Dealing with difficult families:)

Specialties Home Health

Published

How do you handle difficult families? What's your strategy? What's your game plan? Just wanted to pick everybody's brains:) thanks!!

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Difficult how?

In my experience there are many ways in which families of patients can be difficult.

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Such as standing over your shoulder during wound care- telling you that you'd better take really good care of their mother because they aren't above suing!! Or a patients daughter that openly admits in front of her mother that she wishes she were sick enough to be in a nursing home- the mother is in her right mind- and was almost in tears:(. I wanted to put her in my bag and bring her home with me!! Her daughter calls at minimum 6-8 times a week bc of her mothers normal blood pressure, normal blood sugars- etc!! She's been educated to the max- and honestly her mother will be discharged within the next few weeks as long as her wound remains closed- and it's sooooo close!! For the most part- I'm loving home health and the close relationships that you form with your patients- but some families are really just awful!! So I guess I'm just looking for other peoples stories and how they handled the awkward situations that families can create?

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The ones that drive me nuts are the ones who when you set up a time want you to come late afternoon/evening. I try to finish my day by 2 so I can get my kids from school. The ones who when you tell them you'll arrive between 10-11 tell you that you are late if you arrive at 1:05.

I've learned to nip the calling me all the time in the bud. I guess it depends on what your agencies policy is but to avoid the problems with excessive calling I tell them they can call and leave me a message, but I don't answer the phone when I'm with a patient unless I'm waiting on a doc to call, I also tell them that after hours and on weekends I tend to leave my phone in my purse and I don't hear it so they can leave a message but if it's urgent they should call the on call nurse. I find if I establish boundaries they are less likely to become a nuisance.

Dysfunctional family dynamics are hard when you are there just trying to do your job and the family is letting it all hang out. I have spoken to family members tactfully about how they speak around and to their loved ones. I will say something like the stress level of having to care for someone and how difficult it is, but they are so wonderful to do it and it shows just how much they care. Sometimes it is truly just caregiver role fatigue rearing it's ugly head. Sometimes the family member is just a jerk. If I think it's the second then that dynamic runs much deeper than I can solve in our visits and I just do my work and leave. MSW is sometimes indicated in these situations also. I've had times too where the family member that seems cold or whatever pulls me aside and admits the parent that seems so sweet was abusive and they are trying to do what is right, but there is a lot of bitterness there from the abuse. I have told people that sometimes a family member is better off in a nursing home if they can't give the care for any reason.

There are definitely times when the family member is more challenging than the patient.

I love home health! Been doing it for around 3 years and I don't know that there is another type of nursing I could possibly love as much.

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Thank you for your post!! :).

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I was with my preceptor that day- and all she said was welcome to home health- that the family is sometimes harder to deal with than the patient!! So just thought i'd ask for other suggestions!! Lol:). Some families seem awesome and helpful- but other situations are just awkward!! Thank you for your post!

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Specializes in Pedi.

"Difficult families" are a very broad category. I am a pediatric nurse and I would say the majority of my patients' families are difficult, but for different reasons. Some are difficult because they are overbearing, others because they are abusive/neglectful. I'd rather deal with the family who calls for a temp of 37.9 (when guidelines are to call for 2 temps > 38 or any temp of 38.5) than the family who decides not to check a temp on their child who is rigoring because "the nurse is coming in the morning anyway" and then I walk in and find them with a temp of 39.4 and a blood pressure in the toilet and end up calling 911. If a parent is anxious about CVL infections and counts to make sure I scrub the hub for 15 seconds, I exaggerate doing it and count out loud with the kid to please them. When parents are going through a divorce and Mom wants to make disparaging comments about Dad but their school aged child who I'm there to give chemotherapy to is in the room, I say "let's do this first and we can talk about that later, when she's not in the room." No 2 families are the same and there is no formula for dealing with difficult families.

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Specializes in Pedi.
The ones that drive me nuts are the ones who when you set up a time want you to come late afternoon/evening. I try to finish my day by 2 so I can get my kids from school. The ones who when you tell them you'll arrive between 10-11 tell you that you are late if you arrive at 1:05.

Well, if you tell a patient you will arrive between 10-11 and you arrive at 1:05, you are 2+ hours late, no? I don't see how that's an unreasonable thing for them to say. If I'm running that late (which can happen when child protection issues are raised at my first visit of the day or there is a bad snowstorm), I'd call the family to let them know and give them the option to reschedule.

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I bet she meant 11:05. I've had to really work on not giving too tight of window than I can stick to.

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