Difficult families - page 2

by HurricaneCasRN 3,910 Views | 19 Comments

How do you deal with them? I'm talking about the families that take shifts and are on the floor all day and evening. Each shift wants to talk with you, complain to you and assess Mom and create complaints. They suck up HOURS of... Read More


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    HurricanecaseRN,

    I asked them to write their questions and "our" answers into a notebook. Note: I didn't write they did.

    That way when family were relieved they could scan the notebook for answers first. Most of them want a procedure to follow. Of course, if they get too demanding individually, then find the one you get on best with and ask for his/her help in solving the problem. Otherwise, it will escalate out of control.
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    Quote from Rodoon
    HurricanecaseRN,

    I asked them to write their questions and "our" answers into a notebook. Note: I didn't write they did.

    That way when family were relieved they could scan the notebook for answers first. Most of them want a procedure to follow. Of course, if they get too demanding individually, then find the one you get on best with and ask for his/her help in solving the problem. Otherwise, it will escalate out of control.
    I like this response to the problem a lot! I am just getting ready to start my first job in a LTC/Rehab and can imagine having issues with family camping out. Asking them to write down their questions to share among the family is brilliant!
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    Quote from HurricaneCasRN
    How do you deal with them? I'm talking about the families that take shifts and are on the floor all day and evening. Each shift wants to talk with you, complain to you and assess Mom and create complaints. They suck up HOURS of valuable nursing time, often with repeating the same things. It's SO frustrating. Mom never complains of Angina until the family convinces her that she is having it. Mom doesn't want ice cream until they wake her up and tell her she does. They TIME the call lights. In addition to the talks they wish to have about Mom, they are there so often, they think they are one of the gang and wish to just have general chit chat!

    Our difficult family is on a hall with FORTY ONE other patients and one nurse. That 40 minutes of specific attention can result in a a huge back log on med pass. And MOM. IS. FINE. She never "needs" nitro except when her children decides she does, and her VS are always WNL.

    So, what's the solution?
    So how do you deal when even the water is not wet enough? You come to allnurses after your shift with your choice of beverage in hand and share. Just when we think we have heard it all another thread like this comes along and we can all vent and have a laugh. (Ice not cold enough??? Whatevah!!!)
    I work in a non-profit LTC-it's the last stop for folks who have outlived their riches. Just recently we had someone complain that the staff at the nurses desk was not "welconing enough " I believe that we had an actively dying hospice patient on the unit that day-and doctor's rounds. Excuse ME if I forgot to get up and curtsey......
    itthybitthythpider, wooh, and opossum like this.
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    STICK UP FOR YOURSELF! Be professional, but firm if you have to. You have a job to do and people's lives are on the line! Take an authoritative stance and let them know that you're in charge and you know what you're doing. Believe me this works!

    The over-involved families drive me nuts, too. A lot of the time they are really just projecting their own needs onto the sick family member. I've had a few where they were obsessed with finding fault with me and other staff, to the point of having someone follow me around the room and writing down everything I was saying and doing! Timing the call lights, yeah, I've had that, too. I don't know if I've ever been recorded or video taped, but I've heard of people doing that, too!
    LTCangel and eyeball like this.
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    Last week I had a patient whose family had earned the reputation of "difficult/needy/demanding" from the previous nurses. And they were, in every way possible. These are the families that to my mind, suck the oxygen from the room and interfere with care. At one point I went in and found the Aide had closed the door and was in there alone giving her a bath while the hypervigilant family hovered in the hallway outside. She said to me "I can't deal with this...I kicked them out so I could give her a bath." I said "Good! Maybe we can get something done here." She and I worked in there for the next half hour doing bath, meds (Peg tube), turning, suctioning, reapplying restraints, and assessing. We both agreed to hang there till the other was done, help each other out, and not leave the room till our care was done and to keep the entourage from flooding back in. It worked really well. The patient received good care and the two of us were calm, cool, and collected throughout the process. I think it was a relief for the three of us, truthfully.
    JZ_RN, LTCangel, wooh, and 4 others like this.
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    Quote from eyeball
    Last week I had a patient whose family had earned the reputation of "difficult/needy/demanding" from the previous nurses. And they were, in every way possible. These are the families that to my mind, suck the oxygen from the room and interfere with care. At one point I went in and found the Aide had closed the door and was in there alone giving her a bath while the hypervigilant family hovered in the hallway outside. She said to me "I can't deal with this...I kicked them out so I could give her a bath." I said "Good! Maybe we can get something done here." She and I worked in there for the next half hour doing bath, meds (Peg tube), turning, suctioning, reapplying restraints, and assessing. We both agreed to hang there till the other was done, help each other out, and not leave the room till our care was done and to keep the entourage from flooding back in. It worked really well. The patient received good care and the two of us were calm, cool, and collected throughout the process. I think it was a relief for the three of us, truthfully.
    Let's give this aide a hand for having the balls to kick them out! That's what I call good judgement!
    JZ_RN, LTCangel, wooh, and 5 others like this.
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    Quote from Quickbeam
    That really made me laugh. Thanks for a day brightener. I've had MDs go through my lunch bag looking for food. They are like raccoons.
    I now have a mental image of one of our docs with raccoon stripes painted on his face, eating out of my lunch bag at the desk...dunking my sandwich in coffee...
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    Quote from nerdtonurse?
    I've done the "over the top" like wooh -- sometimes, that works. Sometimes they just want an older nurse because they don't think anyone under the age of 40 knows anything. In ICU, we run into a lot of families who think there's a doc sitting in the unit all the time (only if there's food does the MD do that), and want us to call them all the time.

    I had one memorably horrible family when I was in telemetry, and they all jumped the nurses about stupid stuff -- the window wouldn't open (sealed shut, presumably to keep the nurses from escaping), TV screen wasn't big enough, ice wasn't cold enough (still can't figure that one out), too hot, too cool, where's the doc, etc. The patient was the family matriarch, and a cough was pneumonia, a sneeze was the flu, a headache was meningitis, etc. In all the time for nothing. It got to the point where the house supervisor would just schedule a drive by of the room about every 6 hours to get the current list of BS complaints, which she just tossed. Finally, after one of the family members hit the code blue button in the room because we didn't bring ice water fast enough (the CNA was coming down the hall with it, we reviewed the tapes and it was 90 seconds between when they asked for the water and hit the big blue button), the doc came in and dc'd the patient at 0100. I'll always remember what he said, "We've got 38 patients on this floor, and we can make 37 of them happy, and you'll be unhappy, or we can make all of them unhappy because the nurses are always running and doing stupid S**** for you and you'll still be unhappy. So...go home." The family had an apoplexy, but they were discharged, and we fed that doc all the goodies in the station for days....They went on the ER's "don't admit unless she's actually sick" list.

    Trust.
    This is what it is all about. The family wantst to know that mom is getting the best care. Somewhere down the line, someone might have dropped the ball or they had a bad experience. Hovering and nit picking is the only way they think they can have control of the situation.
    First impressions are HUGE. Since for the most part, this pt will be around for a while (weeks to months) you need to try to get this family on your side, but still remember that your resident is the patient.
    Be professional and firm. Don't let them push you around but give them the power to be included in the care.
    Those "note books"....I love them!!! If you have shifts of families...encourage them to keep a book to communicate with each other..that way you don't have to be tied down discussing things with each of them. Heck....I give them a pen or pencil and tell them to go at it! Don't be afraid of them because you are going to be doing your own legal documentation of any thing that needs to be documented!

    After all of this and all of the suggestions that we all give you remember that not every family can be reached. Some people just aren't good people...they love to complain, they don't want to be part of the team.
    LTCangel likes this.
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    My favorite is when I tell the family that I can't do something, and their response is to look at me like I just grew two heads and each head is speaking a different language at the same time!

    If my nurses are busy (when aren't they) and I know a crazy family is here, I usually try and get there first and talk to them, make sure everything is ok and whatnot, before they have a chance to corner the floor nurses. That way I can try and get their problems taken care of before they have them!
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    :bowingpur How do I deal with a difficult resident in LTC? This is a Veteran's facility.This person has MS. He is in his early 60's, very smart. I understand his frustration, I empathize with him. He monopolizes every one's time. He stated that he "is more important than the crazy old men" on his unit. He has terrorized more aides and nurses than we can count. Every month someone is quitting or transferring off the unit because he is so vicious. He files formal complaints against anyone for things like dropping his toothbrush on the floor! Everyone is afraid of him. He uses the "I am a disabled VET" blah blah blah all the time. The facility tried to discharge him, but he filed a lawsuit and is now in the midst of fighting to stay here. He is resistant to anyone who tries to reason with him.I would transfer off this unit but I adore the other 40+ residents. I wish I could file a complaint against him for creating a "hostile working environment"!! Ahhhhhhhhhh...glad I have someplace to vent
    JZ_RN likes this.


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