Patient's and Angry Families

Altra, BSN, RN · Jan 2, 2008

Under no circumstances do I tolerate yelling for more than a few seconds. If a patient/family member cannot/will not self-correct and *use their indoor voice* I immediately ask them to do so as they are disturbing sick patients.

If the complaint is non-specific ("you people don't know what you're doing!") I ask the person speaking to clarify: "What aspect of care are you concerned about? What questions do you have for me?" And then I answer those questions, in detail, or offer to contact the physician. This gives patients/family members another chance to absorb information and regain their self-control.

I do not "stand there and take it." I am not mentally abused.

Patients/family members get upset and lose control for a thousand reasons, some of them justifiable, some not. Explanations go a long way, especially when you can pre-emptively advise them on how things are likely to go: "you'll be going for your CT scan as soon as the scanner is available. After that, you can expect it to be read by the radiologist within 90 minutes. If that scan is negative, the MD will be back in to speak with you about discharge."

Hope this helps. :)

DutchgirlRN, ASN, RN · Jan 2, 2008

I have tried explaining, apoligizing, smiling, talking...tried it all. In the end the only thing that worked can be summed up in two words

"call administration".

I've been fortunate in that administration has always stood behind me but from reading the boards I can tell you it's not the same everywhere.

señorburns · Jan 2, 2008

\If a patient/family member cannot/will not self-correct and *use their indoor voice* I immediately ask them to do so as they are disturbing sick patients.

That just leaves you open to the pt asking you: "Show me a patient I'm disturbing." I know I'd ask that.

Not that I'm that nasty in real life.

Bugaloo · Jan 2, 2008

As a traveler, the hospital that I am at right now is a small rural hospital and the administration always backs up the family, no matter what. Staff is highly encouraged to do everything in their power to pacify them (ie. offer them coffee, call the house super, etc). Staff is highly DISCOURAGED from putting them in their place. I don't particularly agree with this approach, but I try to abide by it, for my job's sake. That being said, I will not put up with outright verbal abuse or threats to my physical safety. When they cross that line, security is called to deal with them.

nurturing_angel · Jan 2, 2008

Twice I have had experiences as the charge nurse where families were agitated about something and as I work night shift in a small hospital I had no administrative back up and no security to speak of. Not even a house supervisor. Called supervisors at home and they gave me the old "get a telephone number and we will deal with it in the morning."

So administration gets to go back to bed and go back to sleep and I get to go back into the lions den and get yelled at for another 30 minutes. :angryfire Can't walk away as I am the charge nurse. The one guy just followed me all over the department anyways. I made it through both incidences and after the second one I told my supervisor that I would not do it again. Next time, I call the police and have the angry offenders arrested and when that shift is over I find a lawyer to file a "hostile workplace" suit.

And I will repeat my plan to the next administrator who refuses to get up and handle their own administrative crisis and tells me to get a phone number for them.

:angryfire:angryfire:angryfire

Blee O'Myacin, BSN, RN · Jan 2, 2008

I am curious, how do staff nurses handle angry families who are angry over the care of patient by both the nursing staff and medical staff? How do we as professionals handle the mental abuse that we get when the families are yelling that we don't know what we are doing and that we don't care. Is is right that we just stand there and take it? Are we supported by our administrators?

It's only mental abuse if you stand there and take it. No where in my job description does it say that I must be a doormat. I have said "Please stop shouting at me. All I hear is the shouting and not what you are trying to tell me." (This works equally well on irate doctors that call the ER, are all po'ed because the phone rang more than twice, and are hollering about "what the heck we are all doing down there if no one is answering the *% telephone"... um.. I dunno, taking care of the 52 patients we have down here with 10 more charts in the rack and 40 in the waiting room, and we "let" our wonderful, hardworking unit clerk leave her desk to use the ladies room every so often? - and no, I didn't get into "trouble" for saying it either...)

So to answer your question, I don't let people holler at me. I've had to call security to escort people from the building. And I would not be intimidated into not pressing charges if things got that out of hand.

"I understand that you are upset, but please stop shouting at me." usually does the trick.

Blee

Altra, BSN, RN · Jan 4, 2008

That just leaves you open to the pt asking you: "Show me a patient I'm disturbing." I know I'd ask that.
Not that I'm that nasty in real life.

Senor, respectfully ... you have to be kidding me. The hospital is full of sick people. Have you ever spent time in a facility (outside of the OR & certain other specialized environments) where you were not well within hearing distance of the next patient ... and their assorted visitors?

TheCommuter, BSN, RN · Jan 4, 2008

I am curious, how do staff nurses handle angry families who are angry over the care of patient by both the nursing staff and medical staff?

If the family is that angry and inconsolable regarding the care being provided, gently remind them that they have other options that do not involve hollering at staff. They can choose to speak to administration about their concerns. They can even (duh!) have their loved one transferred to another hospital if they feel that the care is not up to snuff at the current facility.

queenjean · Jan 4, 2008

I look them in the eye and apologize. I don't try to make an excuse, I just apologize and then fix it. "I am really sorry that your mother did not get her scheduled pain pill. That was unacceptable, and I completely understand your frustration. My name is Jean, and I will be her nurse tonight. I will bring her pain pill right away, and I will personally make sure she gets it on time for the rest of this shift. This is my minicell number--that way you can contact me directly if you have any more questions or concerns tonight." If it isn't as simple as giving an overdue pain pill or finding some long-awaited lab results, I will accompany my apology with "What can I do for you, right now, that will help make you/your loved one more comfortable?"

Usually when people are out of line, it is frustration and fear. An honest, simple apology does not have to admit that you are somehow responsible for things that are out of your control; it is an acknowledgement of their frustration. Offering an immediate solution or extending assistance within the best of your abilities helps alleviate fear--fear of the same thing happening again, fear of the unknown, fear of increased pain, whatever.

I find this works best, most of the time. Sometimes you just have to grit your teeth and walk away; but I find a sincere apology and some immediate action brings most family situations back under control.

RNperdiem, RN · Jan 4, 2008

Who says the angry families are yelling?

I don't consider angry families(not yelling or threatening) to be abuse.

This is where some good people skills come in. Sometimes the family does have a legit complaint. Listen to them and try to understand why they are upset. Don't be too quick to jump in to defend anyone, just let them talk until there is a pause. If you can help remedy a valid complaint, do so. Sometimes overtired, stessed people just need to vent(just like us sometimes).

getoverit, BSN, RN, EMT-P · Jan 4, 2008

Tough situation to be in. You're rarely ever going to come out "right" if you argue with the family, no matter how badly you need to or they deserve it. Try to pacify them, explain things, offer to let them talk to a manager or patient advocate. Currently we've had a patient for about a month in the unit, end stage pulmonary fibrosis and probably will not get off the ventilator. The family is OBSESSED with the SpO2 and rate of Versed/MSO4 gtts. you can tell exactly what they have Googled the night before when they show up in the am and start grilling us. It's an everyday thing and we just tell them to make sure they express their concerns to the MD.

Under no circumstances are we expected to put up with verbal abuse, but sometimes there's no way to escape it. I never take anything personally and always tell myself:

"At least when I go home I won't see this person, but someone has the misfortune of living with them!"

Also, to a degree, we are dealing with people during the most stressful times of their life. There are no small emergencies....to the patient. One of the privileges of nursing is dealing with people and trying to bring out the best in someone during one of the worst experiences they've had.

and some people are not happy unless they have something to complain about, I always say they are "too busy enjoying their poor health to recover". Or "they only have enough strength left to complain".