Difficult patients and families - page 4
This is something that I don't see discussed in much detail here, and I am thinking to myself that maybe I am just a b***h, but do you ever get really irritated by your patients and/or their... Read More
Jul 12, '00Originally posted by tweetieRN:
Occasionally, I've wanted to go in with a restaurant order pad and say"May I take your order, please."
A nurse I worked with the other night mentioned that thru nsg school she waitress..she was commenting the only diff now is that she is one with a degree.
May 21, '04I have used the do the task then give permission for family to do it themselves thing.
It only works once...make sure you choose the right thing.
If they fluff the pillow they firmly believe they are now responsible for 95% of all nursing care. If you tell them they can easily fill the water jug or turn up the volume on the tv they will look horrified and then the sarcastic comments start flying...my favorite.".well if I am doing all your work what you will be doing?"
I just cracked up laughing in disbelief and said oh please and walked away.
They really truly believe all we do is fluff pillows and give a pill or two to just their loved one.
I have been a high maintenance family member but only after the staff has shown me they can't be trusted. I was in my husbands room and 2 times in less than 3 hours he had a blood tech come in to take blood..both times wrong patient.
The nurse let his IV run dry...it was nitro for chest pain...all she did was hang a new bottle...the line was full of air and ofcourse on the pump it just beeps and beeps and beeps...she just hit silence alarm...finally I unplugged the IV and flushed the line and called her back into to reset the pump...her response..I am on my lunch . It was ridiculous so I got pissed and called the manager and explained I was not going to leave until they gave him a nurse who knew what she was doing...and god bless her they gave him a great nurse..she was funny and really good...she wasn't the best nurse in the whole world...she just did her job with competence and confidence and a great sense of humour...we kept her all through CCU..CVICU and back to CCU.
I know she changed her schedule for us and I know she knows we loved her..we made sure to write management and let them know they had a treasure..we told everyone we could that she was a good nurse.
I have bent over backwards for family and still had them complain...I have done really minor things and got letters of praise...you cant win.
I agree with the big s***eating grin and the half bow...you can crack yourself up and that gets you through it.
I know some families don't mean to be awful but I also know some families are completely aware of how horrible they are being and they don't care...they want what they want and they couldn't care less about anyone else..sometimes that includes the patient they supposedly "love".
May 21, '04i learned really quick in nursing that it is important that we "train" pts and their families. working in ed you see alot of people that take advantage of hospital services and nurses. a few of my rules are:
1. if you walked in, you can walk out (with the exception of condition of course). why do you need a wheelchair all of a sudden?
2. no, we don't have sandwiches for you and your family (never mind pt just arrived 30 minutes ago) the cafeteria is down stairs.
3. you will be admitted when we get a bed. i am sorry that you left your children at home unattended because you didn't expect to be in emergency for 5 hours
4. there is the blanket warmer. there is the ice/water machine. help yourself .
when pts are alone i am more willing to bend the rules, but if there is family present i involve them in the pts care because they need to know what hospital, not hotel means. its working for me so far.
May 21, '04Handling family members is touchy. Some truly do not KNOW how busy we are. Others are spoiling for a fight because confrontation gives them the much needed power that they crave.
Sometimes I feel sorry for the family members who do not truly know how sick their loved one is or what is going on. They do not (or do not want to for whatever reason) communicate well with the doctor and expect the nurse to tell them everything. I find this to be really difficult because if you give out test results or anything on the progress notes you can get in big trouble with the doctor. I have had doctors yell at me because they didn't want the family to know this or that because the family took it out of context and acted like the world was coming to an end. Now I refer the family to call the doctor on things I feel may be touchy.
My job would be easier if my hospital enforced visiting hours and put out a placard explaining to patients and family that it is their responsibility to communicate with their doctor. But I don't see that happening.
May 23, '04i always try to get family members onside as soon as possible. kill them with kindness and keep open communication going at all times. offer information instead of leaving the relatives to ask you. be brutally honest with all your transactions.
remember it is best to keep your enemies close to you!
seriously, this seems to work with most clients and families but there are always the exceptions!
May 23, '04i work in va hosp and you should see the bigwigs come out when "i'm calling my congressman" is said--sometimes i can't blame the vets for wanting what they've earned but then you get the ones who"know the system" and demand everything--and then you get the "keepers" --families who just drop off dad and say 'he's yours" knowing we can't just release them--but when we start saying "if he stays here so does his check" its a different story--and then you get the most neediest and they are so appreciative of even the littlest thing---our job is an ever balancing act !!!!!!!
May 23, '04I agree with all of you. We recently admitted an elderly gentlemen to our long term care facility following a CVA. He wasn't any trouble until with the assistance of physical therapy, he began walking and trying to elope every five minutes. He was very confused and wanted to go home. He was also very big and strong. He would get physical with the staff. It came to the point that a staff member was practically one on one with him the entire time he was awake. When we notified the family that we couldn't provide one on one care (they were told this prior to admit and watched a video on it) they told me "he is your problem"
Then, a year later, he became very ill and died. The family wrote a thank you note to the local newspaper and thanked every caregiver in the state EXCEPT us! Oh, by the way, his daughter was an LPN.
May 23, '04I work in long term care. All families who apply to have someone admitted to our facility are required to watch a 30 minute video on what services we do and do not provide. The video also includes the family's responsibility in the resident's care and the fact that yes, your mom's new socks may get lost in laundry.
May 23, '04poor mom who was elderly and ready to go home with family--dgt A could no longer care for mom but held the bank books--dgt B would take mom home but now she wanted the bank books--not so said dgt A so they had YELLING-SCREAMING-CHAIR AND WATER PITCHER -THROWING match right over moms head who was oblivious to the whole thing--police were called and escorted the whole family out--mom and her bank books wound up in nsg home instead of with family
May 23, '04One time we had a patient that needed to use the urinal often, so as a test the family member pushed the call light to see how long it woluld take someone to come. There were 3 RN's working and 2 orderlies. It was one of my patient and I was busy in another room with a blood transfusion and a pateint getting ready to code. When I left that room to get something the patient's daughter says to me "I was doing a test to see how long it would take for someone to come, my father's has been waiting for someone for half an hour for help with the urinal, it;s a good thing I'm here now because I can help him but what will happen tonight?" I almost lost it. I told her that there would be someone to help him. She said well you know as soon as the light comes on you have to answer right away"
I felt like saying ya lady your father definently needs the closest care tonight becasue I don;t have any sick patients. Of course you can't say that but I was soooo furious.
May 23, '04I try really hard to 'kill em with kindness', but the other day I blew it. The doc had just walked out of this patient's room, caught it out of the corner of my eye. I suspected pt was to be discharged. Unfortunatley I had a patient to transfer to ICU...didn't take but 10 minutes my unit is right next door. As soon as I got back, the family member came charging into the nurses station demanding the discharge papers. She had been "waiting to leave". I lost it. I told her the rules of prioritizing nursing care. I had to care for my pt who was in need of emergency care first before paperworking her loved one out of the room. No apology from me regarding her horrible 15minute wait. I also added that somebody was waiting for the bed and I would be hurring asap to clear the room for somebody who was in desperate need for it. She left discussed. I did the paperwork and got em out asap, turned around and admitted the next person after the room was cleaned. One nurse told me, 'you go girl'. Yet another just looked at me with the 'your written up if they complain' look. Oh well, I believe in apologies etc, but not when they are unreasonable. Wish I could have felt better about the moment, but I didn't.:angryfire
May 24, '04I know how you feel, VHope...sometyimes we are driven to our limits by the pressures we work under, and it is only human for us to feel overwhelmed sometimes when family members or patients persist in unreasonable, 'me me' demands.
What bothers me most are the nurses who 'suck up' to the demanding people ...AND those who even go so far as to deliberately 'take their side' and/or feed resentment against another shift or individual nurse. So unprofessional...as well as dysfunctional. <sigh> I see waaaay too much of this.