How do I deal with over-involved families?

How many times have you wished for responsive family members? You know, the kind who will stay with the patient when you can’t, help set her up for supper and get her water when the pitcher runs dry?
What you didn’t have in mind, however, was a family who crowds into the patient’s room and refuses to leave during procedures, brings in fast food despite a diagnosis of coronary artery disease and hangs out at the nurses’ station hoping for a glance at their loved one’s chart.

Time to set some boundaries. Begin by letting the family know how much you (and the patient) appreciate their love and concern. Stress the fact that you’re sure you all want what’s best for the patient. Take time to listen to their cares and concerns as well. Over-involvement is often a front for fear. The family member who’s afraid of something bad happening to Mom may be the one who refuses to leave her bedside.

Consider family patterns as well. For many families, making and bringing food is a way of showing love. If that’s the case, let the family know what diet the doctor ordered for the patient and why. Help them brainstorm about some alternate (and appropriate) foods to bring instead.

Tell the family exactly what you need to do, and why. If you’d like them to leave during dressing changes, for example, tell them you’ll be doing a dressing change, that you’ll be medicating the patient in advance and that it’s absolutely critical to maintain a sterile field. Most likely, they’ll get the picture and leave you alone—especially if you promise to fetch them from the waiting room as soon as you’re done. And stick to your word, if you promise to let them know when the procedure is finished, be sure to do so. That will develop a rapport with the family and they will be more apt to trust you with their beloved.

If all else fails, enlist the physician to talk to the family. For better or for worse, some families still respect the doctor’s word over everyone else’s. Worst-case scenario, you may need to contact your nurse manager or security to establish and enforce strict visiting times.