It seems like no matter where you go around the country, no matter which hospital, which clinic or which ER, you always have the same type of family members. Here is a humorous look at some exaggerated family types.
The Normal Family:
This is the family we all love. When their loved one is ill in the ICU, they ask questions, try to understand what is going on, and are very appreciative of what everyone is doing to help their loved one. This is the family type we all love and is usually the most common type of family.
The Expert Family:
This is the family that always mentions that they have 5 doctors in their family and wants everyone from the janitor to the CEO of the hospital to know. I’m not sure how they think this will change the course of their loved ones disease, but they think that it may change outcomes.
The False Expert Family:
This family always mentions that they have 5 doctors in the family, and when you finally meet them it turns out one is a podiatrist, one is a chiropractor, one is a dentist, one is a PhD in engineering, and one is a pharmacist. The actual “experts” are all very nice and interact professionally, but that doesn’t seem to bother the few family members that aren’t “doctors” from mentioning that they have doctors in the family eight hundred times per day. No one is sure why they keep mentioning this, they just think they’d get better care if they did.
This type of family always talks about suing the hospital and suing the doctors that are taking care of their loved one, even when their loved one is receiving the best care. Of course, this type of behavior may result in worse care for their loved one as all the doctors go into, what I call “cover your ass” mode of practice and start treating the chart not the patient.
We all know what cover your ass means in medicine. Order the extra test, the extra CT scan, the extra lab test, just to make sure it isn’t something else that is rare that may be missed. This is not what I am talking about.
This mode of cover your ass care seems to be different. The primary doctor will start adding more and more consultants (experts in various fields of medicine) to help spread the malpractice wealth. If they are going to sue, they sue a whole host of doctors, the less one doctor takes a hit. Can it be that all these experts were wrong? Of course not. It’ll probably be thrown out of court or never make it to court. If it does, all these experts can’t possibly be wrong. Just look at how good the chart looks!
So what’s wrong with that? Lots.
You start seeing every expert offerring an opinion and deferring to another expert. You see, “Restart coumadin if ok with cardiology.” Cardiology comes by and writes, “Hold coumadin for now, get head CT and restart coumadin when ok with neuro.” Nerology comes by and says, “MRI/MRA head and neck, may restart coumadin if ok with GI.” GI comes by and says “May restart coumadin after EGD and if ok with heme/onc.” Heme comes by… and you get the picture. You start seeing a lot of charting and not much really being done to fix the patient. And eventually, said patient dies.
Advice…. don’t start threatening with lawsuits! Period! This will just prolong and slow down the process of healing. (and they may never heal) This is the surest way to insure that your loved one won’t get proper care.
The Loud Family:
This is the family you can hear from a mile away! Before they even make it up to your floor, you know they are coming. They’re harmless and funny as hell, but man, they are loud! This family is usually fun to talk to and always have funny stories to share. A lot of times though, suddenly the ICU staff will start enforcing the “2 visitors per room” rule. While everyone else has five or six people visiting, this family suddenly is told that the limit is two.
The Know it All:
This family usually starts off as a normal family; very appreciative of the wonderful care and very happy with everything in the hospital, until the Know it All shows up. The Know it All may have some medical background, just enough to be dangerous, and they start making comments to this seemingly normal family about how everything is being done backwards here.
“Back at my hospital they’d never use that type of IV tubing” or “How come the did the EGP before the colonoscopy?” They don’t even realize that’s it’s an EGD. They just spew medical terms and sound informed to the rest of their family.
The Know it All is usually some distant relative to the family and the family barely knows them, but they seem informed, and the family starts getting fired up. They start asking questions that they think make sense when it really doesn’t. The poor doctors and nurses answer their questions without being condescending and they try to be as polite as possible. The family starts thinking that they know more than the nurses and doctors because the Know it All says so. The family will eventually push the Know it All to the forefront and have them start asking questions the next time the doctor shows up,
“Doc, how come she is on 8 different pressors?”
“Mam, there isn’t 8 pressors, and she is only on 2.”
“Why did you guys give her packed red cells instead of albumin?”
“Her hemoglobin is low and albumin doesn’t provide any benefit, let alone fix hemoglobin.”
“Why aren’t you guys following the latest guidelines?”
“Mam, what guidelines are you talking about?”
“From the IDPRC, for sepsis.”
“I am not familiar with that organization and we always follow the sepsis guidelines.”
“Why haven’t you guys transferred her to a better hospital.”
“What is it that you think they will do differently?”
And so on and so forth. The Know it All is toxic to a situation. They are usually stubborn and too misinformed for their own good. Logic and reason doesn’t work with the Know it All. It’s like having Terrell Owens or Tiki Barber in your locker room. They are cancerous and things start turning bad.
Sometimes you just have to appease the Know it All. Most humans highly value the feeling of feeling important. Everyone wants to feel important. It’s the ultimate feeling. If you can find a way to make the Know it All feel important, then you can win these battles. You have to make them feel important and “consult them” (not really consult them, but make them feel a part of the decision making process). You may have to educate them subtly, “As you are well aware, and I am sure they do this at your hospital, albumin in most cases, is useless.” Get them on your side somehow. Have them talk to the family and calm things down. Try to get them to be your ambassador.
If all else fails, “You’re right, we should transfer her to a better facility.” At least you get them out of your hair!
The Religious Zealots:
This family is overly religious. If not overly religious in general, they are overly religious about something. Sometimes it’s blood products that they won’t accept, sometimes it’s heparin, sometimes vaccines, sometimes coffee… who knows. But they always blame God.
Reasoning with the Religious Zealots requires a lot of maneuvering. A lot of times they don’t want to withdraw life support on their 120 year old grandmother who has been brain dead and on a ventilator for the past 40 years growing out every resistant bacteria, fungus, and some things we haven’t identified yet, because, “God will take her when he wants her.”
You have to be careful, and if you aren’t the religious type, just levae it alone. You could always try, “Well God tried to take her so many times, but you guys keep insisting that we do our best to resuscitate her and she always makes it.” Or, “Is this how God wants his people to live? Let her go to be with Him and enjoy heaven.” Just be careful.
There are a few other family types which I will add soon. Stay tuned….