No Respect. - page 10
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... Read More
Dec 16Quote from FlatlineOkay, 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.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.
Dec 16Quote from CardiacDorkI 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.)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 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.
Dec 16I 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.
Dec 16Quote from NuGuyNurse2bIt wasnt the patient wanting water, it was the family demanding it.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...
Dec 16Quote from JennerizerYes. The hardest part is when the family interferes with patient care. Because the patient has still not interfered in their own plan of care. So you have to navigate the plan of care with people making the flow and delivery of care nearly impossible.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.
When the patient interferes, I learned that my own satisfaction reigns superior to convincing a patient otherwise.
Of course, when the DKA patient wants a sandwich when the gap is still open, and I'm chasimg blood sugars in the 600's I will try my best to educate the patient and identify learning deficits. I do genuinely try. I ask questions and am always open to education.
However if after I've educated you and you persist to refuse or complain about the plan of care, I'll just page the resident to come talk to you.
If you refuse after that, it's all on you and I don't care. You wanna eat donuts with an open gap and in a state of acidosis? Have it ma'am.
Dec 16Also, when families are rude and disrespectful it by no means works in their favor.
Staff only enter the room when they must and on hourly rounds. Meds/treatments and silencing alarms.
The truth is that a receptive and open minded family garner much more attention.
Because staff are actually happy to go in there and provide education and compassion ... because they aren't afraid of being yelled at or abused.
Dec 16I want to also make it clear that there is a huge distinction between concerned and asking a lot of questions... I know this annoys people sometimes but I handle that.
I can handle the concerned families that ask about what we're doing. That ask even after we've told them twice. That's OK. Explaining myself while I do is a task is a breeze.
Asking me what their lab values were after we have them a replacement of K+ and did a follow up BMP doesn't bug me.
You wanting to know what we're doing for their condition or symptoms doesn't bug me. Even if you ask over and over.
I know you're just worried. You want to know what we're doing. That's okay!
It's the disrespect and demanding this and that. It's the belittling staff. The threats. The rudeness.
And unfortunately there's little we can do. We can't change people. Our strings are the only strings we can play.
We can set ground rules and be a figure of authority and compassion.
Educate educate educate families and patients.
The more I educate the easier my job becomes.
Dec 16Pressure dressing? Sand bag? When/where did you last care for cath patients? Sand bags have not been beat practice for well over a decade. As this patient went straight to ICU, they likely still had the femoral line IN. ICU patients are very different than healthy patients here for a diagnostic Cath going home the same day. I'm glad YOU feel comfortable giving patients water or ice before settling the patient, getting them on the monitor, or even assessing the site, but those of us who care for our patients safety and our licenses are just gonna tell the family to wait in the hall. Incredible
Dec 16Rn BSN msn
You would be surprised how far behind some hospitals are. I worked at a hospital that still had rotating tourniquets for CHF in the crash cart within the last ten years. We never used them, but by God, they were available if needed! If the poster's hospital still uses sand bags, that RN is bound by hospital policy.
Dec 17I was recently a patient. I brought in a box of candy to pacu and the surgerical floor I was on. People were amazed I thought of them. I got good care. I appreciate them. I respect them. Floor and pacu nursing is hard work. It's even harder knowing you are taking care of a nurse. I didn't tell them. I'm a coworker. I've been at the same facility for 40 years.
Dec 17Quote from Rn bsn msnTHANK YOU!Pressure dressing? Sand bag? When/where did you last care for cath patients? Sand bags have not been beat practice for well over a decade. As this patient went straight to ICU, they likely still had the femoral line IN. ICU patients are very different than healthy patients here for a diagnostic Cath going home the same day. I'm glad YOU feel comfortable giving patients water or ice before settling the patient, getting them on the monitor, or even assessing the site, but those of us who care for our patients safety and our licenses are just gonna tell the family to wait in the hall. Incredible
I am not sure why there is such a disconnect with the request for water and CardiacDork's desire to actually assess the patient FIRST. If this patient came from cath lab to ICU, then clearly this patient is unstable and needs a lot of monitoring. The prudent thing to do is not "like, um, go get some water. it's just water." Assessment first, then water, if indicated. If I had a dollar for every time some clueless family member or visitor insist I give the patient water (who either aspirates everything they swallow, is NPO, etc), I'd be rich. This applies even AFTER having explained the circumstances. I'm honestly surprised that people are actually debating the topic of water even after it has been explained ad nauseum. Why is this even up for debate? Assessment first, water later.