Ever been chewed out from the patient's family because of miscommunication from the doctor?
Last week, I had a patient that transferred to my hospital (McMemorial) from a different hospital (BurgerHospital). During SBAR, pt CC's was a syncope due to dehydration. The BurgerHospital gave IVFs and did kidney function tests. My hospital was waiting the results to be faxed. I am not sure what the MDs of BurgerHospital told the family, but the pt's family thinks he is in line for a kidney transplant.
I go assess the patient, and the family was on high alert asking questions about kidney transplants and how I must do everything in my power to save it. Unfortunately, I did not have all the information on what was going with the patient's kidneys to give a solid answer.
I told them I do not have all the information to give you a direct answer. Pt's MD team are on their way to get a better picture of what BurgerHopital has done. Right now, I have orders to continue to give IVFs.â€
Pt's family, Well what good are you? You are just a nurse. Get me ice chips.†And storms off.
As I walked out, quite upset, Pt's mother (that was driving from work) calls my unit asking questions. I explained I cannot give any pt information outside through the phone due to HIPAA. The mother starts cursing profanity and tells me I deserve to have my license taken away†right before she hangs up.
For the rest of my shift, my patient's family continued to kick me out unless the doctors were present. At change of shift, the pt's family left for dinner and the pt gave his deepest apology about his family's behavior. MD team finally came in and determined no kidney transplant. Plan of care was to continue IVF and electrolyte replacements. Pt was discharged the following morning.
I don't hear that this has anything to do with the miscommunication on the doctors' part, and the way this family treated you is also doesn't have anything to do with any particular doctor. I would kindly recommend you consider that this repeating "us vs. them" issue in nursing is to a great extent "what you make of it" anyway. I wouldn't mention it except that this topic is kind of the headliner of your post.
These people behaved rudely and in a just plain mean fashion. I personally do not make excuses for ongoing behavior like this. A moment of stress is one thing, treating someone like crap for no reason? No one gets a pass on that. I won't argue about it or reply in kind - but at the same time I won't be bothered by it; I resist being roped into others' misery.
Put it behind you. And I recommend the appropriate amount of detachment, as mentioned above, in the future.
A couple yrs ago, we had moved into a rental apartment, where one internet provider had a monopoly. Connectivity was terrible -- we basically had no internet access. After 4-5 calls to customer service, being told the signal was not going through, and I had to make a trip to the local McModem for a new modem.
I was ticked. I was in my partially-online BSN program, and I have five kids. Late at night was my only homework time, and of course libraries were closed. Plus, ALL of my middle-schooler's textbooks and assignments was on her school-issued iPad. It wasn't about my or S's social sites; it was about NEEDING internet access for schools.
It was not my proudest moment, but I let an f-bomb slip while on the phone AGAIN. It wasn't even directed *at* her -- it was as an adjective which modified "access."
She said: "Ma'am, if you use more foul language, I'm going to release this call."
Which brings me to my point: she did not deserve to hear hostility in the course of her work. Neither do we. Sure in many cases we should show some grace, but if someone is cussing you out over the phone?? Discontinue that conversation!
I get people can act out of character when stressed out... but behaviors like this? I tend to think they're just ugly people, who don't need to be defended. I take care of BRAIN DEAD patients, many of whom who are that way through no fault of their own. New quadriplegia, TBIs so severe that they will NEVER be able to go home. Some of these kids are 17, 18 yrs old (adult unit.) If anybody is stressed and grieving, it is these families...yet the vast majority are kind and appreciative.
I'm sorry you had to deal with that.
Your point is good.
What happened with your internet access? I'd have been very upset, too, after several calls to the provider and trying to work it out peacefully. Then I'd have started going up the chain to the CEO, writing a letter to that person and/or getting his or her executive assistant. Then the BBB.
Honestly, we should not curse at people and she is to be commended for giving you a warning and not cutting you off immediately.
But it is simply not acceptable to be in the situation you were in and not get quick and competent repair of the problem.
So what came of it? Did it end OK for you? How quickly?
Roll your eyes in the break room. Be a duck... and let it roll off your back.
Our first responsibility is to the patient. If the patient is apologizing for their family, you can bet there are other factors at play that have NOTHING to do with you. Take nothing personally. Develop some really good canned answers for other people's quips: "you're right, I AM just the nurse" or "I'm sorry you feel that way, let me know what else I can do for you" and defer to the patient in all interactions.
Difficult family dynamics are just a part of nursing.
This is reason one of ten million why I work night shift. More often than not, I can convince people to leave, because "He's sedated and the ventilator is breathing for him now; he'll need you to get your rest so when he wakes up and we take the tube out, you can have the energy to support him." I fervently promise to call them if anything changes, and they get out of my hair. If they don't actually leave the hospital, I can usually convince them to sleep in the waiting room, at least.
Even better are the times I go days without seeing any patient family members at all, because they get there after 0700 and leave before 1900.
I feel like people are like this more often than not these days. I can remember one time I snapped at a customer service person who didn't deserve it because I was having a horrible day, but it's only happened once in my life, and I came back and apologized later. I don't see how these people who constantly beat everyone else around them down just because they're having a bad day can look themselves in the mirror. I don't care how bad things are going for them, basic human decency should still be a thing. There is no excuse to treat people like those family members treated you.
You need to approach this from a psychological view point. The family is upset, looking for someone to blame. Is it right...no. What do you do; patience and understanding. The less said the better. Staying in the room accomplishes nothing. Alert social services and your charge.
Any nurse who thinks it's OK to correct rude behavior of family members who just found out horrific news about thier loved ones does not belong in nursing. We need to understand their frustration and anger. Gently redirect. If you must stay in the room, you are the calm they need. Be the calm. Call for help from the charge and or social services.
Many times these family members are only hearing fragments of information and formulating their own theories; fantasies, wishes, hopes and are connecting the dots wrong. Empathy, compassion and understanding are the major keys in situations like this. Even if it's been explained to them it takes 3 times for somoene to understand what is being said. I don't know if they've ever done studies with medical emergencies. but I am sure that's it higher.
Not all are "jerks" as someone put it...they are human beings that just got terrible news and are not experienced with the right coping skills to handle medical emergency situations...they are frightened. Most are not educated enough; we are. Most family members aren't around this kind of stuff day to day...we are. Most of them are not nurses...we are.
How you handle these types of situations will say what kind of nurse you are.
Should you stay in the room and be verbally abused if it's beyond the pale; no. You know where the door is, you know where your charge is, you know how to contact social services. You can also ask them to leave the room so you can perform you're duties without distractions.
Never hang your head...always keep it up with a look of real conern. Your non-verbal language is screaming in situations like this (as theirs is as well); your affect is telling the family a lot.
And of course...we don't argue or discuss grim outcomes in front of a patient. I don't care if they have been in a coma for weeks...go outside the room to battle.
I don't see how these people who constantly beat everyone else around them down just because they're having a bad day can look themselves in the mirror. I don't care how bad things are going for them, basic human decency should still be a thing. There is no excuse to treat people like those family members treated you.
Sadly there are people like that everywhere. My experience with a hyper vigilant family member last week went down like this: family member asks current labs, updates, pending exams. Was advised there was a pending exam in radiology, they can't get to said pt yet as there are ER cases ahead of pt. Family member really said "well how can we get to the top of the list? who do I need to call? I'll make the call myself. Your manager? Patient advocate? The president of the hospital?" - you can feel the seething venom in her words. I politely rolled along with the veiled threats and said I'll work on it and went about my business.
Poptartin
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disregard