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?


Aspiring2Be said...

I'm not an ICU nurse, in fact, I'm only a nursing student. However, I have been a CNA for several years and have seen this happen - where nurses are inconvennienced by family members and their needs. I worked in an outpatient Cancer Center where I imagine the needs of the patients and families are probably as demanding as those of ICU patients and I believe that to really treat the patient we must treat the family as well. They are an integral part of a person's health and wellbeing. Not to mention that if we neglect the family, they may soon be our patients as well.

E.J. said...

They asked him to leave because he was asking too many questions? It sounds like you could be working with a very burned out nurse!

In my ICU (of the neonatal variety), having family at the bedside can be a tremendous benefit. They can let me know when the patient needs to be suctioned, rather than me finding out when the monitor alarms for low sats and low HR.

And I'd a lot rather have that family member asking me periodic questions at the bedside than to have them call me on the phone every 30 minutes of the shift.

Keep up the good work.

Cartoon Characters said...

I have been nursing for 30 plus years and I agree with you 100%!!!
Family centered care is what we strive for...not alienation of family to their own. You sound like a genuine caring nurse and I would have done the same!
I have had an experience in ER where I was not allowed to be with my husband for no good reason (later got an apology) and it was a horrible experience.
I can't believe the callousness of the other nurses. Thank goodness for nurses like you.

peny113 said...
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PJW said...

ICU nurse for 20 years, Family members are and have always been welcome in my practice. I often involve them in the care.