I’ve been a family caregiver all my life, from helping my grandmother when I was young, to recent years helping my aging parents. Our family definition of care extends to hospital stays. In recent years, my siblings and I have expanded my mother’s longstanding tradition of going all day every day, to staying overnight to help out when the nursing staff is reduced. Our last hospital caregiving experience happened shortly before Covid came to the USA. My family has counted our blessings to have gone through our loss while we were still able to provide that family caregiving in the hospital. Now, I keep thinking about how hard it must be for families, AND for the nursing staff, to have to go through all this without the extra help. I started to wonder, What has it meant to the nursing staff to not have family around, which made me wonder, Do family caregivers help or hinder the nursing staff. So, I reached out to a nurse practitioner to ask.
Impact of Covid on Nursing Staff
Our discussion began with the impact of Covid on the role of nurses. Without family caregivers, nurses have had to take on the role of the loved one, on top of their already demanding job. In other words, they were tasked with providing the comfort family caregivers usually provide, such as holding a hand, helping make a call, or help with ordering a meal. The nursing staff has also had the added responsibility of helping patients communicate with their family via Facetime or other forms of communication, contacting family regarding care decisions, and navigating protocols when family was allowed into the hospital. All additional tasks to above and beyond their normal healthcare duties.
This added emotional responsibility has put an emotional drain on nurses that has left many with Post Traumatic Stress Disorder (PTSD). Think of it this way: a lecturer on stress management lifted a glass of water and asked how much it weighed. But the point wasn’t about the weight of the glass—a.k.a. the burden you carry— it was about how long you had to carry it. In stress management, you need time to put down your burdens and refresh before carrying them again. During this pandemic, the nursing staff has had to “carrying the glass of water” longer and longer without a respite. As family caregivers, there are some things we can do to help ease their burden.
One thing our family has done to support the nursing staff during a family member’s hospital stay was to bring treats for them. These treats did not only showed our appreciation, but it provided a bit of comfort. In the absence of families, this little extra boost has fallen off too. But it doesn’t have to. There are ways to “fuel” your nursing staff from afar. For example, my local area coffee shop offered a program to provide coffee and treats to hospital nursing staff. There are other ways you can have treats delivered. But most of all, remember to remain empathic and patient when you make requests over the phone.
What TO DO
And when the pandemic is over, here are some of the things you can do to help the nursing staff as an effective family caregiver:
- Make sure the patient eats by providing feeding assistance.
- Help calm a patient who may experience hallucinations due to the illness or medication they are taking.
- Help keep the patient comfortable, like adjusting their pillows, or getting a glass of water, or helping them order their meals.
- Flag things that aren’t normal. Because a nurse does not have a baseline of what is normal in the patient’s daily health condition, they don’t know if a patient’s symptoms or behaviors are typical for them. The family is best equipped to point out what is and isn’t normal. For example, with my father, we had to point out that he DID NOT have dementia. That he was normally very clear thinking, and that it was his illness that was affecting him.
- Help provide continuity of care. When family members are involved in the entire care process, they can share information from one specialty health provider to another. This helps by giving each of them more background on a case. We’ve done this with many family members during their hospital stays. Having a notebook to record what various care providers say and do is very helpful.
- Know the patient’s wishes regarding care. This has been another extra task nurses have had to take on when family is not allowed into the hospital. They must contact the family for care decisions, including do not resuscitate (DNR) orders. I can’t stress enough how important it is to have Power of Attorney in place before someone gets ill. It was a tremendous help when my father was in the hospital.
- Simply hold a patient’s hand and provide company to help ease the stress of being sick and stuck in a hospital bed.
- Make sure that the patient is heard. Communication is a funny thing. Health professionals don’t always speak the same language—both literally and figuratively. Literally, the patient may need an interpreter. Figuratively, a family member may need to restate questions to help the patient better understand them.
But keep in mind not to speak for the patient. It may seem easier to just provide your observations when a patient is weak or slower to explain their issues, but it is important to remember they are still a living human being and are the best person to explain what is going on with their body. It’s helpful to ask the patient questions to provoke them to tell the healthcare provider about concerns, but give them space to speak for themself. You can always fill in details you may feel are helpful, but confirm with the patient that your input is correct.
What NOT TO DO
With all that said, I couldn’t help but wonder how caregivers might not be helpful. You know, like when a small child wants to help you make dinner and you end up spending more time cleaning up spills than getting the job done? Well, there are ways that family caregivers make a nurse’s job harder, such as:
- Please don’t treat the nurses and the nurse’s aides like they are servants. They are professionals that deserve your respect. When asking for assistance, consider whether you – the family caregiver – could handle it. For example, ordering a meal.
- Try not to question every number on a monitor. If you are not knowledgeable in healthcare, it’s easy to misunderstand the readings. It’s okay to ask a nurse when they are in the room already taking care of your patient, but please refrain from calling them repeatedly with questions. The monitors have alarms for when a vital sign moves into a dangerous range.
- Show respect when you question care. Please don’t challenge everything the health providers do. They (doctors, nurses, nurse’s aides) have studied and learned their field and have a patient’s best interest at heart. Have some faith.
That said, questioning things can be helpful. It is okay to get involved in your loved one’s care and partner with the team to problem solve. Inquiring about a reaction to some treatment can be helpful, especially when you know what is normal for the patient. This can provide clues for diagnoses and care. But be sure to question with respect for the healthcare staff member.
- Be careful not to get in the way of the nursing staff doing their duties. I always ask before lending a hand because I am sensitive to how “a child helping in the kitchen” can make a job harder. Sometimes it’s just easier to let someone do their job without help. The key is: ask.
Ultimately, when hospitals open to visitors again, remember that caregiving is a team event. As a family caregiver, you are not just an advocate for the patient but part of the care team that will restore the health of your loved one. Be a good team member and keep these insights in mind to help the get-well experience for everyone. And above all else, follow CDC guidelines to protect yourself from getting sick because the best way to lighten a nurse’s load is to NOT ask them to “carry your water.”