Intimidated Nurse Informed Patient and WebMD

12 Just writing to see if anyone else has experienced anything like I did the other night. Had a patient admitted from the ED. Fifteen family members (I kid you not), followed her to our floor and went directly to her room. There are no restrictions on the number of visitors or time of day in my facility r/t the "ultimate Hilton experience" for our patients. We politely asked them to leave the room twice, so that we could assess the patient and hook her up to the tele monitor. They were either deaf or chose to ignore us. We then hooked her up to the tele unit while trying to bare her breasts as little as possible as sons, daughters, and grandchildren looked on. I found this quite bizarre. As I was doing the admission assessment, two of her sons who were 6 feet + got in my way and stood almost chest to chest with me and refused to move out of my way until I said "excuse me" twice. And...if looks could kill. Having worked with the public in various ways including the criminal justice system, I am not easily intimidated. To be honest I was getting really irritated. I was then grilled for over an hour about orders that the doctor had written (he had talked with the family in the ED and explained the plan of care) , asked some very strange and detailed physiological questions, and was educated on how to properly administer BP, DM, and cardiac meds. It was obvious that my inquisitors did not have a clue and were attempting to appear self-important and informed while making complete asses out of themselves. As this was happening; both the bodyguards were playing with their cell phones, and I did not think much of it, because texting and multitasking appears to be an American (and probably foreign) obsession. I left the room to get the patient a blanket and the CTA assigned to this patient said, "Wow, it's amazing how ignorant people are....what they did to you...they were harassing you as they were looking up information on WebMD." I had to laugh, because I was completely unaware. I guess I am the fool, since I went to college to wipe butts and continue to advance my education and pay student loans, when all I had to do was go on WebMD and get my education for free. I am all for an educated and informed public, but seems that there is a growing trend to self diagnose. There are some real horror stories out there r/t this. If people feel that they are their own best physicians, nurses, or other healthcare worker they should stay at HOME!!!! ... The doctor was still on the floor. I went back into the room and politely told the family that they doctor and WebMD would be in shortly to answer any questions.
"Code Green, room with all the weirdos..Code Green..."

I get friends and family asking questions all the time after they've read the worst possible scenario for some benign issue. AND, my Dad calls me a month ago, sitting with his lady friend at the beauty shop- they were all in a debate as to what killed Jackie Kennedy Onasis...as if I've got the celeb obits memorized.... I did a quick search and cleared up the "leukemia vs something else"-they were specific-I wasn't interested, and don't remember - issue.... it was lymphoma.... all were wrong. I tell anybody who calls me now to get a real dx from their MD, and call me if they don't understand the vocabulary.... It also doesn't help that every other commercial is for some "bad drug" (that nobody read the side effects for before taking it). Education is good in the right hands And in doses they can handle.

I've found it strange that when I've gone to WebMD and other sites of this nature, I often felt the info I read was lacking something.

Quote from caliotter3I've found it strange that when I've gone to WebMD and other sites of this nature, I often felt the info I read was lacking something.

I think we've all encountered these families from time to time.My new all-time favorite quote, courtesy of another thread here at allnurses (paraphrased):The degree to which families are a PITA is usually inverse to the functionality of their relationship with the patient.However, you have to get some control of the situation. When I work inpatient, families are asked to step out to the waiting room until the patient gets settled in the room. (and I and my coworkers stop everything and STAND THERE until they comply) When I work in the ED and am transporting an admitted patient, I also send families to the waiting room or cafeteria with the instructions that they have 30-45 min. of "free time" while the patient is transferred.Under no circumstances would I expose a patient with multiple family present -- they would again get the instructions to step out, and the door would get shut until the patient was settled.WebMD -- knock yourself out -- but I will be answering questions and providing education only as long as it appears that I have your full attention. If I do not have your full attention, or you wish to consult other sources, then we've probably reached the conclusion of our education session for today. We'll start again tomorrow when you've had a chance to digest what I've told you today. I will also pass on to the MD that you have questions about x, y, and z.An "intimidated nurse" has lost the ability to be an effective patient advocate -- don't become "intimidated".

It's stories like this that make me glad I'm in psych. We only let our patients have visitors once or twice a week and we limit the size of the entourage to 3. So most of the family hassles are done over the phone. The most I have to deal with WebMD and "web medicine" is when patients/families look up medications on the internet and try to sell me on or off them. That's where my doctors and/or PDR come in handy

Quote from AltraI think we've all encountered these families from time to time.My new all-time favorite quote, courtesy of another thread here at allnurses (paraphrased):The degree to which families are a PITA is usually inverse to the functionality of their relationship with the patient.However, you have to get some control of the situation. When I work inpatient, families are asked to step out to the waiting room until the patient gets settled in the room. (and I and my coworkers stop everything and STAND THERE until they comply) When I work in the ED and am transporting an admitted patient, I also send families to the waiting room or cafeteria with the instructions that they have 30-45 min. of "free time" while the patient is transferred.Under no circumstances would I expose a patient with multiple family present -- they would again get the instructions to step out, and the door would get shut until the patient was settled.WebMD -- knock yourself out -- but I will be answering questions and providing education only as long as it appears that I have your full attention. If I do not have your full attention, or you wish to consult other sources, then we've probably reached the conclusion of our education session for today. We'll start again tomorrow when you've had a chance to digest what I've told you today. I will also pass on to the MD that you have questions about x, y, and z.An "intimidated nurse" has lost the ability to be an effective patient advocate -- don't become "intimidated".

I'm not here to bash you ... but did you feel effective when you were taking care of this patient? Or did you feel you had lost that because of interpersonal dynamics with the family members?

What! How dare they use webMD instead of Google?! This is a teaching moment for sure!

Sometimes it's really hard to get a situation like that under control. I'm not good at it, either. That's where teamwork comes in... there's usually someone on the floor that has no trouble getting people to do what they need to do. I have no problem utilizing these people (charge nurse, house manager, really assertive co-worker, whatever) as I continue to develop these skills. Don't be too hard on yourself - think about what you should have done better, and move on.

An "intimidated nurse" has lost the ability to be an effective patient advocate -- don't become "intimidated". FROM ALTRA THIS IS BRILLIANT, I LOVE IT!

Yes, but I guess I left out the fact that the patient condoned this, because after we asked the family to leave twice, the patient stated she wanted them to stay. My interpersonal dynamics with the family? I think that I was dealing with some very F'd up people with equally F'd up family dynamics and handled it as best as I could. I now realize that I left a lot out of this post, because I tend to be very wordy, wanted to hear some other experiences, and was trying to get to the point. Apparently, I did this ineffectively. Patient (a & 0 x 3 and ACS) also condoned their behavior by insinuating that I had incorrectly impute her meds on the med rec (actually med rec done in ED), and that I also told her that she was taking a med that she never heard of (gave both trade and generic names). And this is after I went through the med rec with entire family. Fortunately, family had brought all of her script bottles with them. Went through med rec on computer again (one by one, script bottle by script bottle)...guess what, no error. Also, I have been around long enough in life to realize when someone is basking in attention. The next morning, the patient apologized to me for her family's behavior. Told her it was no problem, "they just care about you." That did not stop her from calling her family an hour later on the next shift and saying that she was poisoned because her nurse gave her the wrong antibiotic. Another sad play for attention. Well, from my understanding, only 8 of the family showed up and caused a big disturbance. Security was called and visitors were limited to 1 at a time, excluding those who had caused the disturbance. So...to make a long story short (LOL), I did the best I could and gave this patient the same care that I give to all of my patients, despite the fact that my patience was definitely tried. Peace Out.