No Respect.

[CardiacDork]

Where did the respect go for nurses and doctors? My nurse friend whom is in her silver years was a nurse many many decades ago and recently has retired.

I was telling her a story of a patient whom I received from the cath lab. The patient arrived as usual from most operational/procedural suites, a hot mess. Lines and tubing everywhere. Bloody sheets and so forth.

Well soemhow the family snuck in with her and it was such a busy night with no tech or secretary so instead of the family being told to wait in the waiting area (while I settled her in) they chose to barge in with the patient and began ordering me on what needed to be done!

I nicely and kindly explained to the daughter what the priorities at the moment were and why, despite my explanations she said

"well the priority right now is getting her (the pt) water and ice".

EYEROLL

Excuse me but that's not the priority and I told her so. I told her that with all due respect I've been doing this for a while and although I understood her mom was thirsty, I had to assess her mom and wait for the fellow to give further instructions.

She finally settled down and stopped talking.

I find this behavior annoying, and families are equally entitled acting and rude to physicians. They do not care that you are an expert and there to care for them. We are not the enemies. We went to school and have experience, and before we can accommodate to your every wish we must ensure your safety.

Anyway, my nurse friend commented how in her early years as a nurse DECADES ago... people respected nurses and doctors more than they do now.

Guess this is just a rant vent. One more reason I want to leave ICU.

Also, I'm so done with the elimination of visitor restricted hours and this new fad in "open visitation".

[CelticGoddess, BSN, RN]

While I know the stress of the acute setting and priorities, but this is like the second thread I've read where the communication breakdown involves such a simple task. Just get them their water...

And then when the patient aspirates on the water or ice chip, then what? I've aspirated on ice before, because a tech got me ice chips before they assessed my swallowing and before the intensivist wrote orders for me to have ice chips. I have also seen otherwise healthy people aspirate on water/ice because "their young, healthy". The priority is not water nor should it be with patients who are sick enough to be on the unit. The initial assessment is more important.

[Irish_Mist, BSN, RN]

I have often wondered why "loved ones" feel that treating the caregivers with distain will ensure increased quality of nursing care. Honestly, being treated with hostility makes caregivers avoid entering the parient room unless necessary to avoid another episode of abuse.

My philosophy has always been "you catch more flies with honey". Families who choose to alienate the nursing and medical staff by being abusive jerks has actually been linked to bad patient outcomes whether it be the particular crazy family patient or another patient of the nurse. This is why my strategy is to demonstrate through my actions and verbal communication with the patient and family is that I am part of the team and that I am advocating for the patient. I am not the enemy and neither is the nursing staff or physicians. I am also firm in my boundaries. I refuse to allow anyone to monopolize my time as ALL of my patients deserve the best care possible and I refuse to neglect my patients due to irate family members. Most of the time, these are scared people who aren't using reason but once you get speak to them, all is well. But, there will always be those groups that nothing anyone does is good enough.

[CardiacDork, MSN, RN]

While I know the stress of the acute setting and priorities, but this is like the second thread I've read where the communication breakdown involves such a simple task. Just get them their water...

It's a simple task, yes but that doesn't mean it's the priority. It doesn't mean I'm going to stop my assessment to get the patient water (that the family is demanding), while I return a host of complications could have occurred. I literally had NO other nurses in the room with me. It was me myself and I. That's the first impasse. The second is that the orders had not been entered by the fellow, and although sp cath patients can typically have ice chips, there are variances. Some are to be taken back to surgery, some the cath lab in a few hours - I simply did not have enough information. Quite frankly it was A) for the safety of this patient and B) for my own protection. The patient and the family can wait 10-15 or even 20 minutes while I settle her in. Get my vitals. Explain to her the plan of care. Make sure I know if she's having any adverse symptoms. Make sure she's not bleeding! Finally get some ordered from the fellow.

Sorry but I have a roof to keep over my head and ice chips and aspiration won't be the reason I lose my job. Because while I won't lose my job for not bringing ice chips RIGHT THERE AND THEN... (as requested) you can your bottom dollar I WIlLL be in trouble if patient aspirates and then the family will not care to have my back and admit they asked for the water.

What will they do? Throw me under the bus along with my livelihood.

Ice chips and water can wait. She may be dehydrated but a cup of water isn't gonna make difference within a few minutes.

People need to learn patience and that things don't always go the way we want them to. This includes sucky thing like being NPO. Yes it sucks it seems unfair but guess what? Life is unfair. I'm not trying to insensitive but it's ridiculous to justify this behavior.

Keep in mind I wasn't asked if they could have water please.

I was demanded to STOP what I was doing and get water that very minute.

No sir. No ma'am. Nope nope nope. End of discussion.

[DextersDisciple, BSN, RN]

What is very concerning to me is your ability to read much less assess a patient. Do you not know the difference between a cardiac cath patient and a cardiac cab patient??? Really?

On top of that you're willing to pass your big judgement with all that big long 3 years of experience.

What's also concerning to me is the judgmental and cliquish turn this thread took over a differing opinion. Oh it's just too much to handle a varied opinion with all that wisdom only you possess!

Takes a pair of judgmental kahunas to tell someone they don't 'belong' working in the ICU. It's bully behavior actually! I tried to just ignore the hateful comments, but no. So go take a good look in the mirror judgmental nurses. You just have to be one up, always right, no room for variance, and everyone has to know it because you're going to prove it by golly! You're part of the reason good nurses leave this wonderful career!!! You want respect...ha!!! Go earn it!!!

Oops so sorry grammar Police. Forgive my autocorrect. Cardiac cath** there I hope that's better. 3 years is enough to know ice and water are not a priority in said situation. :)

[Flatline, BSN, RN]

I have often wondered why "loved ones" feel that treating the caregivers with distain will ensure increased quality of nursing care. Honestly, being treated with hostility makes caregivers avoid entering the parient room unless necessary to avoid another episode of abuse.

Your car is broken down and making funny noises.

You see the mechanics coming in and out doing things you do not understand, sometimes seemingly making things worse by adding more damage. You see your car and hear it, sometimes it sounds the same and sometimes it sounds worse.

How would you feel in this simple situation?

When we see people we are usually seeing them at their worst time of their life. They may be scared, their may be worried.

Sometimes people act out when stressed. Doesn't excuse poor behavior but I think it is important to try to understand it.

[Flatline, BSN, RN]

Oops so sorry grammar Police. Forgive my autocorrect. Cardiac cath** there I hope that's better. 3 years is enough to know ice and water are not a priority in said situation. :)

If that simple cup of ice and water is going to prevent a great deal of stress and trouble that may hinder your ability to perform at your best then maybe, just maybe, it should be considered?

My brother had a situation where his wife thought he was in the wrong for a minor issue. He assessed they had enough sour cream for their tacos that night and they were planning on a big grocery trip the next day anyways. He had the choice where he could prove her wrong or simply stop by the store on the way home from work, a minor inconvenience, to satisfy his demanding wife. Assessing the situation he determined that although he was in the right, and the extra stop was going to be a minor inconvenience, he would go the extra mile to prevent any kind of angst that night. Thus he avoided the Pyrrhic victory, sometimes it is better to lose a trivial battle and to go on to win the war.

[JKL33]

Flatline, agree with you but here's another part of reality. There can sometimes be an "incredulity factor," don't you think? We, too, are human beings, after all. This really isn't so much about "How dare you disturb me while I'm doing my uber-important work" but more like, "What compels people to not have any idea that care is taking place here, or that someone might be doing something important?" and "What in the world compels people to not even be able to employ a smidgen of manners, even if their timing happens to be unfortunate?" They didn't say, "Could s/he have sip of water as soon as possible?" or "Would now be a good time to ask for a sip of water?" but rather more along the lines, "Hey, you there, I see you fluffing those blankets as if you don't know what's important; GO GET WATER." If OP would've had a sip of water ready and offered it immediately, I dare say these are the kind of people who will find some other way to comandeer attention.

This is two things: 1) Self-absorption to the point of being completely oblivious of anything but self, and 2) Abject rudeness.

With experience one can learn to head these situations off at the pass and also to finesse them when they do happen. But I also know that we can't be everything to everyone, and the "biggest stress of their life" thing gets old, especially since it's not true nearly as much as people like to say.

[Elibri]

OK -- but there's a big difference between ICU Cath patients and cath patients who go home the same day.

HUGE difference! And the prioritizing of all the other details of the situation can't always be translated in a post. Who knows what else was going on. I totally get what the OP is saying. It's always when you least expect it that some crazy event happens.

[LightMyFire]

I agree that in some situations respect has decreased. We need to demand that respect back. Diplomacy always is important though. Usually patients and family members can be appeased. When the patient can't, document. Noncompliance is not YOUR problem. Family members? My patient is my priority, not the family. And in my ICU family members interfering with care are removed. Diplomacy first though. I can usually get them to my way of thinking by explaining with authority what's what.

[NotAllWhoWandeRN, ASN, RN]

Your car is broken down and making funny noises.

You see the mechanics coming in and out doing things you do not understand, sometimes seemingly making things worse by adding more damage. You see your car and hear it, sometimes it sounds the same and sometimes it sounds worse.

How would you feel in this simple situation?

When we see people we are usually seeing them at their worst time of their life. They may be scared, their may be worried.

Sometimes people act out when stressed. Doesn't excuse poor behavior but I think it is important to try to understand it.

Okay, but if there's smoke coming from under the hood, you don't demand that the mechanic stop and clean a bug off the windshield. And if you do, expect to be rebuffed.

[nursemike, ASN, RN]

Yes. Sadly. I believe you are right on the money there. Let me tell you something, before nursing I was a very patient and optimistic human.

After nursing I've become pessimistic about humanity and a slight misanthrope. My tolerance for disrespect or rude people is low. I also despise driving and have grown to dislike crowds or masses of people, not because I'm shy but because after becoming a nurse ... it just feels like the LAST thing I want to do is deal with more rudeness.

I have to admit, my initial reaction to the OP wasn't particularly sympathetic, but after reflection, I have to admit we can probably all relate to the quoted post, at least to some extent at least some of the time. That said, I've been lucky that such experiences have been rare, and I remain pretty optimistic, most of the time. And then again, it hasn't been entirely a matter of luck. As a neuro nurse, empathy has been one of my most basic assessment skills, and as I've gotten better at it, I've learned to apply it to visitors, co-workers, and anyone else in my vicinity. (The first-hand experience I've had over the past few years, first as the son of a very sick patient and then as a very sick patient, myself, have given me some perspective, as well.)

I am firmly not in the just get her some ice chips camp, either. As far as I'm concerned, a new patient is unstable until proven otherwise. Ideally, the family should wait outside until the patient has been settled and assessed. If I must, I can do a fairly quick lesson on Maslow's hierarchy, but I much prefer to handle that sort of thing during the admission questionnaire, rather than the initial assessment.

I've started telling my patients and their families a thing I learned as a patient: it's nice to be nice, but it's important to be heard. If you have to choose one or the other, be heard. Then I work hard not to make them choose. But on a recent shift, it occurred to me that I need to practice the same attitude when I'm being the nurse. I had an assortment of folks who needed some of my time and a patient who needed 10 mg of IV metoprolol. I don't think I was rude to anyone, but diplomacy only goes so far toward preventing an ischemic stroke from converting to hemorrhagic, and I really didn't like the way her BP had been trending. So I was more heard, and nice later.

[Jennerizer, ASN, RN]

I get what you're saying. I see it all the time. Nurses these days are viewed as personal assistants rather than medical professionals. I was admitting a patient last night and during the assessment, the family member kept interrupting because they were hungry and wanted something to eat. This is what nursing is becoming and the hospitals cater to it because they want/need high patient satisfaction scores which nowadays includes making sure the entire family is satisfied.