Patients And Their Families

Back to work tonight! I'm looking forward to it. Last week was CRAZY! Lots of admissions, not too many sad stories, but lots of drama to make up for it!

I'm beginning to realize just how much families can interfere with the care of a loved one. We had several instances like this last week, but one stands out above all others. We had a patient come in with respiratory failure. He was ventilated and subsequently trached. His family was outrageous. Two by two, they would switch "shifts" with one another to make sure the patient has someone in the room with him at ALL times. They kept a detailed notebook of drugs given, for what purpose they were given, the name of the nurse or repiratory therapist that administered those drugs, and names of all techs (including me). They refused to let us turn the patient because it would cause him pain, even after being told that this would surely cause skin breakdown. They would run out to the nurses station anytime they felt a vital sign was too low, or when the monitor alarms went off. They demanded the patient be given his pain meds well before it was time. And they hovered over anyone who was rendering care to the patient, even to the point of becoming a hazard. They were unbearable. Furthermore, they somehow got the doctor to order the presence of a family member in the patients room at all times. There was nothing we could do to get rid of them. What makes all this so bad is the patient was one of the sweetest I've had since I started working there. He was in horrible pain, but always managed to smile and crack jokes. I loved him, but hated his family.

I wish families would understand why their loved one is in ICU to begin with. When one walks into the ICU, 1) they are usually very sick, and 2) require special care that requires lots of knowledge and expertise. If this patients family felt they had the expertise to take care of him, why didn't they discharge him and take him home???

I think what made me more upset is the lack of authority on the part of the nurses. Not once did they sit down and talk to the family about their behavior. Not once did they draw the line. I can only recall two people who made it clear in one way or another that the family needed back off: me, and only one nurse! I know this is risky business. I know the family thought they knew what was best. But clear lines must be drawn when it comes to rendering care. And if anyone gets in the way of that, we have a problem. The night techs rotate units every week, so fortunately, I will not have to deal with this family anymore. But as the saying goes, the grass is NEVER greener on the other side!!!