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The dialysis facility's rights, responsibilities, and duties when there is conflict with family members.

The stressful effect that a chronic illness may have on a patient and his or her family can make the requirements of a chronic dialysis treatment program most difficult. There will be times when tensions arise between staff, patients, and family members, especially when the needs of the families and the patients are perceived as being unmet, unacknowledged, or otherwise lacking in importance to the staff. Frustrations, if not addressed and successfully resolved, can lead to conflict and the threat of or incidences of violence. Questions that dialysis unit administrators/managers should ask when considering or revoking visitation privileges are: What are the causes and contributory factors that resulted in the unresolved issues and conflict? Did we clearly communicate our policies and procedures and the consequences for failing to follow them to those accompanying the patient? Did we fail to maintain proper boundaries with the invitee (Allowing the family members to engage in inappropriate behaviors such as threats, cursing, name-calling)? Have we attempted to resolve the issues with the family members? If so, how and what was the outcome? Did we document our actions and the family members' responses? Is the revocation of the visitation privilege the only viable option? If so, why? If not, what else could be done? What steps should be taken to minimize the disruptive effect on the patient, whose family member is being disruptive? What are the reasonable and the required steps that a facility should take to ensure that the patients are properly cared for and free from abuse and neglect? What did we learn from this situation that we could use in future situations? The uncomfortable position that Sacred Heart Hospital found itself in is a difficult one and one that many other clinics have or may experience. The focus on continuing to meet the needs of a patient while dealing with issues, such as those presented here, depicts and represents professionalism at work. Answering these questions before problems arise will help unit administrators be prepared to deal effectively with conflict at the dialysis facility. Having a plan of action in place ensures a suitable, uniform response to unacceptable situations and reduces the risk of reacting inappropriately when those situations arise.