As nurses we learn early in our careers that, whether we like it our not, our patients are not our only concern. We also must deal with the family the patient brings with him to the health care setting. Here are three suggestions to help you work more effectively with the families of your patients.
1. Establish trust
Put yourself in the family’s place. Ask yourself: how would I feel if this patient was my mother, father, brother, sister or child? How would I like the nurses to treat me? Families do not know they can trust their loved one with nurses they just met. To develop this trust, answer all their questions honestly and treat the family as an extension of your patient.
When my father suffered a stroke, I found myself in the unfamiliar role of family member instead of trusted health professional. I arrived at the hospital at lunchtime. Dad, a diabetic on insulin, was not eating. As a consequence, I learned, his blood sugars were dropping dangerously low in the late afternoon. I asked Dad’s nurse if he could have a diabetic supplement.
“He’ll start eating when he gets home.” she replied defensively and left the room.
I didn’t understand what I had said to offend her. I was not challenging her nursing knowledge or authority. I thought I was advocating for my dad. I was concerned that he may not make it out of the hospital alive.
Dad’s nurse could have reduced my fear and started to solve the problem by saying instead, “I hear that you are concerned about your father’s blood sugars. How about I look at what they have been running the last few days and see if we need to reduce his insulin or maybe add a supplement as you suggested. I’ll get back to you once I have an answer.”
2. Get on the same side
Remember both you and your patient’s family want your patient and their loved one to have the best quality care and get well. If you share this goal with the family and tell them what you need from them to accomplish this goal, they will be more willing to work with you, not against you.
When Dad was going to be admitted to the rehabilitation hospital at the end of the day, I wrote down all of his diagnoses and the problems he had since the stroke the week before. That way nothing would be forgotten and Dad, who I knew would be tired, would not have to answer as many questions. Good thing, because by the time he got admitted, he could barely stay awake. His admitting nurse thanked me for my help.
3. Set limits
Most families have never worked in a health care setting. They aren’t health care professionals. They don’t know what is reasonable and what is not. So teach them. If they ask for something you cannot do at that time, see if someone else can or let them know when you will be able to get to it. If they ask for something that is not possible to do, let them know and explain why.
In the long term care setting, good practice is taking residents to the toilet about every two hours. Any more than that is difficult to do with the number of patients and the amount of staff. Sometimes, families want their loved one changed more frequently. Of course, if the resident is soiled, the nursing staff change them as soon as we can no matter when they were last taken to the toilet. Explaining this to the family is usually enough. If not and the family wants more than that, they may have to hire private duty help.
Working with families does not have to be difficult. In fact, it can be rewarding and beneficial to you and your patients. When you establish trust, share the same goals and set limits, you can make most families allies in your patients’ care.