The Patient's "Guests"

[rnsheri]

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.

1. 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.
2. 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...
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. Please, guys. Don't ask me about labs. I want to tell you. I can't tell you. I'm sorry.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. Please let the patient talk if he/she can.
16. 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.
17. Do not sneak alcohol to my patient.
18. 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.
19. For those randy, lonely spouses missing their lover in the hospital: NO. Your time will come.
20. Visitors, never assume you know what's in a random cup.
21. No strippers. I don't know why I have to include this.
22. 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.

Ya'll got some "guest" goodies?

the-patients-guests.pdf

[vintagemother, BSN, CNA, LVN, RN]

Seriously. A thousand apologies to anyone anywhere who ever had to deal with my mother or someone like her...

Ditto for my apologies! I've been a brat before to nurses caring for loved ones. Now that I know the reasons, "why" I feel bad about my behavior.

[Croweater]

Hospital visitors' behaviour reflects the deteriorating standard of manners and behaviour in society. There is a difference between the family member who acts inappropriately because of stress (and most nurses recognize this) and the visitor who is simply rude and believes a hospital is an extension of their home. I thought the article was humorous and accurate and perhaps in a few years time you may appreciate its jaded tone.

[rnsheri]

This wasn't meant to offend! I understand how my humor may fall flat for some people. Best of luck to you in all your future endeavors.

[juljube94]

For the nursing student who is not a nurse yet....

bwahahahahahaaaaaaaaaaaaaa! oh man! Good one! You are joking...right? Right??

[icuRNmaggie, BSN, RN]

I can not understand why four generations feel that it is necessary to sleep on the carpet in the waiting room when the family member is scheduled for return to the SNF, or why they are even allowed to take over the waiting room at all. One woman filled up the coat rack by putting all of her clothes on hangers. An infestation of bedbugs, roaches, lice, or scabies is a legitimate concern. One visitor was overheard saying let's go shopping and they went through the lobbies and restrooms to steal toilet paper, magazines, bottled water, cookies and paper cups.

Even the hospitality industry does not put up with theft and squatters, yet we as nurses are expected to keep them happy.

When it gets to the point when I am spending more time providing attention, supplies and services, and saying no to requests for guest trays and cafeteria vouchers to these hordes of local visitors than to my assigned patients, I simply say that I am here to take care of him, not all of you.

[CHESSIE]

When you have walked in the shoes of an RN/LPN for a couple of years, please write again. As nurses, believe me, we see it all. Do we use humor and sometimes dark humor? Yes, we do, as this is what it takes to be there for patients and their families, some of whom really do "get it," and some who need some education. All of our patients need our care, which we give and keep giving even under very difficult circumstances, such as short staffing and too many administrators, many of whom "do not get it."

You cannot understand, yet, but if you graduate from nursing school, pass your boards, and are hired, you soon will. Trust me on that.

[Jensmom7, BSN, RN]

Ok, to get back on track:

Had a MedSurg patient who had injured his hand in an industrial accident. Surgery was required to repair the damage.

His wife of one year camped out next to his bed, sobbing and crying. She kept moaning about his "poor hand" and asked him about every five minutes if he needed anything.

All the poor guy wanted to do was get some post-op rest and push his PCA button in peace. He was mortified.

I gently steered her out of the room for a few minutes, to preserve his sanity. She tearfully told me that they had never spent a night apart and she didn't think she could fall asleep alone in their bed.

All I could think of was the difference between being married for one year and being married for twenty. My husband had recently been hospitalized and diagnosed with several fairly serious medical problems. My reaction when told he wouldn't be home for s few more days? "Who-hoo!! Queen sized bed to myself!!"

[TriciaJ, RN]

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.

It's not your place to judge, either. And yet you did just that, to a whole profession you know nothing about. Was it really your intent to teach people-skills to nurses?

If you ever do become a nurse, and last 20 or 30 years to the point of being "overworked and jaded", please re-read your post. You may have a very different perspective by then. Or not.

Those of us who've been around a while couldn't have done it without a sense of humour and other sharp nurses to share it with. The self-righteous pontifical types either run away screaming fairly quickly, or stick around and enjoy being the fly in the ointment.

And just a heads up for this site: people really appreciate the use of paragraphs. Truly not trying to be snarky, but they do help.

[cockadoodie]

A grossly obese diabetic sending his grandchildren to the vending machine for candy and soda. wifey and grown children thought it was ok they placed orders as well. grandchildren running top speed through the hall nearly broadsiding little old lady with her walker.i was shaking and nearly peed myself. I scolded grandchildren who reported this outrage to management now my hours are cut. oh, well the little

old lady lived and it was a second job.

[cockadoodie]

Triciaj- you are so much nicer than me...I was thinking more along the lines of -IN YOUR EAR, TOOTS.

[joycejoycean]

I am sorry but the computer in the room in not for watching movies on Netflix.

[Idaho_nurse]

HAHAHA!!!! I have experienced most of these in my many years, and had to TRY to deal with many with the patience of a saint... Which didnt always work well. I have lost my patience with some vistors, family, etc, and especially those darned little kids who have absolutely NO discipline or the ability to keep quiet. With the latter, I have solved some of that by explaining (ok, maybe lying a tad, lol) that the patient down the hall is complaining about the noise level. Hey, it is a white lie, lol.

But by far, the worst had to be the visitors in the ER. The constant round of visitors, the hundreds of question, which I dont mind answering, but sorry, you just may have to wait till I deal with the critically injured patient down the hallway before I deal with your headache and (gasp) family history of aneurysms. Or the family member or patient who is visiting the "non emergent" ER, and mad that that the trauma patient got seen before you.

I also love it when I get how mean and rude we are when we are having a joke about something that, yes, probably should not be joked about, but because you are out wandering the ER where you are NOT supposed to be, you overhear it. As for humor, it is often what gets us through the day when all we see on some days is death or horrific injuries.

The point being... humor is just that humor, and sometimes you just have to roll your eyes (hopefully not in front of the patient or family, lol) and trudge through it. I do draw the line at being your servant though. when your demands for coffee try to override my care of your loved one or another patient, I may not be very nice about it. As for that, to heck with patient satisfaction scores. I am a nurse, not a waitress.