The Family

[NurseKrissy]

I work in the icu where family members are given certain visiting hours but almost always fail to acknowledge them. My patient had spiked a fever while recieving ffp prior to a scheduled open lung biopsy for the next day. His wife, sister and mother were all in the already small room swooning over him rubbing his legs, up in his face. They were driving me crazy too, coming out the nurses station to tell me/ask me something every two minutes. I was getting so far behind, I had barely payed much attention to my other patient. I called the doc to notify him of the spiked temp and he instructed me to continue the infusion (given he had spiked temps all day and he was admitted for neutropenic sepsis secondary to leukemia) but I was just doing the cya thing in case of a possible rxn. I just could not concentrate with this family up in my face and up in my patient's face. I was fed up, walked in the room looked at my patient and asked him if he would like to sleep, he looked up at me like a sick child would look at his mother and shook his head yes, I felt so bad for him. How could he realize the situation was not conducive to his healing, his pulse was up in the 130's partially d/t his fever, but also his anxiety from these three women hovering. I looked at the wife and said- maybe it's time for you to leave. She looked at me like- how could you say that! But i guess something clicked in her head and she immediately complied with my request. So they gathered up thier things and the sister asked me 3 times if I would come get them if anything happened, as if i'm retarded or something. UGGGH! I just thought to myself if this guy codes you will not be the first thing on my mind! Shortly after they left his temp came down from a whopping 39.5 back down to 37 within two hours.....hmmmm... I wonder why. He actually got to get some sleep.

I just think it is fascinating how a reasonably stable situation can worsen tenfold when you are struggling with the family. Maybe I was harsh in asking them to leave but it was certainly in the best interest of my patient.

I understand looking at it from their perspective how the majority of their actions were emotional, however I can't get over how angry it made me.

Thanks for listening to me vent!!!

[kidsccrn]

sorry if people took my previous post the wrong way. What I am trying to say is that 99% of the families are ok it's the 1% that is a pain. Beleive me I have asked parents to leave due to inc. ICP and they can't keep there hands off the kid! I strongly believe in 2 people at the bedside at a time. It is hard enough to get around the bed without triping over people. The problem is when one nurse lets the whole gang in the nurse that enforces the rules is the bad guy. And what about siblings visiting the PICU I love it when they sneak them in with snotty noses or call the next day to say Johnny has the chicken pox. I spend the time explaining why we have restrictions in the PICU the parent are very compliant then the next nurse doesn't and the circus starts all over again. When a child is dying we have open visiting for that pt. with as many people as the family wants. (of course then the other families whine "why can they have so many people". I can't remember who said you tell a family something and 2 mins later they ask the same question- I was that way when my daughter was in the NICU the nurses finally figured out when I had that spacey look I was overloaded and they would stop trying to give me info. Nobody ever said life in an ICU would be easy.

[Tweety, BSN, RN]

Visiting hours in our unit are totally at the discretion of the nurse. Most nurses are good at working with the family. Because yes, they are wives, mothers, etc. A person they love more than anyone is critically ill.

But when it gets in the way of patient care, or as in this instance the care of her other patient, the nurse should have the right to ask then to leave.

I've dealt with this as house supervisor and always support the nurse.

I've never seen a nurse ask a family member to leave for nurse convenience.

I transferred a patient to ICU the other day and the wife insisted on accomanying me all the way to the unit. She was completely overbearing, aggitating the patient. I had her wait and informed her security would be coming if she entered critical care. I left her pacing back and forth in the hallway. She eventually went in to sit with her husband, but become so overbearing she was asked to leave again. This of course is an extreme case.

I totally support the actions of the original poster. The family was exhausting the patient, interfering with the care of her other patient, and in my opinion her feelings of frustration are justified.