Dear Family Members - Page 4

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

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!!!!!