouse's side, of course each situation is special to the people embroiled in it. While routine to staff, the
people actually living it are actually living it.
The original thread took place in May 2012 . . . when I was dealing with my own cancer issues and surgeries. I was an inpatient on four separate occaisions between May and June that year. And my opinion at that time was the same as my opinion now. I make a point from the patient's point of view as well.
I make a point from the patient's point of view as well.
I think most of us can come from that point of view since most of us has been in the patient's/patient's family's shoes at some time.
People often talk about "the patient's point of view" forgetting that we've walked in those shoes. We just have the added bonus of our nursing shoes as well. We can see both sides of the matter.
I think the problem on this thread is that some people who are nurses and have also experienced being patients and family members, believe they can see both sides of the matter, and are forgetting that their experience and perceptions of both sides are their reality, and that patients and family members have their reality too. Just because you think it entirely reasonable that spouses be asked/forced to leave the room during the nurse's assessment/other care, because you experienced it this way, doesn't mean that it is reasonable to impose this on patients and family members who don't share your views. The point is to try to meet the patient and the family where they are. Nursing care is centered on the patient and their family, not on the nurse.
Ruby Vee, BSN
17 Articles; 14,051 Posts
You make a very good point about the importance of asking the spouse to step out of the room while a history is being taken. Taking the very best care of your husband involves an assessment of his knowledge base about his illness, his ability to answer questions, his ability to communicate. It is also a very good time for us to ask HIS preferences for visiting. Maybe he's not quite as eager to have you at the bedside 24/7 as you might think. Maybe he is. But we need to hear that from HIM rather than from YOU. And he's not going to verbalize his need for time away from you in front of you.