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.
Specializes in LTC,Hospice/palliative care,acute care.
Fistfight between visiting family members!Back before private rooms were the norm I was working a busy med surgery unit.The hospital was bursting at the seams.In one of my rooms I had two women,one was post op TAH and the other was close to a hundred.And a DNR.She died.The entire family just had to gather at the bedside for an impromptu wake.My post op and her hubby were giving them privacy and sitting down the hall in the chapel...I had two TURPs with CBI and was running my buns off all shift.Apparently some of the old ladies children and grandchildren were 5hours away.The husband of my post op got into a fist fight with a grandson of the old lady.Security came,my supervisor came.There was no other bed for the post op.We ended up moving the old lady to one of the exam rooms.She was still there at the end of the shift....
I would like to add to number 7. If you would like a word for word on what the doctor said, call during DAY SHIFT. Also, don't show up at 10 pm expecting to see the doctor.
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.
Really? Really? Do you have jokes or...?
Until you have dealt with the ridiculous situations the "actual" nurses here have dealt with, YOU shouldn't judge.
Bottom line? Visitors aren't the priority. EVER. And trust me, there are more visitors who don't "get it" than those who do. Wait until you walk into a tiny room packed with 20 visitors, all of whom don't have the common sense to get out of your way. And you think asking them to step out is easy? LOL Sometimes it is but clearly you've never dealt with the super vigilant, hung ho visitor who wants to dictate everything and miss nothing.
Come back and see us when you're a nurse, working in the real world.
When I was working as a CNA on the Oncology floor we had to call a family and tell them their loved one wasn't going to make it through the day. It was about 2 pm. Husband responds with "u sure? I'm on my way to work" two hours later a whole group of about 20-25 people show up, they then send people to get Popeyes chicken for everyone and had a grand party as this poor lady laid there dying! She was the sweetest thing and so deserved better!
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.
You'll be even more shocked when you actually start nursing and have some gems of your own to add.
I agree with so many of these things but I've always wondered why, when we post NPO signs, they don't also say "nothing by mouth". We all know what it means but random visitors coming in might not and might not ask before giving the patient something. Just an observation. Oh and in the ER No we won't give you a drink and sandwich the minute you and your loved one gets in the room. No food or drink until AFTER THE DOC SEES YOU AND ALL THE TEST RESULTS ARE BACK!! I think I need to get that tattooed on my forehead......
My fav was when I worked nights on postpartum, "Don't turn on the light, you'll wake my husband". Sorry dear, I need to make sure you're not bleeding to death under the sheet. Your husband can go home
Specializes in Patient Safety Advocate; HAI Prevention.
In defense of "visitors" who I prefer to call care partners, they often do not understand acronyms. NPO except Ice needs to be interpreted for them saying DO NOT GIVE HIM/HER anything except ICE! Also, post written instructions on the PCA medication. Never assume that they know these things just because you do and don't question their intelligence because they don't know "nursely" things.
Every patient needs a trusted advocate by their side while they are in the hospital, but they do not need droves of visitors including tiny babies and toddlers, who will exhaust them and disrupt everything. The designated advocate can be the note taker or the recorder of doctor visits, keeping a list of medications, special instructions, etc. Then they can relay pertinent information to the rest of the family/guests as appropriate.
There is a way to work out all of these things, and communication is the first step in all of it.
Specializes in LTC,Hospice/palliative care,acute care.
In defense of "visitors" who I prefer to call care partners, they often do not understand acronyms. NPO except Ice needs to be interpreted for them saying DO NOT GIVE HIM/HER anything except ICE! Also, post written instructions on the PCA medication. Never assume that they know these things just because you do and don't question their intelligence because they don't know "nursely" things.
Every patient needs a trusted advocate by their side while they are in the hospital, but they do not need droves of visitors including tiny babies and toddlers, who will exhaust them and disrupt everything. The designated advocate can be the note taker or the recorder of doctor visits, keeping a list of medications, special instructions, etc. Then they can relay pertinent information to the rest of the family/guests as appropriate.
There is a way to work out all of these things, and communication is the first step in all of it.
And we can never assume they have common sense,either.Simple common sense would keep a visitors butt in a chair ands their off equipment until they could speak to staff to find out what they can and can't do for their loved one.Sadly it seems common sense is being bred out of human beings.We feed our kids took animals .....
Specializes in NICU, PICU, PCVICU and peds oncology.
I can usually tell what's going on before I enter the unit just by how many people are in the waiting room. Patients who come from some of our smaller, rural communities will usually have the entire community turn out to visit them within the first 24 hours. As soon as word gets out that so-and-so is in the hospital the troops mobilize for a trip to the city. Connections to the patient are sometimes so tenuous that there's no reason under heaven that they should even be here. They'll file into the patient's room, donning iso gowns and gloves, stand at the foot of the bed for a few minutes then file back out to set up camp in the waiting room. Lather, rinse, repeat. I suppose in some way they feel they're supporting the patient and the patient's family but I'm not sure the bigger force isn't the unexpected opportunity to go to the casino, do some shopping and maybe have a nice steak dinner. The ones that really baffle me are the ones who arrive at 1 am, small children in tow, coming to see their cousin's neighbour's sister's grandchild.
The last time I was hospitalized, the only visitor I had in the entire 3 day stay was a coworker who brought me breakfast each morning. My spouse stayed away and I was overjoyed that I wasn't going to have to entertain him, run interference with the staff for him or have to send him home because I just wasn't up to visiting. On the other hand, I was in a two-bed urology room, with a revolving door on the other bed. First was an off-service patient who was transferred to the appropriate floor after only a couple of hours, only to be replaced with another (ENT) patient who was elderly and spoke no English. So her son and granddaughter sat at her bedside chatting with each other the whole night. She was discharged in the morning and her successor was a lovely lady with a lovely, large family. They at least seemed to have some insight and weren't loud, disrespectful or demanding. When they all left, I found myself listening for the tell-tale PCA beep, and then counting her resps... What's a nurse to do as a patient when her room mate is breathing at a rate of 6?? I didn't want to get my knuckles rapped, so I'd drop something on the floor and rouse her a little. That worked...
My favorite guest was the sister of a patient on neutropenic precautions, WBC was 0.2 due to chemotherapy.
The sister was educated on the precautions, including the one that all visitors must wear masks and why this is important. I walked into the room to see the sister with her mask on, but pulled down fully exposing her nostrils. I told her that she would need to pull the mask up to cover her nose, she replied "I can't, my glasses keep fogging up" .......
I took care of a 2 year old newly diagnosed ALL pt. We were transferring her to a larger hospital in the morning, but she spiked a fever and had to get a full workup. I asked mom how she was doing and mom was fine, but moms friend snarked back "we'd be better if you'd just leave us alone and let us sleep. Stop poking that baby with needles." Well unfortunately lady, what I did to her tonight was nothing compared to what she has in store for her. And sorry for not letting her die of an opportunistic infection. What a jerk of me.
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ktwlpn, LPN
3,844 Posts
Fistfight between visiting family members!Back before private rooms were the norm I was working a busy med surgery unit.The hospital was bursting at the seams.In one of my rooms I had two women,one was post op TAH and the other was close to a hundred.And a DNR.She died.The entire family just had to gather at the bedside for an impromptu wake.My post op and her hubby were giving them privacy and sitting down the hall in the chapel...I had two TURPs with CBI and was running my buns off all shift.Apparently some of the old ladies children and grandchildren were 5hours away.The husband of my post op got into a fist fight with a grandson of the old lady.Security came,my supervisor came.There was no other bed for the post op.We ended up moving the old lady to one of the exam rooms.She was still there at the end of the shift....