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.
1. (When I worked at a nursing home as a CNA) The family who puts their loved one in a nursing home but harps on the staff to make sure their loved one is taken care of to their standards, the dentures are always in a particular place, the sheets are perfect, the room is always immaculate, and won't hesitate to make your life hell and report you. Watches every thing you do with daggers in their eyes, looking for the slightest "wrong." It's always fun delivering care to your loved one, when she hits, kicks, and tries to bite our fingers off. We give her the best care we possibly can, but remember we also have 14 other patients to take care of. We don't have the time to deliver 1:1 care to your loved one.
2. The family member who claims to be in the medical field and yells at you in the doorway of her loved one's ER room because of her needing to go to the ICU because her labs aren't good and her vitals aren't the best.
3. Pt is in isolation with C-diff. Whole herd of family comes in, refuses to wear isolation gear even after teaching the importance of it.
4. Unresponsive elderly pt arrives in ER with advance directives not to do anything. One brother is POA, the other isn't, and are yelling and arguing about the advance directives. The POA is on board with his father's wishes, the other one (who's been estranged), of course, isn't. Demands you follow their instructions and not the other brother's.
What appears logical and perhaps a "no brainer" to us nurses does not necessarily mean the same to visitors/family/friends.
While there are things that are annoying to a nurse on one level or another, education with empathy and understanding will go a long way. Visitors may not understand instructions fully or have their own reasons for not following, which needs exploration.
I believe that there is no intent to sabotage the nurse's workflow or work for that matter.
Being a patient in a hospital and on the "other side" was an eye opener in many ways!
Yes, I understand that MeMaw (my patient) is looking better and said she will "watch the kids for a few hours" while you run some errands, but.....NO.
I love that my patient's family member have unbelievable artistic abilities.... but please don't erase my whiteboard with my CBI tallies for your doodling pleasure.
It's comforting to have your boyfriend/girlfriend spend the night... I get it, and I'm usually ok with it. However, this is not a hotel and I will ask you to get out of my patient's bed. Call me old fashioned.....
While I was in nursing school my dad had stents placed in his legs. My mother took him to the hospital and when it "took too long" apparently went up to the nurses station and told them she had to leave--she had a hair appointment Mind you, my dad was end-stage COPD, kidney failure, AAA, hx of stroke and MI. She called me later all in a huff about how rude the nurses were because they "thought she should stay". She said "I told them, what's the big deal? He's already here, just keep him here until I get back." Seriously. A thousand apologies to anyone anywhere who ever had to deal with my mother or someone like her...
I understand that you want to see your son who was just in a car wreck. It is however, not my fault he decided to load his buddies up in his sports car while intoxicated and then proceed to put it into the ditch. Nor, is it my fault that he decided to not wear a seat belt. It is also not my fault that we have asked the 15 visitors here to see them politely to limit it to 2 visitors to a room at a time and to quit clogging the hallways. But, it is my fault that I decided that none of them would have any visitors because his drunk visitor told me to "Go (four letter word) yourself." Your child is an adult and he is more than capable of talking to the sheriff by himself. Oh you want to talk to whoever is in charge around here? That's me, I'm the Charge Nurse tonight.
Omg. Well...here's something that came to mind and not a story of my own. It came from a person I know that was a spouse to a OB patient many years ago. He said they were both very young,...as a matter of fact, the wife was only in her teens and had just delivered a baby. She thought her husband needed to be taken care of, so against advice (of course) they had sex in the hospital bathroom. Bad news was, he did not know he had German measles. She got them internally and almost died... yikes! I bet that nurse was upset.
I once had a patient whose family was constantly arguing and there was a lot of odd goings on...but they packed the room most days. One of the SIL's was a pediatrician...but I had to spell out some bloodwork results to him. I guess the differences in the pediatric counts and adult counts were getting him.
12 year old comes out of his mothers post partum room carrying his 2 hour old brother and tells us that "my parents are tryin' to sleep and he won't stop making noise". ermmm.....yeah
Wow...I work in a skilling nursing home and so many of these things happen daily. I really wish we had the same security/assertiveness of staff to be able to kick out problem causing individuals. I wish I worked in a hospital.
Antepartum patient in for preterm labor. She and her s.o decided to indulge in a little recreation in the shower. In the process she leaned up against the emergency call button.
Hearing this all available staff responded to the room. Boyfriend was left trying to preserve his modesty in front of us all with nothing but one of those little hospital washcloths.
Specializes in CNS Pediatric Surgery, now retired.
Child was in PICU with septicemia. The pediatrician tried to explain the diagnosis and planned treatment to the family. They seemed to have little understanding of germ theory and he resorted to explaining how bacteria are like little bugs and the IV medication would kill the bugs.
A short time after that I overheard one of the relatives speaking to family members who were home in another city. Shouting into the phone, "What's wrong with him?....He swallowed a fly."
...cue the music...I don't know why he swallowed a fly...
Told the pediatrician what I had overheard. He just shook his head.
I am not a nurse yet, so, I have not had the opportunity to experience any of the situations mentioned before. I will start this fall in an RN program. I am an older student and this is my second career. I know all careers have their challenging moments since we are dealing with human beings from all walks of life. However, I get the impression that many nurses are just jaded and extremely over-worked. Like the last nurse who commented, not all people know and understand "the rules". Visitors and loved ones are worried, scared, uncomfortable, nervous, etc. to see their friend, father, mother, grandmother, etc. in pain and sick. As nurses it is important to understand this and have empathy and sympathy not only for the patient, but their family as well. It is not our place to judge other people's intentions, motives, behavior...what might be unacceptable to you and your family, might be the norm for others. Some families are loud, some are reserved. Your place is not to judge. If the loudness bothers you and inhibits your duties, say something, otherwise, it isn't your place to judge. It is a nurse's job to explain to everyone what is needed for you to care for the patient. If that means sending 6 of the 10 people out of the room, just tell them to come back later. How difficult is that? If you need everyone to leave so you feel confident in your care, explain that...being kind and honest is usually a good choice. Tell people the rules in a non-condescending manner, yet, be authoritative in explaining why. Don't expect people to know and think like you do. Expect people to hear you and abide by the rules, once they know them. Some people have never been in a hospital before, you have to be empathetic to all situations. People handle stress and sadness in different ways...I thought they taught this in our fundamental nursing classes...I was just shocked at the tone of the article.
Mind you, my dad was end-stage COPD, kidney failure, AAA, hx of stroke and MI. She called me later all in a huff about how rude the nurses were because they "thought she should stay". She said "I told them, what's the big deal? He's already here, just keep him here until I get back." Seriously. A thousand apologies to anyone anywhere who ever had to deal with my mother or someone like her...
Thought, BSN, RN
63 Posts
1. (When I worked at a nursing home as a CNA) The family who puts their loved one in a nursing home but harps on the staff to make sure their loved one is taken care of to their standards, the dentures are always in a particular place, the sheets are perfect, the room is always immaculate, and won't hesitate to make your life hell and report you. Watches every thing you do with daggers in their eyes, looking for the slightest "wrong." It's always fun delivering care to your loved one, when she hits, kicks, and tries to bite our fingers off. We give her the best care we possibly can, but remember we also have 14 other patients to take care of. We don't have the time to deliver 1:1 care to your loved one.
2. The family member who claims to be in the medical field and yells at you in the doorway of her loved one's ER room because of her needing to go to the ICU because her labs aren't good and her vitals aren't the best.
3. Pt is in isolation with C-diff. Whole herd of family comes in, refuses to wear isolation gear even after teaching the importance of it.
4. Unresponsive elderly pt arrives in ER with advance directives not to do anything. One brother is POA, the other isn't, and are yelling and arguing about the advance directives. The POA is on board with his father's wishes, the other one (who's been estranged), of course, isn't. Demands you follow their instructions and not the other brother's.