How Much At-Home Nursing is Too Much

For nurses, the instinct to ease pain and care for the sick becomes so inherent that it just becomes habit, even at home. While taking a sick child’s temperature is a normal parent duty, nurses may end up crossing the line in giving at home care to family members. Are you a 100% sure that you are making the right choice when you choose to skip the doctor’s visit and care for your spouse and kids alone?

If you are routinely treating your family without the guidance of a physician, you are potentially putting their health at risk. Sure you have seen a thousand strep throats in your career, but your child will still benefit by being seen by their pediatrician. Know what your limits are in providing treatment, and when you reach that limit, pick up the phone and make an appointment.

When a Doctor’s Visit is a Must

• When you think that a prescription medication is needed: As an RN, you are not permitted to write or dispense prescription medications. Asking a favor of a physician to write one for a member of your family without being seen is ethically and professionally inappropriate. You are putting them in an awkward position that also puts their career on the line. Even if you think a simple antibiotic will do the trick, you should always let a doctor examine your family member first.
• When Their Health is Not Improving: Follow the same advice you would give a sick patient when leaving your facility, and bring your family member to the doctor if they are not showing any sign of improvement after a reasonable amount of time.

All medical professionals, including doctors, are discouraged from treating members of their own family. The AMA Code of Medical Ethics does state this, and cites the reason as being that professional objectivity may be compromised in these situations.

Before whipping out your nursing bag and stethoscope the next time one of your kids is sick, ask yourself what you would do if you did not have that degree hanging on the wall. If you are going beyond what a typical parent does in the same scenario, than you are likely taking things too far.

So What Can a Nurse Do At Home To Treat Their Family?

Imagine that you get home from work to find your spouse splayed out on the couch in pain. You can use your skills as a nurse to assess the problem, much like you would in a clinical setting. Go ahead and take temperatures, check pulse rates and even pull out your stethoscope and listen to their breathing. All while asking your spouse-patient the same types of questions you would if you were at work.

Once you have the information ask yourself honestly if a doctor’s intervention is necessary. If you are considering a course of treatment that you would not be permitted to perform professionally than it should not be done on a loved one.

What About Nurse Practitioners?

The gray line darkens when you are a nurse practitioner (NP) when it comes to treating your own family, as your medical skills are more pronounced. Yet you should still follow the same guidelines as any medical professional, and ensure that you are within your scope of training for the level of treatment you are providing a family member.

As a NP you also have the ability to write a prescription, and may feel compelled to do so for a family member who is ill. While there are no laws which prohibit this, you should ask yourself if that is really in the best interest of your spouse or child. Unless you are 100% positive in your own diagnosis and treatment plan, getting a second opinion from your collaborating physician is highly recommended. Especially if your family is not enrolled as patients in the facility where you practice.

Where you should never write a prescription for a family member is when it is for a controlled or addictive substance. There are laws in some states which prohibit this, and it definitely raises ethical questions. Even if you are only seeking a stronger cough syrup to treat bronchitis, the prescription should come from a physician who is not connected to you or your family.

The Bottom Line on Treating Your Own Family

Your first instinct when a loved one is in pain is to ease it to the best of your ability. Since your abilities are heightened by your training, this could put you in a difficult position. Giving the situation thought before it happens will help you in setting your own personal rules for how much is too much care at home. Consider the legal and ethical questions carefully as well as your own expertise to make a rational plan for when a medical situation arises with your family. With a mental plan already in place, you are more apt to make the right decision when it comes to the health and well being of your family and career.