What I Wish I Could Say to My Patients’ Family Members
by Rachel Johnston, RN
I recently had a patient that had suffered from a massive stroke. It left the family devastated.
This particular patient was mechanically ventilated, on the cardiac monitor, with multiple IV drips infusing. Her husband and her four adult children were at the bedside talking in hushed voices.
As I’m going about my business caring for this patient, I see one of the daughters closely watching the heart rate on the patient's monitor. With a concerned look on her face, she turns to me and says, "Her heart rate is in the 90s now, which seems kind of high. She was in the 80s earlier. Isn't there something you should be doing about that?"
I stop what I'm doing, and patiently attempt to explain to her why this is something we wouldn't be concerned about. She gave me a very unconvinced look and turned away.
Now, in my four years as an Intensive Care Unit nurse, this experience is just one of many. I can recall countless times when I’ve had to explain things to a family over and over again, often times having it fall on deaf ears.
I can think of times when I’ve experienced hostility, mistrust, or just blatant rudeness. I’ve been yelled at, called names, and threatened by the loved ones of the person that I am doing nothing to but try and help.
All nurses know this feeling – the feeling of a family member at the bedside trying to tell you how to do your job, doubting your ability, or flat out getting in the way of care. As if they know best, despite the fact that YOU are the one with the training and expertise; as if what you are doing to the patient can be done better, in a way that “hurts them less”, or in their opinion just doesn’t need to be done at all. (I can recall a time when a family member told me to stop suctioning down my patient’s endotracheal tube because they looked so uncomfortable when I did it – that was a frustrating conversation to have).
If I had to bet, I would say there isn’t a single nurse out there that hasn’t had at least one experience like this.
After my last conversation with that particular family member I couldn’t help thinking, “I wish they would all just leave so I can do my damn job.”
Now, don’t get me wrong, this is not the first, nor will it be the last time I think something along those lines. But I couldn’t help but wonder what it is that makes us nurses breathe a sigh of relief when the patient’s room is absent of family or visitors.
The truth is sometimes family can be awesome to have around. The patient is less stressed to see a familiar face: their vitals look better and they’re less restless. Sometimes they even help out with the caring side of things; helping to turn the patient, adjusting pillows, giving them sips of water. And don’t even get me started on how great it is when a family members speaks English when the patient does not. Translators are vital to us doing our job, and family members above anyone are often the best at this.
The frustration lies in not being able to give them our side of the story. Sure, we can say to them “I know how to do my job,” or “I’m working as fast as I can,” or “please show me some respect so I can care for your family member” (this list could go on and on). But that’s only a fraction of what we really want to say. So, pulling from my experience and talking to other nurses, I’ve come up with a few things I think we all wish we could express to the families of our patients.
We know what we are doing
Some of us have been doing it for longer than you were born. We were not just given a RN license, we had to work for it. We went through hours of training where another nurse watched us like a hawk to make sure we were competent and ready to care for patients on our own. We know every beep and buzz you hear like the sound of our own voice, and we know how to manage it. We are intelligent, skilled individuals that wouldn’t do the job we do unless we knew we were capable enough to do it.
We understand that this is likely one of the most stressful times of your life
We want nothing more than to take that stress away from you, but sometimes that’s easier said than done. And our sincerest hope is that by giving your family member the best care we can, we can show how much we sympathize with what you’re going through.
We care about your family member
Many of us may wear stoic faces and make only little conversation, but I can promise you we care about our patients more than you can imagine. We quietly fret over their vital signs, lab results, their pain and comfort, and even how they look when you come to visit. We juggle all of these things often with full bladders and empty stomachs simply because we strive for the best care possible for our patients.
It is just those simple things we want our patients’ families to know. We want to do our job knowing that they trust our judgment and respect our role in the very difficult time they are going through. No matter what the situation, we will always care for the patient to the best of our ability. Doing that becomes so much easier when we have the support of the family on our side.