The Patient's "Guests"

As health care professionals, we have a unique opportunity to meet many people who affect us in so many ways. Our patients challenge and encourage us, and each one has a story. If we're lucky, we are allowed the rare opportunity to not only know our patient--we get to know our patients' loved ones, too. I love it when a loved one wants to help and become involved in my patient's care. There are some instances when those who try so hard to help inadvertently create unusual situations that can be, well, non therapeutic. I have some favorites I'd like to share with you.

Oh, yes, we know them. The throngs of visitors, family members, and guests who flock to comfort our patients. This is just for fun. See if you can name some of our favorite guests.

The good Samaritan who brings your post-surgical NPO except ice patient some pungent tacos because the patient said he felt hungry. Patient eats three bites and begins vomiting epically. The visitor, big-eyed and instantly remorseful, tells you, "But he said he was getting really hungry and you guys weren't bringing him anything!" At least three places in the room, including the door, say "NPO x Ice". There will be Phenergan. Visitor bolts because of the smell and leaves the wrappers in the garbage.
The PCA pump spouse who watches the clock and pushes the PCA button every ten minutes, even if her husband is asleep. She tells me she doesn't want him to wake up in pain. Luckily, with the help of Narcan and some skilled critical assistance folks, the husband gets to see his wife's face again. No matter how many times you educate...
To my young patient's friend: I can see you care about your buddy's comfort and worry that we aren't giving him his choice dose of powerful narcotics. There are reasons. He is constipated, he is experiencing AMS, and a zillion other things. While it's kind of you to bring supplementary meds and slip them to your friend, it kind of messes up his breathing and living. Please don't visit again.
I like meeting my patient's relatives, but if I have already met 20 and answered the same 400 questions, I'm going to nicely ask you to start talking to my patient or to each other. Maybe bring a tape recorder when the doctor comes in if the patient agrees. I want you all on the same page.
Speaking of relatives, I know the hospital can be noisy, cold, annoying, and frightening. Should your facility permit, I have no problem with one of your relatives staying overnight. Just a foreword--the couches don't get any more comfortable, we will be coming in the room to do annoying procedures like vital signs and medication administration, the room will either be too hot or too cold, the patient down the hall may yell, there may not be 4 pillows readily available, and the TV does not have HBO. Plan accordingly.
We love kids. We just don't love it with young children decide to bounce on Grandpa and bust his stitches. Unfortunately, the care providers prefer that catheter bags, oxygen devices, JP drains, bed controls, suction canisters, computers, IV pumps/poles, and just about any cool thing be left to the appropriate hospital care provider. We hate to be a bummer. Oh yes, and the gloves. The gloves won't hurt you, but if you pull the entire box on the floor, it costs the hospital money and we don't want that.
Dear overzealous advocate for your sick loved one: I am proud of you for standing up for your friend/family member who isn't feeling 100%. I am happy to report complaints to my supervisor and if I can rectify the problem, by golly, I will. I can not help the shows on TV, the food, the lack of closet space, the consistency of the sheets, the brand of orange juice the hospital provides, the absence of a beauty salon, cafeteria hours, erratic doctor's rounds timing, or the size of your room. I will give you some paper to write those things down for my supervisor or let you talk with my charge nurse. I know I will get bad patient ratings for not correcting all these problems. Next time I will learn.
Please, guys. Don't ask me about labs. I want to tell you. I can't tell you. I'm sorry.
Shift change is a bad time to call about an update on patient condition. Try to call 2 hours before or two hours after shift change. If before shift change, the last shift nurse can give you the low-down. If you call a few hours after shift change, I will have a good handle on your loved one's status. Otherwise, it might be messy and I won't get a chance to thoroughly evaluate my patient.
If you are a visitor and if you curse, threaten, hit, or disturb my patient in any way, you will be leaving. Same goes for me and my colleagues. This is a place for healing.
Family drama is not conducive to healing. If grievances must be aired, please have quiet, non disruptive discussions. Screaming profanities is not therapeutic and everyone will be asked to leave.
I like help, don't get me wrong. But, uh, no matter how strong you are, certain patients require certain strategies to move about, pivot to the commode, whatever. The patient might wind up caught up in any number of tubing, fall, reopen a wound, etc. I like your go-getter attitude, but I'd prefer to help you get the hang of things. I like my patients unharmed.
We all make mistakes. Usually they are minor. It is painful, not fatal, if I accidentally blow an IV on MawMaw's floss veins. Don't call me names, don't assume I am just poking around for kicks. I'll get help if my technique fails. Twice is a good number before I ask another colleague.
I do love family stories, and I'd love to hear them all, but a floor nurse is on the go 24/7. I'm not ignoring you.
Please let the patient talk if he/she can.
There's generally a reason I ask patients' families to call me should something happen. Please don't unhook an IV, remove a mask, or any other 500 things without assistance. Some things could turn out bad.
Do not sneak alcohol to my patient.
Please do not paint my patient's nails, dye her hair, or otherwise alter her appearance unless it's been run by the doctor or me. The polish irritates other patients' lungs and dying hair is messy. No make-up... it's a no-no for surgeries. Please don't clip toenails, wax, or beautify without first checking with your nurse. Some hair styling tools may burn patients and hospital beds.
For those randy, lonely spouses missing their lover in the hospital: NO. Your time will come.
Visitors, never assume you know what's in a random cup.
No strippers. I don't know why I have to include this.
But I must say, on the whole, a good friend or family member helps brighten my patient's day. Please watch to see if my patient looks tired or in pain, because he/she may need a break. Your love, support, and comfort help beyond what I can do sometimes.