Question

"I am the primary caregiver for my mother, who is currently hospitalized in the ICU with multiple issues. I am having a hard time with the nurses, aides, and doctors. I work in health care, myself, and know that they are not doing what they should at times. They are over-medicating, being inconsistent with infection prevention techniques, and not responding to my mother when she is in need. What is the best way to deal with them? I am afraid for my mother." - READER

Answer

Caregivers, especially those who work in health care, often come into conflict with those paid to provide health care for their loved ones. This is because health care is complex and, quite frankly, is a bit of an art.   We all have our individual approach and no two caregivers do things the same way. Yes, we have strict standards, but there are usually multiple paths to accomplish a good outcome for our patients. As a nurse, I rarely find another nurse who performs procedures, writes clinical notes, or tackles situations in the exact same way as another nurse.

In your situation, you need to figure out a way to work with the ICU staff. It is best to become an ally rather than an antagonist. Your mother’s health care workers have the same goal, a good outcome for your mother. Believe me when I say, that those caring for your mother do not want anything negative to happen to her. Health care workers tend to take clinical failure personally. After all, we are people that chose to care for others as our life’s work.

Here are some examples of how you might consider addressing the issues you mentioned in your question.

• Overmedicating – It is challenging to determine if a patient is overmedicated in an ICU if you are a family member. ICU patients are often deliberately sedated to protect them, giving their bodies a bit of time to heal and to provide pain relief. If you truly believe that the medication regimen is incorrect, it would be best to schedule a conference with the physicians and nurses who are prescribing and administering the medications as soon as possible. There is always logic behind prescribed medications, and it may go well beyond what can be found in an internet search. If you still disagree after the meeting, respectfully request a consult.
• Infection Control – Breaks in infection control are most upsetting to those of us who work in health care, as infection control techniques are drilled into us from the first days of training and regularly thereafter. It is most uncomfortable to witness this type of error, such as a procedure being started without proper handwashing. I recommend that if you are present you say something like, “Hold on, I think we missed something here.  Would you mind scrubbing your hands again before starting? Somehow I missed it and I am nervous.” The point here is that you start with a soft approach of letting the individual know you are watching. If you see continual breaks in infection control, you will need to speak with the nursing supervisor without a doubt.
• If staff is not responding to your mother’s calls, ask if your mother is calling frequently or if there is some other problem. Make this inquiry without anger or accusation. Remember, you are allies in care, and you are trying to get the best care for your mother.

If you see yourself as a problem solver and a partner in care, you will be able to work together with the hospital staff to achieve the outcomes that are desired. You can always file a complaint with the hospital if the situation does not improve.

I wish your mother and you the best.