Families

The range of family involvement in patient care is pretty stunning and diverse. In the last few weeks, I've had patients who are dropped off by family members outside the emergency department, and I've had families who stay at the bedside night and day trying to micromanage. From the standpoint of a resident, I don't think either is good. Families are a necessary component to care; they support their loved ones in the hospital, they are an invaluable source of information, and they are critical around the time of discharge. It is really hard for me to see patients in the hospital who have no family, no visitors. On the other hand, families that micromanage can be intensely frustrating. Family members have a wealth of information about their loved ones and their diseases, especially if they manage the patient's chronic conditions. Family members know a lot, and they can contribute a lot, but sometimes this makes them imposing. All care, whether inpatient or outpatient, must be a concordant plan of action negotiated among the clinician and the patient. But I've had families demand unreasonable things, and in one case, something that proved detrimental to the patient (this will be the next post).