Spouses being asked to leave the room

[Indenial]

Hi

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.

Thank you for reading; I hope someone can help.

[Morainey, BSN, RN]

I kick family members out during every transfer. Very rarely have I seen a patient say "it's ok, they can stay". I invite them to go grab a cup of coffee or go check out our great water view, we're just getting the patient settled, it will be a few minutes but I'll come find you when they're all set.

Family members do on occaison contribute meaningfully to a health history, but not often.

[Indenial]

I'd just like to say that I'm not an overbearing interfering wife who takes over the situation and answers for her husband. I'm a quiet, reserved, and respectful person.

At no point did I answer a question that was put to my husband, and I was not asked to leave the room at any point during the consultation.

I was present at the consultation in order to support him, and fill in the gaps where he had left important information out, which he did several times, as he knew he would. He couldn't remember the order things had happened, or what medication he had at what time, whereas I could.

At all times, I was careful to state that my husband "was complaining of [symptom] at around 10pm", rather than telling them how he felt.

My query was not about the consultation, or about sharing information, just being asked to leave the room during the examination, and transfer to bed.

[Indenial]

ayla2004 said:

From the term consultant and porter I guessing you are in the UK/RoI

The being asked to step out during the physical exam may be due not just to privacy but to allow for a objective exam, you have already said you had spoken with the consultant and given your account of your patient health.

Asking to step out while your husband is being transferred could be due to space however they may have also taken the opportunity to check pressure areas and perhaps do admisson mrsa swabs.

Thank you for your reply; yes I am in the UK!

Just to clarify, the consultant didn't ask me to leave the consulting room; he just pulled the curtain accross during the examination My husband just started taking his shirt off on the way to the bed, obviously unconcerned that I might see his chest, but the consultant almost barged my husband to the bed before he could take his shirt off.

As I said in my latest post, my husband was having difficulty remembering all that had happened over the previous weeks. He'd been back and forth to A&E several times, and had been in severe pain equivalent to when he passed a kidney stone. His memory was understandably hazy.

[Indenial]

getmethisnownurse said:

I think it's a weird a family member would come on a nursing forum to ask such a question.

I know it must seem wierd to a lot of people, probably everyone.

I'm asking on a forum rather than speaking to the hospital, because I would be embarrassed to ask the question in person. I know it's silly to be concerned about something like this, and no-one else would be remotely bothered by being asked to leave the room.

I have tried to tell myself this and let this go, but as I explained in my opening post, I have a couple of mental health conditions that make it difficult to cope with even small things.

This situation wouldn't have bothered me at all 10 years ago. I just wouldn't have given it a second thought or even a first thought.

Anyway, all your replies have helped me see that it was not personal, and I feel much better about the situation now.

Thank you!

[Susie2310]

Altra said:

The textbook situation would be filling out the form/checking off all the boxes.

But of course, you & your husband's situation is different.

Altra, your later post "This" in regard to another quoted statement "Everyone thinks their situation is different" causes me to believe your reply to me above was sarcastic. You replied initially to my post where I explained the reasons for answering questions for my husband when he was extremely sick. My husband, his doctors and nurses appreciated my help. As a nurse, and a wife who has taken care of my husband through serious illnesses, you seem extraordinarily uncompassionate.

[Meriwhen, ASN, BSN, MSN, RN]

Indenial said:

My query was not about the consultation, or about sharing information, just being asked to leave the room during the examination, and transfer to bed.

It's at the exam where we get a lot of the patient information. Transfers too...we take advantage of any opportunity we can to assess. The exam/transfer is not just a physical look-see at the patient's body without us saying anything. We're going to ask him questions as we're doing it. And we're not only assessing physical status but mental status.

Mind you, it's easier to assess physical status with family in the room than the mental status. But mental status is also important, even in non-psych settings. When family members are being helpful--and sometimes too helpful--by providing info and answering patient questions, I lose the chance to really assess the patient's mental status.

Yes, you have a better memory regarding his symptoms, meds and pain and that can be very valuable. However by letting him answer (or try to answer) on his own, I can assess his thought process, how alert and oriented he really is, his perception of what's going on, and whether there's congruence between words and body language, all in addition to seeing how his memory is functioning.

And as much as I hate to say it but I have to since it's not uncommon...often there are things that the patient does not wish the spouse to know. Some are benign things, others are not. But I have to honor the patient's legal rights and keep it private.

Hope this helped.

[deftonez188]

Spouse or family member, you really don't have rights to patient information, unless they want to share it or they are unable to communicate and you are their PoA. I doubt anyone is considering the situation where a patient is unconscious and intubated as a situation where we shun sharing of information with next of kin, but the situation where a spouse/family member gets feelings hurt over not being privy to information they aren't legally allowed to is 'tough cookies.'

HIPAA. HIPAA. HIPAA.

[Been there,done that, ASN, RN]

Please.. if your husband needs medical attention.. give us room!

Maybe he does not want you around , while he is going through his medical emergency.

We can't possibly know WHAT he needs at that point. Even a husband/wife relationship has limitations.

When I have the option.. I will ask.. "is it okay if your (significant other ) is present.

I very rarely have the time to define the relationship or the patient's wishes.

[Altra, BSN, RN]

Susie2310 said:

Altra, your later post "This" in regard to another quoted statement "Everyone thinks their situation is different" causes me to believe your reply to me above was sarcastic. You replied initially to my post where I explained the reasons for answering questions for my husband when he was extremely sick. My husband, his doctors and nurses appreciated my help. As a nurse, and a wife who has taken care of my husband through serious illnesses, you seem extraordinarily uncompassionate.

Susie2310, as a nurse, you seem extraordinarily fixated on this one particular aspect of patient care.

Wishing your husband well.

Edited to add:

"Uncompassionate" for focusing on the patient, and not on you, perhaps?

A number of posts in this thread have specifically detailed ways in which nurses have found family members not only not promoting good patient care but actually inhibiting it. But for whatever reason, you have chosen to focus on my posts in which I have described some aspects of my patient-focused assessment.

To each her own.

[JBudd, MSN]

Indenial said:

I know it must seem wierd to a lot of people, probably everyone.

I'm asking on a forum rather than speaking to the hospital, because I would be embarrassed to ask the question in person. I know it's silly to be concerned about something like this, and no-one else would be remotely bothered by being asked to leave the room.

Anyway, all your replies have helped me see that it was not personal, and I feel much better about the situation now.

Thank you!

It bothers a lot of people as you can see from all our different replies here. It is a good question, especially from someone on the outside looking in as it were. I'm impressed you found us here and asked instead of just brooding about it.

When my husband was ill, I answered things as I was the one doing his meds and home care (TPN, central line, Gtube suction, Jtube feeds, etc.); but I also encouraged him to speak up about his pain and what he was feeling. And I left him alone enough to have private consultations. It is very difficult for the spouse as well as the patient.

Feel free to come back and ask questions anytime!

[jadelpn, LPN, EMT-B]

Just an aside--If the doctor simply pulled the curtain around your husband, and didn't say "would you excuse us", then I would take it upon myself to say "I am going to be in the waiting room" and left the room. Seems silly that you are sitting on one side of the curtain, the patient on the other, and you can hear everything anyway. The doctor seems quite rude to do so without an excuse me or the nurse saying, could you please wait in the waiting room and we will get your husband settled.

And to the other poster who thinks reasoning is that people are assuming you are some overbearing spouse....again, not personal, appreciate you are a nurse and that you can add to the history and medications of your husband. That you have taken care of him, stood by him through serious illness, however each patient has a right to privacy. He can share with you what happend in the admission assessment should he choose to. We would appreciate any information you would like to share, but after we have obtained our own unbiased assessment first, and have the patient's ok to get that info from you. Even if my initial assessment is answered with "I don't know, can't remember, ask my spouse" I need to hear that from the patient. And then ask patient to sign medical information release forms. One never knows. The time to find out that there's a very complicated family dynamic going on is NOT when the social worker comes at discharge. Then the nurse is held responsible for infomation that should have been obtained on admission.

[anotherone, BSN, RN]

MPKH said:

In the first situation, the consultant was indeed protecting your husband's privacy from you. While you are the most intimate person to your husband, you are not privy to his healthcare information unless he consents to it. It matters not if he introduces you as his wife; unless he explicitly gives consent for you to be privy to his healthcare info, there is no obligation to include you in his consult.

In the second scenario, perhaps you would've been in the way or interfere with the transfer. And upon the discretion of the healthcare professional, spouse/family member can be asked to leave the room when a procedure is being done on the patient. Some people are uncomfortable in doing tasks with an audience in the room.

Exaclty, many times there are people in the room and the dr may not have just planned on listening to bowel sounds, palpating etc. maybe he might have anticipated asking questions etc. Your husband has a right to privacy, with regards to health information also, which is probably what the consultant was mainly concerned about? who knows. the hospital staff does not know what he prefers you to know or not. He can next time say, it is OK for you to stay. I do not like asking the patient if the family can stay, becasue I do not know the dynamics of the relationship and the pt may feel pressured into saying yes when he/she really wants to say no.