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June 2010, Volume 40 Number 6 , p 14 - 15


  • Susan A. Salladay PhD, RN


I'm caring for a seriously ill patient whose wife is a retired nurse. Naturally, she wants to make sure he gets the best possible care. She's constantly telling nursing staff what her husband needs and exactly how it should be done. Sometimes her requests support our nursing plan of care, but many of her ideas aren't evidence-based. Whenever we don't do what she asks, she gets angry, upsetting her husband.Our nurse manager spoke with her but she refuses to back down, saying she's just protecting her husband's rights. How can we get her to (appropriately) back off?—D.C., MICH.It's hard to give care to two patients at once, isn't it? But your patient's wife needs your care as much as her husband. Loneliness and fear about the future combine to create anxiety and worst-case scenarios in her mind. Her professional background is a red herring—in this situation, she's a family member under stress, not a nurse.Assigning one person to be this patient's primary nurse may help. Besides providing consistency for the patient, this nurse can serve as the wife's "go-to" person for information and support.The nurse could call a care conference with other team members for an honest discussion about any concerns the patient or his wife has about his care. Team members can then provide evidence-based rationales for interventions, answer questions, and suggest resources for more education and support, if appropriate.Resist the temptation to disregard her demands, however unreasonable they seem to you. Remember, this patient's wife is his primary support person. If she's uncomfortable with his care, he probably is too. By including her in the team and building rapport, his nurse can encourage her to trust his caregivers. As trust grows, she'll be more willing to partner with the healthcare team.My patient was hospitalized for cardiac dysrhythmias after following a very restrictive diet recommended by a naturopath. She's

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