What Part Of Low Lights Minimal Stimulation Do You Not Understand!!!!

[sarahbellum]

I spent more time yesterday educating numerous family members than giving pt care, I left work with a massive headache and was hoorifice from talking in a forced low tone and I need to vent....

I work in a unit newly designated as a "Neuro ICU" My hospital has always been liberal about visiting hours in the ICU and part of me understands the customer service aspect but,

When Grandpa has a head injury, making him perform like a trained monkey for every neighbor and family member that walks in is not going to help healing. After numerous attempts to explain this to two completely different families this week, I finally told the family last night that "Would you have him walk for four hours only five days after he broke his hip?" "Then why are you stimulating him for hours on end, his brain needs to heal, just like the rest of his body!" They spent the rest of their time yelling "Calm down Dad or we'll get in trouble again by that nurse!"---this is my other pet peeve HE HAS A BRAIN INJURY HE IS NOT DEAF

This was not the most tactful thing I have ever said to a family, and they were complaining to nightshift when I left about how its THEIR father and they should be able to see him. I do not understand why I'm supposed to let this behavior go on. Administration acts like we just don't want to deal with the family when we ask for a locked door-- phone at the door unit. We are getting a new unit and moving in June and from what I saw--IT DOESN'T EVEN HAVE DOORS!!

The new unit will be our surgical ICU and the neuro pts are staying in the old unit where the family acts like its their living room. I've had to ask people to stop eating Jack in the Box in rooms with pts with C-diff (gross--why don't you just lick their butthole?) I really believe that these lax rules are contributing to rebleeds and infection rates.

I think I am going to talk to our stroke coordinator. I know she knows this goes on, but I do not think she knows what a problem it is. Of course I need to clear it with my manager first, but I can't see why liberal visiting hours in a neuro ICU are appropriate at all.

Any advice on how to handle these families?

[BlueRidgeHomeRN]

i've had people tell me that they expect a miracle - which i've always thought was the paramount of arrogance - as if god takes orders.

it never seemed like a good idea to me to boss god around.

not to mention, god heals everyone eventually. it does not always occur on this side of life, however. the only prayer that is always fulfilled is "thy will be done". (sorry to be :offtopic:)

[aeauooo]

But don't discount miracles, and don't discount prayer. They happen and prayer is effective, just not according to our wills, but God's. That's why our main prayer in Christianity is "not my will, but Yours".

I've seen what I consider to be miracles, but they are rare. From my experience, life is a lot easier when I submit to God's will instead of my own, and prayer is an essential part of that submission.

I think part of the reason people insist on miracles, and part of the reason people want to know 'chances' ("what are his chances, doc?") is denial.

As health care providers we end up on the receiving end of hostility when we tell people, "I'm sorry, but this is the way it is." They automatically think that we must not know what we are talking about.

It seems to me that most families of dying patients are very grateful for the care I give. It's the families who "expect a miracle" who give me the sour looks when I walk in the room and treat me like 'the enemy.'

The other observation I've made is that refusal to accept the death of a loved one, wanting us to 'do everything,' seems to rarely be motivated by the best interest of the dying patient.

As Christians we believe that death is a release from the suffering of this world and entry into heaven - so why would we want to delay that?

As health care providers, our perspective of death is different. We see death as the natural consequence of life. As nurses we become skilled at helping patients and families make that transition.

[sarahbellum]

I agree completely.......thanks for that summary.....

[sarahbellum]

I'm going to talk to our stroke coordinator this week, our manager has asked for changes until she is blue in the face, The stroke coordinator seems to have more clout since the hospital wants to keep its "Stroke Center" status. I am taking a class on Thursday in the education center. I was going to talk to her then.

[Altra, BSN, RN]

Let us know how this turns out.

[RNperdiem, RN]

ICU's are a closed world for all except those who work in them.

These family members know how to behave and what is expected of them in other situations- work, shopping, the neighborhood etc.

When they walk into your ICU for the first time, unless they have prior experience in ICU's, they need instruction about what is expected of them as a visitor.

Show them what to do. Tell them to speak in a quiet voice.

You will be forever frustrated with families if you expect them to think like you do, and share your beliefs

[nrsang97, BSN, RN]

ICU's are a closed world for all except those who work in them.

These family members know how to behave and what is expected of them in other situations- work, shopping, the neighborhood etc.

When they walk into your ICU for the first time, unless they have prior experience in ICU's, they need instruction about what is expected of them as a visitor.

Show them what to do. Tell them to speak in a quiet voice.

You will be forever frustrated with families if you expect them to think like you do, and share your beliefs

Don't you think we have tried that till we are blue in the face? Some get it some don't. And the ones who don't frustrate the heck out of us. We explain upon admit the reasons for why we are keeping the lights low and a calm environment and minimal stimulation. BUT some just DO NOT UNDERSTAND no matter how many times they are told. We try to be nice, but then when they keep yelling at mom or dad incessantly to show them 2 fingers and squeeze their hands it gets old fast especially with someone with vasospasam, or High ICP.

[sarahbellum]

I HAD taught and taught this family the entire day, until I was hoorifice. Their attitude was that "Dad" was in "there" trying to come out and I didn't know him--therefore they didn't have to listen to me. The neurosurgeon said if the patient was as non compliant as the family, he would have refused to treat him, but since it was the family, we just needed to document everything.

By the way, after I had asked the charge nurse to intervene on my shift and she didn't--he had a rebleed. Thank God, I documented the families attitude to learning and their unwillingness to follow the rules. That poor man....while I do not know if the stimulation caused it, I can say it probably contributed.