As a nurse, your primary concern is, of course, the well-being of your patients. Yet there will be times when that may extend to their family members as well. It is not uncommon for a nurse to have to address the questions of a spouse, parent, child, or other close relatives. You could even find yourself having to counsel them or provide them with the after-care directions. There is a line of confidentiality that you must always be aware of, however, and take great care not to cross it.
Nurses Confidentiality Expectations
Nurses are bound by the same confidentiality codes as physicians are. You are privy to private and sensitive information regarding your patients, and it is a part of your job to protect it, even from their family members if that is the patient’s wish. With this in mind, your first priority when dealing with the family members of a patient is to protect their right to privacy.
Unless your patient is mentally incapacitated in some way (such as with an Alzheimer’s patient), there is never a reason for disclosing information about their health or care unless the patient is in accordance. When preparing to talk with a patient, it is always appropriate to ask anyone who may be with them to leave. Only if the patient requests that they stay may you continue with the conversation or treatment in front of them.
How to Handle a Family Member Who Attempts to Intervene in Your Patient’s Care
You will find yourself in situations where a family member of a patient seeks you out in private. It may just be to ask additional questions, or they could attempt to intervene or offer their own opinion on how treatment should proceed. Again, unless the patient is unable to advocate for themselves, you are not allowed to discuss any aspect of their care without expressed permission. This is true even when they feel they are acting in the best interest of their loved one.
When it is information they are seeking, be polite but only give broad answers rather than specifics. You are allowed to speak about a disease or injury to a member of a patient’s family, but not how it relates to your patient. If they are trying to intervene in the care, such as by asking you to stop a certain medication, you are not permitted to oblige. In this case, it is best to let the attending physician know that a member of the patient’s family may not be in accordance with the treatment plan. They can then further question the patient to try and determine if there is a just cause that they were not aware of.
Overly Aggressive Family Members
The fear associated with the illness or injury of a loved one does not always bring out the best in a patient’s family member. It is natural for people to react in a combative matter when they are scared or worried, and it is natural for you to feel it necessary to take a defensive or run away. Don’t. Learn how to control your instinct and try instead to step into the shoes of the wife, father, or sibling of the patient to better understand where they are coming from. They feel like they have no control over the situation – and they probably are right. A nurse who is adept in family care will know how to calm those fears.
If you ignore the fears of a family member and run off instead of addressing questions, you are actively encouraging that fear to grow. This will turn into even more confusion and even anger for the patient’s loved one, which is not in the best interest of anyone. Acknowledge that the individual is upset and ask them if there is something you can do to help. This should calm the person down, as they get a sense that you are invested in making sure that there is a positive outcome for the patient. Avoid making this a power struggle by throwing around words like privacy or confidentiality, instead, follow the advice above and give broad answers related to the illness rather than to the patient.
When Family Care is Disruptive to Patient Care
There are moments when it will be up to you to act as the advocate for your patient, especially when you see that the presence of certain family members is not positive. You can exert your right to ask family members to leave the room if that is what is in the best interest of the person you have been assigned to care for. Watch for cues from them, such as withdrawn behavior or refusal to make eye contact, to know whether or not they are comfortable having a particular person at their bedside.
Family care sometimes puts a nurse on shaky ground, but with the right training and experience, you will be able to keep your footing. Use your same caring demeanor that you do with your patients, yet with a firm hand, and you should have no trouble in meeting the needs of all involved in the patient’s care and well-being.