Dear Family Members

This open letter is aimed at the difficult, belligerent family members out there who give bedside nurses a hellish time. I know you love the patient who is laying in that bed very much. Not only are we here for the patient, but we are also here to support you during this critical time. Just meet us halfway, please. A little bit of mutual respect can go a long way in fostering goodwill. Nurses Announcements Archive Article

Forewarning: this is an open letter that contains explicit material with which not everyone will find agreeable. However, these are my inner thoughts.


Dear family members and visitors,

Let me start by saying that I know you care very deeply about the loved one who is laying in that bed. Each patient is a living, breathing, pulsating individual with memories, emotions, thoughts, perspectives and experiences that are far too unique to be exactly the same as any other person on the face of this planet. If you didn't care, in all likelihood you wouldn't be here to visit.

If you have been respectful in all interactions with nursing staff, I truly appreciate it from the bottom of my heart. On occasion you may observe something or hear statements that confuse you or cause some anxiety, so thank you for asking us questions to clarify instead of immediately taking a defensive stance. We are here to help people. We are not here to hurt people. Not only are we here for the patient, but we are also here to support you during this rough time.

I'm assured that I'm speaking for the vast majority of nurses when I say that we do not set out to abuse, neglect, ignore, or otherwise mistreat patients. Again, we are here to help the patient. I really detest when you camp out in the patient's room for 24 hours a day, snap pictures with your cell phone, and use profane language when communicating with staff. Not to be mean, but if you think you can provide a higher level of care, you are free to take the patient home. You would not be able to camp out at a library, curse out the librarian, get in her face, and take pictures for very long. You would be stopped in your tracks if you tried to waltz into a sandwich shop, swear and curse at the workers because you feel the service is crappy, and take cell phone pictures of the equipment and people. Why, then, do you feel it is okay to act like a fool at a healthcare facility?

My last question was silly because I already know the answer. You know that management at many hospitals, nursing homes, and other types of healthcare facilities adopt the 'customer is always right' mantra and will coddle to you, even if you misbehave. You know this, so you take advantage. Whatever happened to treating people in a way you would want to be treated?

I have been in your shoes because I have had gravely ill loved ones who once occupied that hospital bed. My mother was in a hepatic coma for nine days in 2002 while desperately awaiting a liver transplantation because a new liver was the only thing that would save her life. My father had a nasty bout of pneumonia in 2009 and required intravenous antibiotics. Not once did I become belligerent toward nursing staff. Some would say, "You're a nurse, so you weren't as scared as other family members." I was a factory worker back in 2002, not a nurse, and it was frightening to see my mother unresponsive. However, I always respected the healthcare team.

This plea is intended for the difficult, disrespectful family members out there. Keep in mind that you attract more flies with honey than with vinegar. Be aware that while the squeaky wheel gets the grease, it is not right to displace your anger. Nurses are working under increased pressure in this day and age and must do more with less, although administration forbids us from telling you this. Mutual respect and shared understanding go a long way during this trying time of illness. We know you love the person who lays in that bed and we'll be here for you. Just meet us halfway, please.

Specializes in ICU-my whole life!!.
Wish we could frame a copy of that and have it posted near the front doors of every healthcare facility.

You actually can. Just do not get caught putting it up. I am doing this for sure.

Yes, when family members are nice, they are very nice, but when they're bad, they're horrid. My personal unfavorites are the ones who know everything and tell me how to do my job, even though they have no medical background and have not the faintest clue what they're talking about.

I know, I know, stress and lack of sleep take their toll. I don't expect everyone to behave every moment as though they were visiting the Queen. But I do know (from miserable personal experience) that it's possible to be polite even when you're under stress. All I really want from my patients' family members is basic courtesy.

One strategy that seems to work. I find if I walk into a room with a charming smile and pleasant tone, but an underlying attitude of "I'm not taking anything off of you" they seem to be more polite. I guess the steel backbone must show through.

I love this letter. It's exactly what I've wanted to say to so many interesting folks.

"the Monday-to-Friday admin personnel - hereafter referred to as the M-F'ers"

This straight night every weekend working nurse thinks this particular statement is incredibly funny!!!

Specializes in Telemetry; CTSICU; ER.

Amen to your letter. I try to "embrace" the patients' families now , I used to try to avoid them. I figure "kill them with kindness", right? It always amazes me how some of the family members can be complaining, swearing, and treating the nurses as sub-human, then when the doctor walks in they are laughing and treating the doctor as if he is the second coming of Christ. It really gets to me when the family member who is nit-picking everything and parks themselves in the patient's room is/or was a nurse. Don't they remember or know what it's like? How busy and stressful working in a hospital is? Then when patients' or their families say, "We don't like this (expletive) hospital!"--then by all means, you should definitely have gone to another hospital & the "my doctors only go to this hospital" is baloney. I don't know of any of the hospital doctors that won't go to any of the hospitals to see a patient. Another family that sticks in my head, is that they were treating the nurses like servants. To the point that one of the daughters, who was sitting right by the seated patient, with two other family members in my way--patient asked for a pillow. She grabbed pillow(right by her, she didn't even have to move), throws it at me, after sighing and rolling her eyes--since I apparently couldn't grab pillow quick enough with people in my way--even though she could have placed it behind patient's head herself(yes patient could move his own head & he was sitting upright in recliner). I understand patients' family are not expected to help, but a pillow? Really?! I wish EVERYONE would have to work in a hospital on the floors in some aspect & get a taste of what it's like. Then maybe people wouldn't be so quick to throw attitudes & be judgmental about how we do our jobs. Our turnover is getting worse on our floor--it is always really busy & it seems the type of patients we are getting are heavier/busier loads. Eventually a lot of the hospital floors will only have new nurses, because no one will want to stay on the floors that long.

Oh my, this just made my night! One thing that gets under my skin are when family members come strolling up the hallway at 0200 talking at the top of their voices to visit their family member. Its 2am! Stay at home! I have your phone number, and I am going to call you if something happens. Let my patients sleep, please!

I work in a memory care unit...80 alzheimers/dementia residents. The families that slay me are the ones who are screaming at us about Mom/Dad losing their shoes/diamond rings/flushing teeth down the toilet.

It's a dementia unit. Mom/Dad has alzheimers....it's our fault they flushed their dentures down the toilet?? Wrapped them up in a napkin and threw them away with dinner? Buried their ring in a potted plant or gave it to the lady down the hall?? I can try to keep an eye on personal possesions, but only to a certain limit. When I do pre-admit meetings I tell these families until I'm blue in the face "don't send Mom/Dad with anything that you don't want getting lost"....and yet they still send them with their original wedding bands or family heirloom jewelery...and then want to give us stink eye like we took it. Makes me a little mad.

Or they want to blame you if Mom is tired, or doesn't recognize them...."ohh...you must have given them something that made them confused and sleepy".

I understand an alzheimers diagnosis can be hard to take and it takes families time to cope...but sometimes you just want to shake them!!!!

I haven't been a nurse long enough to be jaded by family members but I still am. They are very taxing on your time. I can't think of a diplomatic way to tell them that if I didn't have to argue with them for 20 minutes at a time maybe I would have more time to care for their family member and my other patients. Highlights of this week were arguing with a daughter in law (in law's are the WORST) of a pt in for stroke workup about 1) NPO pending swallow study:"She's already HAD all those tests, she can swallow just fine." "Ma'am unless that was in the last 24 hours we won't be feeding her until we have our speech therapist in to test her again.""AM I GONNA HAVE TO CALL THE DOCTOR TO GET HER SOME FOOD? SHE NEEDS NOURISHMENT, SHE HASN'T EATEN FOR 4 DAYS!" "She's been here for 6 hours, so I can only control the last 6 hours. But I can call the doc-"[doctor steps into the room from hallway] "Ma'am I thought I explained all of this to you. Is there something I said or that the nurse said that you don't understand?" (this is the first time this doc has ever backed me up for anything!)2) same daughter in law tells her mother "Don't you feel better with that oxygen on? Why is it so far down there, we need to turn it up so she can breathe even better.""Doesn't she have a history of COPD? Not a good idea. (explain why)""Yeah well whatever."I suspect Ms. Know It All probably turned it up at the nursing home and caused the low sats and confusion that we're blaming on a stroke. Oh, all of this while pt has documents of DNR-comfort care, and they refused stroke workup, which was the only reason she was transferred to us from small town crappy hospital. I tried to get out of them why she was even taken to the hospital in the first place but couldn't seem to get two sentences out of them without more kvetching about how none of us know how to do our jobs. (Woman is a teacher - we all know they know everything about everything.)I got a good lol because she stayed overnight with the pt and apparently none of our fabulous night shift told the woman that the chair was a hide a bed, she laid all curled up in it, I found out the next day. LMAOSecond was 30 minutes of the last hr of my shift last night with a son accusing us of "giving his mother something," saying she is confused and "she's never like this." Even when being admitted to the hospital. I busted out the chart: "EMS report: family says pt hallucinating, seeing things." "History of dementia." "Admitted for UTI-confusion." Also had the satisfaction (thank god) that not only had we not given her anything but her home meds which weren't anything horrible, but we didn't even have Ativan or anything AVAILABLE ON THE MAR to give her! "My brother said you just gave her something!" "Yeah, a Lasix, which I told them and explained when I was giving it. It's a "water pill" that she takes daily at home according to whoever filled out the home medication list. Not sedating. Not confusing." ARGHHHHHHHHHHHHHH
So so true that we would actually be able to care for them more and better if they would just let us do our job and not interrupt us every step of the way. Im all for family teaching, but that's not what we're talking about here. And all the complaining! For example, I went into my patient's room. The family complained that it took too long for me to get there, although acknowledging that they knew I was really busy. What did they do? They proceeded to talk to me about their thanksgiving dinner, and the ingredients. All the while all my other patients were waiting for me. WHY WHY WHY do family say that they know I am busy and have other patients but INSIST on continuing to act like their family member is my only patient? I can chit chat while Im doing my work in the room, but as soon as Im done, I need to GO. I know I sound bitter, thats because I am. I deal with it sooo well on the outside, they would never never know how Im feeling on the inside. I have flat out said, I wish I had more time to chat with you, but my next patient is waiting for me. And family members have insisted on telling me "one more thing" before I go. REALLY? I just told you I HAVE to go and you still refuse to respect that?
While I'm in no way excusing your father's care, I just want to play Devil's Advocate a bit here. The things you describe are symptomatic of staffing practices that directly impact the quality of patient care. When the nurses and aides are stretched too thin, some things fall by the wayside. When documentation requirements are so cumbersome that you spend more time charting than at the bedside, when you're asked to take on more patients and sicker patients with less resources, some things fall by the wayside.As the RN responsible for a group of patients on the floor, there are many things that supersede emptying a urinal or doing a bedbath and linen change. I'm sure you understand this. This is why we have aides to delegate these things to. However, the aides can also be stretched too thin, to the point where patient care falls through the cracks and basic things like oral care aren't even being done.I know, your father's situation was different. You know for a fact that that nurse and NAP (I am not familiar with this term, so I'm assuming it's an aide) weren't busy, they were just being lazy. You saw them sitting around texting/Facebooking/talking on the phone with their friends while call lights were going off. That's not what I'm talking about.Imagine instead that the nurse and NAP are running their tails off just to keep everyone safe and alive, and simply did not have the time to empty a urinal or do a bath and linen change. Neither of them took a break or used the bathroom all shift. Then the next shift comes on and it's the same thing. Pretty soon, several shifts have gone by and these things still have not been done because nobody has the time. Berating the poor nurse who happens to be present when you finally lose your temper just seems a bit unfair, don't you think?Generally, I find that when people are angry, they are angry at the system or the institution itself, but the nurse is the face of that system or institution, and so people take out their anger on the nurse.A solution to the kind of situation your father was in would be for the hospital to have bath aides on day shift, whose sole function is to bathe and do linen changes, freeing the other aides up to do everything else. But in this day and age, hospitals are cutting aide positions, not adding them, so I think it's probably going to get worse before it gets better.Want to improve patient satisfaction scores? Hire more staff!!!!!
Thank you, thank you, thank you for posting this. I could not have responded better. We have to prioritize and work with what we've got. And by the way, swearing is NEVER appropriate. And yes, I can put myself in the family members shoes. If my mother were in the hospital and not bathed for a week, it is NOT OK for me to swear at the staff. Id like to think I would be intelligent enough to know that its not the nurse's fault. Its the higher ups.