When family
members have a loved one hospitalized, it's only natural that they want to be
involved in the care of their family member.
Many facilities now offer a code to the patient, who can then provide it
to anyone that has permission to discuss their condition. If a family member or anyone calls to check
on the patient, without prior approval, they will be disappointed. HIPAA rules
prevent it. So, the first thing to do
when speaking with a newly admitted patient is to determine who they want to
have information regarding their condition.
Families can
get very involved, which is understandable, as their loved one is their top
priority. There does however need to be some boundaries regarding family
involvement, since too many family demands can take your time away from the
patient, and that is unacceptable.
A new Nurse’s Dilemma
All stories
are told by Susan, a retired nurse.
Lela was a
great Nurse; she had a very warm personality that easily won the hearts of her
patients and coworker's alike. As Lela’s
supervisor, I was able to evaluate her as doing great in all areas, until she
encountered a patient, and their family.
The patient was a 55 year old female that was very obese and
diabetic. She was admitted so that her
blood glucose could be regulated. This
patient had a husband, 3 kids, all
adults, a mom, and a very involved sister.
Lela was assigned to work with the patient for the duration of her stay,
however it appeared she was taking orders from the patient's sister. Lela explained to the patient's sister at
least 15 times in a two day period, what the plans were to adjust the
medication for the patient. While Lela
was in the hall explaining things to the patient's sister, the patient's mother
took food into her. The doctor ordered a
high protein, low carb diet, so the 2 double cheese burgers, large fries and
large shake her mom brought, was not exactly on her diet plan. As Lela got back to her room, the patient was
finishing up her very large meal, and Lela spent another 15 minutes explaining
to the mom about following doctor's orders.
Needless to say, after 3 days Lela was ready to quit. Lela’s personality made it difficult for her
to say no, and to confront the family, however, as a nurse, it is sometimes a
part of the job. After meeting with Lela
and educating her on setting boundaries, she took the lead, and advised the
family that things would change, effective immediately. Surprisingly, the family went along with the
new plan, and I would have to say, even
developed a new respect for Lela. A very
good Nurse became a great Nurse, as she learned to draw the line when needed,
to interact with families.
It's always
nice when you encounter a family that is concerned for their loved one, and
visits often, however, when the family begins to occupy too much of your time,
and appear to be breaking hospital rules regarding the patient you are caring
for, it's time to set the appropriate boundaries.
Related: Working With a Progeria Patient
Patient's Privacy
When you are
going to a patient's room for any type of what would be considered a private
procedure, it is appropriate to ask family members to step outside the
room. The family member may try to
assume the role of caretaker even within the hospital, and that should be
monitored closely. If a family member
tries to assist a patient to the restroom, and is not familiar with assisting a
fall risk person, it could create an accident for both patient and family
member. You may find it necessary to
remind family that here, hospital staff will tend to the patient's needs,
however do so in a respectful manner.
Consider from the family member's perspective, they see their loved one
in pain or sick, and they have a strong, loving desire to help in some way,
it's only natural. By directing families
to visit, and spend time, however, leaving the patient's physical needs to
hospital staff, will ensure unnecessary risks are not taken. It's also a good idea to remind family
members they need to care for themselves.
It's all too common that family members
become stressed trying to care
for sick loved ones, so just a friendly reminder to take care of themselves
too.
It's great to
develop a good rapport with family as well as with patients, but just be sure
to follow those all-important boundaries.
Comments
Post a Comment