Today one of the Nurses I work with got "dressed down" by a patient's family member because this family member felt that the nurse had not kept her up to date on the patients situation. The patient then signed out AMA- and since there was actually no acute medical condition, that was alright with us. Now, I know many patients get irate and ugly over nothing, or misconceptions. But, I actually heard this nurse speaking to this family, and while she wasn't exactly rude, she was entirely unsupportive, short and in overhearing her conversation, I did sort of cringe- she was not patient or compassionate and her tone of voice sounded as if she could care less about the families concerns. I actually understood the family member's rage. Another staff member also overheard the discussion and interpreted it as somewhat short and cold. this is not the first time I have seen/heard this nurse behave this way.
After the whole incident, the Nurse was solicitng support as we often do after a patient gets nutty. and I wanted to be really supportive, but I can't help but think that the entire situation could have been avoided, or at least less dramatic (family member shouting at the nurse at the main desk/team leader inbetween family member and nurse). I do not have her experience in years and I am certainly not her supervisor. I do know she is under some personal stress at home. I have tried to have her do this really awesome seminar that I did in the past (sure stopped many of my difficulties with irate ED patients, anyone interested, PM me) but she will not go to that. I really want to support her (and our patients). I don't want to head to management, but I don't know what else to do... Suggestions anyone? I absoloutely hate rude behavior, and hers was up there tonight. I am not trying to make her out to be a bad person nurse or anything, I just don't know what to do to make this stop. I don't think she realises how she is often percieved.?? Thanks in advance
Jun 5, '02
Maybe you do need to go to your supervisor. This family is sure to complain to the higher ups. When I was a newer nurse, I was sometimes short with people. I got called on the carpet a few times by my bosses and have learned to change my ways and have had no problems since. I had to learn that I needed to change my attitude. Good Luck.
Jun 6, '02
There is a difference between a bad nurse and a bad day.....
We can't all be expected to always be perfectly polite, especially when patients and families sometimes *expect* that we should basically be their glorified waitresses. Of course there will be discrepancies between what the public expect and what we actually present to them. But it sounds like this nurse is not just having a bad day, she needs some pointers in communication techniques.
If she is new, or "junior" staff, it could come from someone more senior in the staff who has served as a mentor or preceptor for her. Or else it should be dealt with by the manager.
The manager is not just for getting people in trouble, the manager can be a good resource in helping nurses to become better at their jobs - particularly because it is teh boss that receives all the complaints about the nurses, and can see whether a nurse is always getting complaints about a certain behaviour.
If you feel comfortable talking to her, pick a private moment or pull her aside one day. Or you could share similar situations that you have seen with other nurses, or yourself, to illustrate how others may perceive a nurses attitude or language. Otherwise, I'd say, have a chat with your manager about it. The point is, her attitude is hurting her relationship with patients and families - and can get the hospital in trouble too. If she just doesn't realize, she has to be given the chance to learn and improve. Maybe the manager could require her to take a course such as the one you describe. Or if she realizes that others perceive her as rude, but doesn't care, she needs disciplinary action. If there is someone else in a position of superiority - charge nurse, CRN - who could talk to her, besides a manager, that might be a gentler solution. Otherwise, it is not your job to help a nurse who does not seem receptive to your gentle suggestions, and you have to go to the boss.
Good luck, this doesn't sound easy!
Jun 6, '02
is it really up to you to make it stop?
it will surely catch up with her in time. no doubt that family will report her and if they dont another surely will.
before you drive a wedge between the two of you...and you will...make sure you have your facts straight and make sure that someone else hasnt done this first.
when a person goes AMA at our hospital we must call the doc, the charge nurse and the supervisor. there are papers the pt must complete. what was the reason the pt gave for leaving?
all im saying is there is not much sense is causing friction between you and a coworker if mgmt is already aware of the situation.
Jun 6, '02
I don't know the solution to your problem but I want to congradulate you on being a compassionate nurse and a decent human being. Those with hardness of heart don't have these kinds of conflicts.
Jun 6, '02
The pt left because he was tired of waiting for a transport to another hospital. We knew that the transport was going to be 2 hrs delayed because the transporters got called out to an accident scene. The nurse didn't tell the pt about the delay, and had not actually seen the patient for hours- since she was stable, she has signed her out (completed all transfer paperwork) and was actually not even charting on the pt... for hours while they were still here
The patient and her family flat out refused to sign the AMA forms, and I think they left simply because they were angry at the Nurse. Sure it will come back at her, but I really would like to support this RN- I'm not saying it's up to me to make it stop- but I'd like to support her. We all have bad days and patients who decide we are the spawn of Satan
It is part of the ED game, but for her, it is almost daily, and I think it is wearing her down as well- so instead of waiting for it to catch up on her- which will most likely result in some sort of "disciplinary action" (we are verry customer service oriented) I'd like to support her before that.
Jun 6, '02
I can kind of speak to this because I was accused of being "rude" and "brusque" to a patient also. I had no idea the family or other nurses perceived me being that way. I thought I was going through a "normal" day. Yet, when I was told the patient thought I was rude, turned her "brusquely", and didn't listen to her concerns, it was a wake up call to me. And, once I really thought back on all of it, yes I was. Why? Because I was completely burned out. So burned out, I didn't see it for myself. So yes, sometimes you need to tell your manager AND speak to your colleague. I left bedside nursing after that and have not regretted the decision since. It was time for me to go, and I accepted it. Found a new nursing path and love it.
Jun 8, '02
It is no so much what you say it is how you say it what people pick up real fast. Non verbal communication is a biggie. Nurses are human and we are in the human business I know if someone is starting to irritate me I take a break and regroup. Peopl never remember the good only the bad and will loop the whole facility with that one bad encounter.
Jun 8, '02
That is why I hate working Sundays. All the family of residents come in out of the woodwork. I've noticed most supervisors are rude to family members and if not speaking harshly, or grabbing chart out and sighing heavily they are bending their head down totallly ignoring the person standing at the desk. Therefore they come and find me on the med pass and they shadow the cart and and I will never be rude to them. I usually know what's going on with a resident and can ease their familie's fears by acknowledging some small token of information that only pertains to that resident. I think they just want to know that we care and we are on top of things. But there are the other family members who show up in large groups on a Sunday and storm the desk asking if they could get free lunch today and I'm thinking there are 10 of you and your poor mother has not gotten a new set of clothes in over 5 years and you are worried about lunch or the hat pin you bought your non responsive Mom last year when you made your annual appearance. And guess what your Mom IS responsive when you leave - She says Thank GOd (This is true guys) Or the family members who hounded me all last week end for their mothers room to be changed to a more Airy Sunny room and DO I LOOK LIKE THE ROOM CHANGER? But they come to desk over and over and I have to stop med pass again and again. But the kicker comes when one of our residents got a injury and these god awful vultures are in her room looking at the view after the ambulance leaves and I say NO NO NO - she is not dead and you can't have this room!! COming from a small town whenever the ambulance comes so does the whole town running around the Care Center to see the scoop. It makes me sick sometimes. But I don't know how but I always get the job of talking to families - Even when the next nurse comes on - she passes meds and I'm still charting at desk and who do they ask??????? Some of the families are so wonderful - and faithfully come to see the residents and others have no family coming at all - that is why I think that being rude to family members is very unprofessional but even my DON said - tell then you don't have time right now! I can't do that. They keep telling me to be assertive or I will fall apart (which I am) but to me I don't see assertiveness - I see agressiveness.
Jun 8, '02
Oh and by the way - reporting your coworker is not a good idea - not for something like that - abuse yes - but you really don't know the history between her and this family and maybe it goes way back or you didn't hear the whole conversation, Maybe you could help her talk about it - if she is always like this then, Yes she will burn her britches. Besides if you start reporting for this kind of thing you will start to become like a pest to your DON. Believe me I've tried to report rude staff and I end up looking like the flakey tattle tale because we are so short staffed anyway they can't get rid of a staff member and maybe talking to them would make them walk out. Staff is also vulnerable to abusiveness too - but like you said it's a matter of each individual - I wouldn't talk to anybody not staff, res or family in a short curt tone. It's like dismissing them.
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