My God, these family members!! - page 5
They are just killing me. Why is it that so many of them feel so entitled to sit in their aging parents rooms and just boss us nurses to HELL and back, while they sit there, fully able to do much of... Read More
Apr 22, '09 by surfchickRNAMEN SISTER!! It is so ironic you write this a few days after I got written up for "talking back" to an elderly patient's daughter because she was being so redic. I work on a busy surgical unit that is chronically short staffed, actually no anymore because I QUIT!! I'm to the point where I don't care anymore and if management wont step in, then I'll take matters into my own hands. I have never felt so UNSUPPORTED, because that is what managers should do is PROTECT THE RIGHTS OF THE NURSES. THERE IS ONLY SO MUCH WE CAN TAKE WITHIN REASON AND STILL DO OUR JOB EFFECTIVELY!! I CANT STRESS THIS ENOUGH. WHAT CAN WE DO?? I TOOK THE ONLY STEP I KNOW, AND UNFORTUNATELY THAT MEANS QUITTING MY JOB. Actually, I didn't quit my job, I QUIT MY MANAGER!!
Apr 22, '09 by LTC - LPNPreaching to the choir girlfriend! I think if the management cared about the actual patient...think of this...all the time you're waitressing, how much time are you available for actual nursing? Families have a knack of stealing time from patients, and maybe somehow you can tactfully make them aware of that too. Good luck, we all understand.
Apr 22, '09 by old ICU nurseyou can never please everyone and some people are unrealistic about the function of a hospital--no, it is not a hotel nor am i the maid. direct discussion and limit setting are the keys. however, being an ass and saying "that's not my job" or ******** about getting a cup of coffee doesn't help. i have taken care of patients with families from hell :angryfire. a lot of that "displaced anger" at the nurses is guilt for being a crappy (son, daughter, husband or wife) for years--we are just seeing what is brought in from home. unfortunately, the critical care area (or any place of the hospital) is no place to resolve dysfunctional familial issues--so try not to get caught up in other people's baggage.
i think there is a happy medium in dealing with visitors. the most important thing is open and direct communication. my hospital's icu has "open visiting" which means families can come and go 24/7 to see their loved ones--this can be a curse as it is like the airport at times. i have found that the best way to deal with families is to listen to their needs as best as possible--but i tell them that my job is to take care of the patient first and foremost. we have a two person visiting rule and i stick to it! i involve families with as much care as they are willing to do (such as mouth care or lotioning skin). most are willing to step out during toileting or bathing without much prompting. i also explain that i have a great deal of charting to do on their loved one--and i explain that if i cannot communicate all of the needs of the patient in my notes--that the doctors, therapists, etc. cannot provide all of the treatments that may be needed. that also helps.
here's what i have found that helps:
if i have a disguntled family member or patient--i turn them over to the nurse manager or third party to discuss their issues. let them go to administration to complain. perhaps that is the only way to get staffing deficiencies corrected. it is crazy to assume that a nurse can have 10 patients without a unit secretary or cna to assist--even if it is getting the phone or answering a call light. our hospital also has a patient grievence process where "unhappy campers" can have their complaints and concerns handled by a third party. it is not the responsibility of the bedside nurse to cure all of the complaints!
find out the root of what is making the family member go crazy--are they sleep deprived? do they not have enough money to go to the vending machines for food or beverages? (the economy sucks and people are poor--spending $5-10 in the cafeteria for each meal is a lot if you don't have it). are they having psychological issues such as guilt, anger or depression about their loved one? do they just want someone to talk to?, i.e. they're scared.
use what resources you may have at your hospital--chaplain, doctors, case managers, nurse managers, dietary--anything that may help. i know i have pestered mds to "talk" to that family about being disruptive. the "old school" mds have no problem telling a family that disrupting the nurses for trivial things is disrupting the delivery of important care to their loved one and the other patients.
i know that these are not the perfect answers--and sometimes you just have families that suck. but for every family from hell--there are more that are thankful and appreciative of the care and kindness that we show as nurses--and those are the ones that keep us sane.
Apr 22, '09 by squeakykittyQuote from surfchickRNI LOVE this phrase!!!!!I didn't quit my job, I QUIT MY MANAGER!!
Apr 22, '09 by old ICU nursegood post! I added my own. It never hurts to use the golden rule.Quote from nursemikeGood point--especially since the behavior might not be baseline. Had a patient who came from ICU on an insulin drip. Dayshift nurse didn't realize he needed Q1H fingersticks, because they weren't ordered. ICU just does them and yells across hall to doc, we usually have a detailed titration order. By the time I came on and got report, pt said he felt hypoglycemic. So I got a fingerstick and his BG was 30. Pt complained because I didn't stop the drip until I had a reading. Well, yeah, he had a point. I could have stopped it, then got the reading, and even if his BG had been 59, or 89, or 312, one minute off the drip wouldn't have killed him. (One minute longer on it didn't kill him, either...but still.)
So, the patient later apologized for getting testy, and all I could say was, I think I might get irritable if my glucose was thirty, too. I don't actual recall irritability being a classic symptom of hypoglycemia, like it is of hypoxia, but it's certainly a classic symptom of feeling crappy, and I hadn't had the guy long enough to know whether he was usually grouchy or it was a mental status change (a little of both, it turns out--we got along great, after that, but he could be a bit demanding from time to time.)
Which doesn't address the OP's concerns, but I do try to consider that people are often not at the best under the stress of a loved-one's hospitalization. A lot of times I'll offer coffee or tea to visitors if they've been there a while. Just feels more hospitable, to me. Or a pillow and blanket if they're sleeping in. I've also had some nightmares like the OP describes, but thankfully not very many. We're only six miles below the Mason-Dixon line, but that's "southern" enough that a lot of people still exhibit "old-fashioned" manners like respect for authority figures (who, me?) and the elderly (well, okay, that may fit me,) and speaking softly. Not meaning any disrespect for y'all Yankees on the board. But I have relatives from Kentucky who couldn't speak up to tell you their bed was on fire, and my overall impression has been that the farther south you go, the less acceptable it is to "cause a commotion." At least until you reach Very South Jersey (aka Florida).
Uh, geez, I'm wandering, again. I've been meaning to ask my MD about a scrip for Arricept, but I keep forgetting to.
Uh, so, two quick points: when management talks customer satisfaction, I talk ratios. Ours is generally 6:1, and pretty acute, so I don't have a lot of time to cater to visitors. Last couple of nights, I only had 4 pts, and I could have gotten in a couple of hands of bridge if anyone had wanted to. At 5:1 and nobody too terribly sick, I can fluff some pillows and fetch some coffee without too much trouble, but if 1 or 2 are "busy," I have to set some limits. Other point: when I am pressed for time, "I'll let your aide know as soon as I can," is one of my favorite replies. Kind of a subtle reminder of why I'm actually there. Also reminding myself that it's okay to delegate (one of my weaknesses when I was very new, but I'm getting over it!) Plus, you know, now they're mad at the aide, instead of me. Cheesy, yes, but we're talking survival, here.
Apr 22, '09 by RandeeNthis is a synario that will reappear forever. Families are there for their family member. they do not know or care what you do, for how many, how tired or stressed you are. or pretty much anything you would expect them to know. all they care about is themselves and what they want.They were not educated in hospital process,or how to interact with personnal. it is probably printed clearly in the admission packet,but you know very well, that no one ever really reads or studies that document...God knows they have the time,cause they are there. Perhaps you could direct them to the nurse manager when you have exhausted your first or second line of defense or explanations. Give them a verbal contract on what you will do and when for them..most often, with families like this, nothing will be good enough. Try to include the doctor...When he makes his rounds, go in with him and direct their concerns to him. This may or may not take someof the burden off of you. Take your breaks. try not to multitask a million things at once. Burnout is a progressive and debilitating process, and not to sound like i know it all, but I'm in the process of recovery from it. Encourance your facility to do a burnout seminar. Use what ever resourses you have to relieve yourself of these pressures. Don't give up. Your nursing career will have many challenges in it. Families is just one. Everbody is an individual and needs to be treated as such. Patients/families are a package deal. Don't expect them to know or understand,even thoiugh you have gone over it. Don't expect anything from anybody but yourself and then you won't get disappointed. This is the gospell....God bless you, and pray for the still,will,and the Holy Spirit to be with you in every room you go into. Keep up the good work,and get help when you get frustrated...you need to. :heartbeat
Apr 22, '09 by FireHorseNinjaQuote from getoveritHer husband yelled at one of my co-workers one afternoon about how "no one has been taking care of her". I went in the room and told him to google pressure ulcer when he got home and then ask himself how she had been laid up here for 2 months without having one....then see if he still thinks no one's been taking care of her. He must have done it because the next day he apologized and that was the end of them acting like that. Miraculously, without us ever taking care of her, she managed to survive her admission and went back home.
Apr 22, '09 by nerdtonurse?I will never forget the frequent flyer (diet coke and demerol, q4) who stomped into the middle of a code, demanding his pain med. I mean, pt's naked to the world, I'm doing compressions, resp's bagging him, we're pushing every med we got, and this twit stomps in saying he's been on the callbell for 5 minutes and no one's given him his demerol, and he's going to file a complaint naming all of us. He grabs the ID of the nearest person, who happened to be one of the docs. Luckily, the doc in the room is one of the old war horses at the hospital, and after the code, saw the guy was admitted for "leg pain" and his room was at the other end of the wing. He went in and DC'd the patient home at 2200. Patient goes crazy, screaming, and the doc called security and had him forcibly removed.
Of course, he just went to the ER and got readmitted. But at least he went to another floor.
Only time I've seen a doc stand up for us....
Apr 22, '09 by DangerousCould not make it past page 2 of posts on this topic, as I started getting chest tightness and anxiety from flashbacks. God bless you women and men who are in the trenches on the front lines.
Recently took an early retirement from bedside nursing, am financially poorer, but so much more mentally and physically better off. Am not sorry I left.
If hospitals want to keep bedside nurses, some things have to change. Is anyone listening? In spite of input from myself and my colleagues into hospital "surveys" and other avenues as to what nurses needed to improve working conditions, no one listened.
After that, I voted with my feet. Bye, bye.
Apr 22, '09 by NYCRN6Whenever I go into the patients rooms my goal is to lay down the plan of care (from what I know). Try not to give too much information but give a general idea. I bullet out what I am going to do; then do it. When I am about to leave I ask them if I can get the patient of the family member anything. (Even if it is an ice water).
Most don't take a mile when I give them an inch; they respect that I am offering services when they know I don't really have time. However those who do take the mile, I set limits. I tell him I can get this for you right now (bring back a few extra if your judgement says so); and say I need to give a medication to another patient or I have a meeting to attend to with the doctors to discuss YOUR plan of care. I even say "Unfortunately this is not a priority right now as I have x x x to do. I can have someone else get this for you". Usually they respond well
As for PHONE CALLS. Recently I had a patient's family member call pretending to be their father. The patient was confused and didn't know a thing. I found out that his "Father" died in 1991 and that was his psychotics mothers boyfriend pretending to be DR x. Such BULL. I did not give information but that was really messed up. I also had another patient's family member call 10 times (all different people) because they were concerned and weren't being given any detailed information on the phone. I finally told them "I recommend you appointing one person (which was their brother) to receive all the information and ask all the questions because this is very disorganized and can lead to miscommunication and upset. Also the nurse who is receiving 10 calls about the care of the patient is being TAKEN AWAY from caring for the patient because she is busy answering absurd amount of phone calls" AKA please stop calling and leave me alone so I can do my job.
I was planning on this to be short but... I have a sensitive touch to this topic lol.
Apr 22, '09 by Wade21I understand this situation well! Once I had a patient who had a paid sitter in the room and their job seemed to be calling a nurse in to care for the patient every 5 minutes while they watched tv! The best thing to do is to cool down so that you won't say anything "hateful" to the family and have your charge nurse, nurse manager, or even the unit supervisor speak with them in regards to the difference between a nurse and an indentured servant. If they are of no help(which may have been in your case), then grin and bear it until the end of the shift, then inform the nurse manager that you do not wish to be assigned this pt. again due to an inabilty to meet the expectations of the family; you do have that right! In a case like this, its the family who need more care than the pt.
Apr 22, '09 by dhinson45Quote from amylpn24I have been a nurse for 37 years and agree with all statements!! I will not allow anyone in any facility to abuse me, mentally or emotionally!!! So should all of you. I have been known to tell family members,: If this is an emergency I am on my way, if not I will address the sitation or deligate it to the proper party." I have informed my co-workers that I am going to blank blank to chart, do skin assesment documents, weekly summaries, etc. Notify me of emergencies. We take turns as this is the ONLY way that all the documentation CAN be done PLUS residents treatments, meds, and " WHERE IS MY MOTHERS RED SWEATHER!!!!!!!!!!!!!!!! YOU need to find it NOW.!!!!!!!!!!. Been there ,done that and agree that is why long term care nurses leave that speciality. I love my residents, however the families need to be educated, I see this as the responsibility of the Social Workers or Owners to perform this at the time of admission. We are not responsible for one on one care, FAMILIES they have a choice of hiring a private nurse or assisting in their loved ones care. If they have a problem with that then they can take their concerns to the appropiate department. I am the nurse on duty and am responsible for all the residents here and to make sure they have quality of life.I agree whole heartedly!!!! It's like this; NURSE= ONE WHO CAN BE VERBALLY ABUSED AT ANY TIME AND FOR ANY REASON. THERE WILL BE NO REPRECUSSIONS. (Did i spell that right?)
Anyhow, I too wish there was a way to scream to the world about this very same thing. Just because we are nurses does not mean that we are not human beings. Alot of the time, people don't understand that we too have feelings. I do understand that there is a certain amount of customer service crap that we must put up with but I also believe there is a very fine line. I am lucky that in my job, we do have the support of our managers. I have decided after 18 years of doing this that I will NOT allow people to cross that line with me, patients, family members or otherwise. We DO have the right to be respected just like the next person. Demand it and you will get it.
I have never seen the support from the "Gods above" as I also have been in management and seen the pressure from above. It's all dollar and cents!! Rebab is where the money is so make the 92 year old take OT and PT.
Bottom line is the Gods do not care about us nurses, only to put the band-aid on and pass inspection on paper. It is sooooo sad but true.D
Apr 22, '09 by surfchickRNRight there with ya. I'm taking my early retirement from the profession after only 3 years!! I'm going back to school, nursing is not for me!