Saturday, October 9, 2010

drawing the line on compassion?

The other day I was taking care of an 82-year-old male who had been intubated for a couple of procedures and was quite agitated in the bed, requiring restraints. His son was very concerned and always stayed with him to comfort him and watch over his care. Everyone kept saying that the son was extremely annoying and high-maintenance, but as the ICU nurse who admitted the patient, I had no trouble with him at all and thought the patient was lucky to have such a caring and concerned son. I took him back a couple days later and was informed that he had been asked not to come in at night and his chair had been removed. The day nurse was annoyed with him, saying he "kept coming out of the room to ask questions".

This night, I allowed him to sit in the room all night if he wanted. I didn't want to undermine the other nurses, but he wasn't DOING ANYTHING WRONG. He sat quietly and asked an occasional question, as a family member should. He stepped out when I asked him to step out. He was grateful for everything I did. He did come find me once to inform me that his dad was very agitated again, and I appreciated it because the patient was in pain and uncomfortable and was unable to speak for himself, so I prefer to do something about it! The son was getting very teary-eyed, and trying to hide it, and said to me "please, don't leave me alone". He was sincerely upset and overwhelmed, and my job is not only to keep a patient alive and as comfortable as I can, but also to help the family members cope. So I was singled, doing nothing but watching Lost episodes on, and I pulled a mobile computer up to the room and sat just outside the doorway. It was an act of kindness that I had the time to perform, and I don't regret it.

However, the day shift nurse immediately says to the day charge nurse: "Look what she did! She put the chair back in the room! She sat outside the door!" So sue me. This was a family member who was not being inappropriate or interfering with care, and I chose to give him the comfort that other nurses presumably didn't have time to. I don't think that just because it's an ICU we have the right to treat family members as if they have absolutely NO rights to be there, to ask questions, or to express their concerns. The other nurses told me it's about "setting limits". I sometimes think those "limits" are really limiting our compassion and the other people we are supposed to be caring for- the family members.

What do you other ICU nurses think?