Unappreciated by the patient's family

Nurses Relations

Published

Hi! I don't know if this is the right forum for my topic so please feel free to move it as the mods deemed fit.

I'm an RN-BSN with around less than 2 years experience as a med-surg nurse. I currently work in a critical care unit with a slightly different set-up than most CCU units. I get 5-6 patients in a shift. When I say that out loud, a lot of nurses (from other hospitals) wonder how does that work? Well, I get 2 critical care patients, 2-3 med surg/tele patients and couple of rehab patients so if one practicies prioritization and time management, you can actually get things done within your shift. Like, give meds to the rehab patients and not worry since PT/OT will be working with the patients all shift long.

Anyway, I said all that to give you guys an idea of what my work environment was like yesterday (my friday). I've been taking care of this rehab patient 3 days in a row this week. This patient (Z) has been in the facility since the start of the year. A lot of nurses have been taking care of him but I've only taken care of him this week for the first time. Even though it's my first time with Z, I see how other nurses take care of him. I don't say anything about it but it's always bothered me that they leave this post-CVA patient lying in a fetal position. He's 60+ years old, alert, oriented but non-verbal, contracted in all extremities and all the other nurses leave him in a fetal position.

So when I had him this week, I stretched out his legs a bit because in the back of my mind, this guy will go home someday and I don't want him to go home looking like this. PT/OT doesn't work that much with him except that OT puts a hand splint on his right arm. Anyway, the thing is the son yelled at me so loud that every one in the nursing station heard him yelling at me even the other patients' and their families heard his yelling at me. He yelled that I'm not gentle with his dad and that I feed him too much (of the pureed diet). I politely replied that his dad his contracted and I wanted to stretch out his legs but he wouldn't hear anything of it. He started threatening me about a lawsuit and my license. When it boiled down to that, I just remained quiet. This son was bigger than me and angry so I didn't want to aggravate things further. As for the feeding, a part of me wanted to tell the son that I'm actually one of the very few nurses who take time out to feed and encourage his dad to eat something. Most nurses in the unit would brush that off to the CNAs and since the CNAs are busy, they just only offer 2 spoons and report that the patient doesn't want to eat. I take time out from my other patients to stand their and feed his dad and coax him to finish at least half of the tray. I coax his dad to at least drink all the thickened juice.

Then the wife complained that for the 2nd day in a row, I supposedly left the tube feeding bump beeping and that I did nothing about it. Well, for the last 2 days of my work week, I had harrowing time since considering my experience compared to the other nurses in that unit, I bore the brunt of the critical care patients. That means, I got the severely ill ones.

Anyway, what I'm saying is that --- I was just hurt that the family didn't appreciate my good intentions and efforts about their dad. I do one good thing compared to the other nurses and I get yelled at. I know I'm supposed to grow thicker skin but sometimes, being unappreciated hurts especially when I, for one, believe in my profession. I was just wondering if other nurses have experienced being unappreciated and if so, how do you deal with it?

Oh and those numbers for a CCU is outrageous..I couldn't imagine doing that many plus 2 critical pts.

Read my post later in the thread regarding staffing!

I hate situtations like this because there is no solving it! at that point the family /patient is so set on being out of control no amount of education/explanation will help. ignoring them by walking out, standing there, giving them some customer service bs script line, which is the other alternative -is to an extent is just as bad. I have walked out in some of those situations even though in all i was 100% right because there really wasn't an alternative. I tried to explain rationals etc and the person did not want to hear it and continued yelling, well so be it.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I don't care how for profit they are this staffing is unacceptable. Is this a LTAC? Do you have a separate CCU? How do you have rehab patients with CCU and tele patients. The family should be reporting the unsafe conditions at the facility. I'm stunned they haven't been sued and shut down. I wouldn't have left any meds at the bedside regardless of how much the family bragged about knowing medicine. Your license is in danger here. I'd find another job if I were you. This is unacceptable staffing they should be cited....I'd be calling the Joint Commission and report them. I'd be calling anyone I could think of......that amount of patients and acuity is not safe.

I am stunned that no one has reported them......just when I think I had hear it all, I am yet again proven wrong and speechless (which is hard to do) I have to think about this one and come back....:bugeyes:.

You go above and beyond and are rewarded with anger. Sometimes we deal with that.

It is probably not about you, if that makes you feel any better.

This family is angry before they even met you; they just need a target.

Anger, denial and all those other things that drive us crazy are part of the grieving process.

If you are a nurse long enough you will be able to spot the angry families from the first hello.

I dealt with a family like that last week. It totaly wore me out.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I learned the hard way that even those who seem to appreciate what you do will ***** you over just as easily. I say that without any bitterness at all. They are solely focussed on the moment and their family member, which is how it should be, really. You do get appreciation but things work out much better if you don't expect it to come from any particular source.

If he's being seen by PT I wonder why they aren't doing range of motion or teaching it to the family? It sounds like that person who yelled at you didn't understand the what, when and why of the procedure.

Specializes in Hospice, HIV/STD, Neuro ICU, ER.
Most families don't appreciate what we do - but in reality that is because they don't know what we do. They don't understand what nursing entails or why juggling several patients can be challenging at best and an absolute nightmare at worst.

In your case, they may be concerned about pain when trying to straighten his legs and discomfort if he eats too much (just guessing). It may also be stress or believing that he is dying and should simply be allowed to be comfortable and otherwise left alone. Yelling at you was inappropriate and should not have to be tolerated. You may want to talk with your supervisor/charge nurse about how to handle that kind of situation (my inclination would be to simply walk out of the room, but make sure you won't get in trouble before trying that).

If the pt is getting comfort measures only, he should not be on a rehab unit. Rehab pts are expected to do 3+ hours of PT/OT per day. If the pt cannot tolerate this or is not making progress they are not appropriate for rehab. Surely the family is aware of that :uhoh3:

To the OP: Run. Run far, far away. Those are really unsafe staffing levels. The facility is setting you up for failure. They only care about their bottom line; not your health, sanity, or nursing license. While you may feel a sense of accomplishment by "handling" this pt load, you're not doing anyone any favors - especially your pts! :twocents:

Specializes in Hospice.
If the pt is getting comfort measures only, he should not be on a rehab unit. Rehab pts are expected to do 3+ hours of PT/OT per day. If the pt cannot tolerate this or is not making progress they are not appropriate for rehab. Surely the family is aware of that :uhoh3:

I am continually suprised at what families are not aware of - you would think they would be aware, but often when things are explained, the family does not understand some of the terminology or the person doing the explaining assumes they know certain things (that they don't). I have often re-explained things to family members who, as it turned out, didn't get the message the first time. I have worked on a rehab unit and when a patient was put on comfort measures, we didn't move them, just cared for them until they passed.

We are split into 2 teams, each with one RN and 5 CNAs on early shift, 3 CNAs on late shift & 2 at night.

Take care, try not to let it get you down as you have many years of nursing in front of you. Concentrate on the comments from grateful rels. I keep some written down to look at when I get home from a bad shift!

Megan xxx

Wow. If we only had 5 CNAs on our unit, that would be heaven. Thanks for the motivating comments. I do get good feedback from other patients and their family and that really makes my day. Literally. The best one I had was when a patient said that nurses are the backbone of healthcare. It was like she just nailed it right on the money.

I don't care how for profit they are this staffing is unacceptable. Is this a LTAC? Do you have a separate CCU? How do you have rehab patients with CCU and tele patients. The family should be reporting the unsafe conditions at the facility. I'm stunned they haven't been sued and shut down. I wouldn't have left any meds at the bedside regardless of how much the family bragged about knowing medicine. Your license is in danger here. I'd find another job if I were you. This is unacceptable staffing they should be cited....I'd be calling the Joint Commission and report them. I'd be calling anyone I could think of......that amount of patients and acuity is not safe.

I am stunned that no one has reported them......just when I think I had hear it all, I am yet again proven wrong and speechless (which is hard to do) I have to think about this one and come back....:bugeyes:.

I don't want to divulge too much details for privacy reasons but this XYZ1 hospital is a very small hospital that is situated right next to a bigger hospital, XYZ2. In their brochure, their services state that they have no ER services but they accept critical patients and they also focus on rehabilitation. It's been in existence for 20+ years. It must have started out as a LTAC then from what I understood, they had a contract with that bigger hospital that in case, XYZ2 is overflowing with critical care patients, they can send it to XYZ. And the line that I always hear is "don't worry we're just around the corner and if anything happens, we can send you immediately back to XYZ2."

Then from what I even hear, for some reason, XYZ1 was approved licensed to be a SNF/LTAC or both. I'm not really familiar with all these hospital licensing. But anyway, they started taking SNF/LTAC patients as well so that's why we get a hodgepodge of every kind of patients. When there's room in CCU units, they accept more SNF patients and put them in the CCU. If there's a critical care patient coming, they ship the SNF patient back to the real rehab unit to make room. It is normal to for a patient to be moved into 3 different units within one shift if only to make room for more patients.

Believe me, state comes in to survey XYZ1 all the time but they get away with it. One time, a patient's family complained and state came. To "fix" this problem, HR and upper management took a list of all the nurses taking care of that patient, found a med error, fired her and reported her to the board so her licensed is now pending suspension. I don't know the details but that's what I've heard. And when I listen to those who've worked there forever, this isn't the first time. So when state comes back to re-investigate, upper management claims that it was an isolated incident brought by an inadequate nurse and she doesn't work here anymore.

When I was hired, I was told that I would work solely in the CCU units. And maybe I was naive but I didn't know what I got myself into. I've been looking around for better options and having learned my lesson, I'm just more careful not to get s_ckered into a similar workplace.

Then, last week, one staff member made an anonymous call to the state so they came again to investigate. When a few nurses started speaking up about the workload, patient ratio, etc. Upper management changed their policies and dictated that all charge nurses must be responsible of 5 patients as well as be charge. Every year, XYZ1 has waves of mass resignations. Every year.

Sounds like a B-rated horror movie huh?!?!

You'll get used to being unappreciated once you're married with children and working full-time.

Thank God I'm single hahaha

And as for the PT/OT in XYZ1, they only spend 10-15 mins with a patient and move on. They teach the nurse and the patient the exercises and expect the nurse to do the exercises with the patient as well. When I first encountered that, the first thing I said was "oh so now I'm not just a nurse but PT as well?!?"

Specializes in Hospital Education Coordinator.

don't do your work for appreciation by anyone, employer included. You will rarely get it. Do it for the patient and your own sense of what is right and good.

+ Add a Comment