Reply To: Patient/Family Care Challenges

  • Leticia Valdiviez

    March 28, 2017 at 5:55 pm

    We have a disruptive behavior policy to address these situations. We also emphasize to staff that at any time they feel unsafe, they can call security. The policy is attached. We also have a sheet where staff can document incidents so that the escalation of an issue is consistent and staff are aware of what has already been addressed.

    The refusal of care process we use really depends on what part of the care is being refused and why. Generally conversations with families that include physicians, nurses, and social work as appropriate are used as a start.

    Letty Valdiivez, MSN, RN, CPHON
    Clinical Manager, BMT Unit
    Children’s Hospital Los Angeles
    Original Message:
    Sent: 03-28-2017 05:39 PM
    From: Michelle Gillard
    Subject: Patient/Family Care Challenges


    I’m wondering if any of your institutions have an algorithm/protocol for dealing with challenging families. We’ve all seen those who refuse certain aspects of care or are violent/disrespectful/abusive to staff. I’ve heard that there are institutions who have implemented a “protocol” with guidelines on how to better serve those families (ie. always 2 staff members in the room for conversations, how to handle refusal of care/examination, etc).

    If you have such a protocol, would you please share?

    Thank you!

    Michelle Gillard, MSN, RN, CPHON
    Clinical Education Specialist Phoenix Children’s Hospital
    Phoenix, AZ