Dealing With Difficult Family

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I am a first year nurse on a busy med/surg floor. I have had a few families and sometimes a patient or two who were overall just a bit difficult to deal with but up until this week I've never experienced something so entirely frustrating. Over the last week we've had a family that has been especially trying for me (and several other staff members) to deal with. I'm trying to determine the best way to deal with folks like this for the next time. I feel like I dealt with any and all concerns/complaints from this family in a very mature, helpful manner but they were never satisfied with the answers or teaching we gave them. The last day I cared for the patient was the worst of all. The family claimed that they were very upset because they believed the pt. was "sedated so that we didn't have to deal with him/her". These were their words. The pt. had a knee replaced three days prior to this day and that morning the pt. had received two percocets. Overnight the pt. had received an IM of morphine and phenergan. These were the only instances of medication administration that the family was upset about and they claimed that this was putting him/her to sleep all day long essentially so that we didn't have to deal with him/her. Both the LPN and I spent a lot of time talking to them but they failed to believe that we weren't trying to sedate the pt. so I had the charge nurse get involved and she called the house supervisor. The family still didn't believe that we hadn't "sedated" the pt. but they didn't bring it up too much more after that.

There were two other things that this family was also upset about and in general they just sucked the life right out of me this week. I broke down in tears twice in the supply room this week (and I'm not a crier). I'm a pretty strong person with a great way of dealing with almost everyone, but this family was impossible for me. Each time you went in the room they were asking question after question and telling you that they wanted this information because two of the daughters were almost done with nursing school and they had all these questions, etc. Unfortunately, I have nine or ten other patients on our team to deal with and I can't be spending 10 minutes each and every time I come in the room. I'm always happy to answer questions and help with anything I can and I hear a lot from pts. and their families that I am very caring and take time to answer their question, but this one family took is far beyond normal questions.

I was told that I need to just let it go but I find myself still thinking about how I could have dealt with it better. These folks sucked sooooo much time out of me this week and it's just frustrating to think that it could happen again. I fully expect this pt. to be gone when I return (thank goodness) but I want to know if anyone has any other alternatives or ideas for dealing with truly irrational people.

I know I need to let it go, but I've been hashing it over in my mind and I'm just upset that they believed that we would sedate the pt. so as to not have to deal with them. That is an accusation that I don't ever want to have to hear again. I love caring for my patients and I take a lot of pride in it. Anyone have anything to share with me on how to let it go or how to deal with it better when I have a family or pt. like this in the future?

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Learn how to set limits.

Being nice is not going to do it for this type of family.

You must maintain a professional distance.

1. Don't allow them to address you casually. You're not their personal maiden.

2. Go in there at change of shift immediately and introduce yourself, assess the patient. Tell them you have 10 minutes ask their questions, do they need anything, etc., and then tell them you will be back around 1 hour.

3. Don't tell them you have other patients. They do not care.

4. Tell them to gather all of the questions at one time and you will try to answer them when you come back.

5. This takes experience and don't allow people to suck you dry. You will become homicidal and suffer from compassion fatigue. Just stop.

6. If they call you, send someone else in there...a tech, the manager, etc., remind them you will be back unless there is an emergency.

7. Stick to what you say. Come back when you come back.

8. DO NOT BE THEIR FRIEND. That is a manipulative tactic they will try on you. Don't allow it, i.e. "you're the bestest nurse, ever--no one can be as good to my so and so as much as you." yeah, whatever.

9. Tell them to call you by your title: Nurse Smith. Period.

10. Always always always always always maintain professionalism. don't let them get to you.

11. And last but not least. Stick to the limits.

You're in charge.

Not them.

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Thank you for your ideas. Number 6 and number 8 are especially helpful and I will implement them the next time I have a family like this! Clearly I need to learn to set limits with this type of family. I definitely maintain a professional relationship with ALL pts. and families. That is a must. I guess I'm too worried about a family like this and the Press Gainey type stuff that all the hospitals bow to. The two don't mix and I need to just accept that this family will not like the "care" they received. Because no amount of caring was going to make these folks happy, I don't believe.

I didn't tell them that I had other pts., I was just thinking it :). I would never say to a family that I'm too busy to deal with them because I have nine other patients! lol. (even if it is true sometimes!)

I really need to learn to be firmer with these types of people but my customer service skills are not up to this level yet, I guess. Not sure how/where to set those limits, but I really like the idea of telling them that I'll be back in xyz timeframe and I will answer their questions then. Thanks for your ideas!

Never in a million years will I be homicidal. Nothing they could do would make me want to hurt me, but it does make me wonder what I was thinking with my career change....lol....but only for a second. Then I'm back to realizing that most folks aren't like these folks and I do love my job most days.

Thanks again for your reply!

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Specializes in Hospital Education Coordinator.

my first year as a nurse I learned a big lesson. You can say no. I heard a seasoned nurse tell a family member, who asked her to bring something into the room (cannot recall if it was pillow, beverage or what), and the nurse said "No. I will return in about two hours (before hourly rounding) or you can get it yourself or ask a CNA to help". She said it without rancor and the individual did not get angry.

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Specializes in pulm/cardiology pcu, surgical onc.

JoPACURN gave good advice. These families can be VERY frustrating and I think they enjoy pushing buttons. No matter what you did it would not be good enough.

Dysfunction with a capital 'D'. Ugh.

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In my experience there are 3 kinds of difficult families:

1.) the kind that feel they are not being heard (Mostly these people just want to be listened to and their concerns adressed, I listen quietly and answer what i can and get answers for those i cant. It is unfortunate , but sometimes families are not being listened to and thier concerns are treated as not important)

2.) the kind that have guilt about placing them in a long term care home or guilty about not being able to care for them due to caregivers fatigue, busy schedule,etc. (whether justifiable or not) they feel that if they yell and complain it shows they care and makes them feel like they are doing something.

3.) the kind that just dont know what they are talking about and think that they do. they like to complain and there is nothing you can ever do to satisfy them. it is best to just muttle through and be professional , give the best care you can (as usual) , and let it go when your prayers are answered and they are discharged lol.

each one of these are still family members and deserve to have their concerns addressed, but not at the expense of your other patients. I would also inform the family that the pt requested pain medicine and although you understand their concerns, HE is the pt and if he requests pain medicine and it is not harmful to him and he is competent then it will be given to him. if they would like for him not receive it, then they should speak to him about not requesting it. sometimes you have to be an advocate for your pt even with family members. if they want him in pain , then too bad! (dont tell them that , though lol).

i hope you are able to let it go and know that you did exactly what you should have. :)

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Specializes in Neuroscience/Neuro-surgery/Med-Surgical/.

I can see why you would have this ruminating in your head.

Especially when being accused of 'sedating a patient so that you don't have to deal with them'. My knee jerk reaction would of been to educate that the patient requested the pain medication, that I am a patient advocate, and that I am offended by the accusation. I would follow it up by sending the charge nurse or house supervisor in to deal with them. Based on what you had mentioned earlier, they wouldn't have been satisfied with anything, but at least you could get that much off your chest and the family could vent to someone else.

And I have no problem pulling out my beeper/phone and stating, "I must excuse myself now, I have another patient calling for me. Can you write down all your questions/concerns, and we can address them when i return in about _______ time?"

I find that just having the presence of being in control, stating who you are, assess the patient, discuss what the plan is for the shift, and addressing misunderstandings/concerns right away (if possible) is the best way to deal with difficult families/patients. They will otherwise have you running in circles.

So sorry you had to deal with it, but it is a learning experience that you can soon master!

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What a bizarre family! I think they sound like they have serious anxiety issues and a guilt complex ... geez! They should be glad you guys gave out the pain meds and the anti-nausea meds! There are some really weird people in this world ...

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
What a bizarre family! I think they sound like they have serious anxiety issues and a guilt complex ... geez! They should be glad you guys gave out the pain meds and the anti-nausea meds! There are some really weird people in this world ...

I find these people very sad, actually. They no longer bother me because if they are like that in the hospital, they must be very, very unhappy in their regular lives.

I feel very sorry for them sometimes.

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Specializes in OB/GYN, Peds, School Nurse, DD.

Never in a million years will I be homicidal. Nothing they could do would make me want to hurt me, but it does make me wonder what I was thinking with my career change....lol....but only for a second. Then I'm back to realizing that most folks aren't like these folks and I do love my job most days.

Thanks again for your reply!

:clown: Yes you will. If you stay in nursing long enough you will have a day when you think, "If he doesn't stay off that light, I'm gonna put a pillow over his face!" And then you will be horrified--because you really are a good nurse and "good nurses" don't have those thoughts(except, they do, trust me!)

JoPACURN gave you great advice. Learning to set boundaries is very important in nursing. It's not being mean, it's being professional. Some patients and their families will never be pleased, not if you stood on your head and spit gold coins. Your only defense with people like that is to remain professional and cool in there presence. If you give them any hint of who you are(inside) they will find your weakness and use it to the utmost. I'm just telling you. I have 32yrs experience and I've seen this happen to a lot of nurses,including me. And it's not fun.

Now, don't spend another 15 minutes of your days off worrying about these people. You will never please them so stop trying to figure out how to win them over. People like this are going to find something to complain about. If you fix their current complaint,they'll just make up another. You will never win at this game.

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You are all so very right....thanks for helping me understand that I did what I could with what I had. Thank you even more for helping me to learn to think strategically if I run into this type of pathological individual or family in the future. I WILL set boundaries and not go in the room each time they tell one of the staff they want to talk to me. I will certainly take all that I've learned here and it will make me a better nurse (hopefully). I really appreciate all the advice and helpful hints!

And homicidal/suicidal....lol, I got them mixed up. I totally talked about the family needing to be thrown out the window and teased that this would be therapeutic in nature! So I get the homicidal feelings.....then I go home and get on the elliptical or go for a run to get those homicidal feelings out of my head.

I'll prevail and maybe some day I'll be more adept at dealing with these dysfunctional folks.

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Specializes in Corrections, Cardiac, Hospice.

originally posted by mustlovepoodles

yes you will. if you stay in nursing long enough you will have a day when you think, "if he doesn't stay off that light, i'm gonna put a pillow over his face!" and then you will be horrified--because you really are a good nurse and "good nurses" don't have those thoughts(except, they do, trust me!)

hehehehehe, been there!

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