Unable to meet basic care....

[locolorenzo22, BSN, RN]

hey all...just wanted some opinions. I had a recent pt that was TOTALLY deaf, as in uses ASL around the house to communicate. was having post-op dementia...and even the son in the room was having difficulty getting through to her(took 20 minutes for evening meds)....when I suggested that one of them stay the night, as she was getting up, confused, kept writing about needing to pay for water, to go to the doctors tomorrow....

And the family suggested that I call the doc for ativan, and a sitter order. I explained that there was no guarentee that we could keep or even get a sitter....but they didn't care. They would not stay, and I felt that the patient's care was VERY compromised...she wouldn't even take tylenol because they would make her sleepy. shouldn't the family have provided some sort of interepration for us?

[MedicalLPN, LPN]

No, they don't. Everywhere that I've worked you just called the Doc, got an order for a sitter. If we were lucky the house supe had someone to provide us, if not then someone from our floor got pulled to sit in there and we just worked even shorter. Ultimately you're not going to be able to force the pt's family to stay there.

[rachelgeorgina]

When the patient is in hospital, then they are in the care of the hospital - you get to look after them because you work in that hospital and have been assigned as their nurse on that shift. Therefore, it's your job to care for them and meet their care needs (or find a way to meet those needs, e.g. get a special (what I think you must be referring to in a "sitter".)

Perhaps the family doesn't normally care for the patient at home. Why should they care for in hospital. I apologise for sounding harsh, but directly or indirectly, the patient is having you paid to care for them, not the family. It's not their job to care for the patient overnight because they're being difficult - that's YOUR job as that patient's nurse.

[tewdles, RN]

Can't really blame the family...the patient is afterall in the hospital where their insurance is paying for that level of care..they should not be REQUIRED to provide it. On the other hand, it is hard to identify with a family that is so detached that they do not DESIRE/WANT to stay and insure that their loved one is safe.

[llg, PhD, RN]

I agree with the previous posters. The family is paying for your facility to provide care. Your facility needs to provide it. It's very wrong for them to charge the family and then turn around and ask the family to do the work.

[MagsMom]

At the hospital where I work they have people on call to sign when a deaf patient comes in -- just like there are translators for Spanish and other languages. I am surprised that there is not such a service - BTW I am at a small regional hospital.

[Michifura]

So far I am agreeing with other posts....it's your responsibility to keep this patient cared for and safe. It would be nice for the family to stay but they do not have to.

Where I work we will assess the patient and if there is a need for a sitter our NA is pulled and we work without and NA. In the facility where I work we have a patient relations dept and they pay for an interpreting agency to send a sign language interpreter which stays at bedside (if no family around) with the patient as long as you need them to, they do not provide any ADL care. This is something the hospital has to provide under the disability act.

[wooh, BSN, RN]

We're not allowed to use family members to translate. (Do we off the record use them? Of course, but for official stuff, we're supposed to use an official translator.) After all, we have no way of knowing that the family is actually saying what we're saying.

As for the family staying. Yes, that would be nice. I can't imagine being family member that wouldn't stay. But it happens. And we just have to deal with it.

[SuesquatchRN, BSN, RN]

While it is certainly not the responsibility of the family to stay I, too, can not imagine being even needing to be asked to stay with my confused relative. My youngest niece has peritionitis from a burst appendix some years ago and I told my brother and sister that I would spell them on overnights so the Fiona was not alone and frightened and perhaps neglected.

While the family was within their rights to refuse, loco is within his rights to be disappointed that they cared so little that not one of them was willing to help their family member, let alone the hospital staff.

[~Mi Vida Loca~RN, ASN, RN]

While it is certainly not the responsibility of the family to stay I, too, can not imagine being even needing to be asked to stay with my confused relative. My youngest niece has peritionitis from a burst appendix some years ago and I told my brother and sister that I would spell them on overnights so the Fiona was not alone and frightened and perhaps neglected.

While the family was within their rights to refuse, loco is within his rights to be disappointed that they cared so little that not one of them was willing to help their family member, let alone the hospital staff.

I know it's different being that it's a child, but when one of my sons had to stay overnight in the hospital I had someone that was shocked I was going to stay the night with him. I was like, where else would I be? I couldn't imagine NOT staying. I mean not always is it doable for a family member to stay but it sounds like this patient had a few family members around.

Then again, I know it's LTC but doing my clinicals there I have been shocked by lack of family visiting for a lot of the patients. My kiddos BETTER come visit me, then again they best not be sticking me in a nursing home, that is why I had so many!