Well this post will be half advice seeking and half venting, I suppose I need both. I was a fortunate new grad, and started my first job as a LTC/Rehab nurse the end of August, less than a month after passing my NCLEX-RN. It was an environment in nursing that was so far beyond what I'd learned in nursing school, but I have adapted and made it through many of my 'firsts' there. One recent issue has thrown me off a little, and that's a difficult family member.
I have experienced many difficult family members in my short time as a nurse already - the overbearing, uneducated, rude, and sometimes just plain daft. I've so far been able to deal with these family members well enough to not only help improve their knowledge and comfort level, but to be told I was one of their favorite nurses. We recently got a new rehab admit with a family member who is beyond anything I've had to deal with yet. I'm told this new admit has been there several times already, and everyone hates having her there because of this family member.
This family member is present in the room with her mother from early in the morning to late at night, and makes constant demands on the staff. We're usually short staffed every shift, and just plain struggle to make it through the day with what we have without having to deal with this person, and the added stress is making it near impossible. This person has no difficulty getting right in your face yelling at you if things aren't done to her standards or on her schedule, she's been known to verbally berate and insult staff for little to no reason, throw things around and even at people, and one time even resorted to harshly pushing someone into the wall.
The first day of her admission she had one of my four CNA's in tears, and another nearly walked out on the job simply because of her. She has yelled, screamed, insulted, and even threatened myself and my CNA's. She's in the ADoN's office several times daily complaining about everyone and everything. I'm being told by my ADoN as well as some staff that has been there a long time simply to treat her well, basically giving her the royal treatment. We have already been bending over backwards trying to meet the needs of this family member, and still have been told we're doing a bad job of it.
I have tried every therapeutic communication trick in the book to try and deal with this person without any luck. I find it very difficult in trying to reward bad behavior like this. I would never let the actual patient suffer because of the actions of her family, but giving her family priority when I have 32 other residents/patients to care for seems very wrong to me. My first question was why she was even allowed back, since she's been like this the last four visits, and my second was why I had to make this person happy.
In the end, I'm faced with the difficult choice of how to deal with this person. I firmly believe that there is no excuse for this type of treatment, and that there's no reason I should accept this kind of behavior. I have come to the aid of my CNA's with this person, defended them, and even stepped in to take the onslaught to protect them. I carry a phone with me at all times ready to call the police if she chooses to get physically violent with anyone, I step in and attempt to talk her down when things heat up, and usually walk out after telling her, "I cannot talk with you when you're like this. When you calm down you let me know and we can talk about what's upsetting you so much."
I'm now told I may lose my job for not giving into her demands, for walking out on her, and even for considering calling the police on her. I'm frustrated that I'm expected to simply take whatever she has to throw at me and my staff, and that my employment is even remotely threatened by my desire to keep myself and my staff safe. I know the best way to deal with difficult family members is simply to do what they ask with a smile, but where do you draw the line? How far do you let things go before you stand up and say, "no more!"
