Difficult families....

NoCrumping · Apr 21, 2005

OK, we've had a run on crazy families lately. I am not talking about the normal stressed and anxious parents, I am talking about people who are completely out of touch with reality and seem to have been raised by wolves or something. That's the only logical explanation for their behavior that I can see. Our unit really seems to coddle these people. They will even switch nurse assignments in the middle of a shift if the parents don't like the nurse they have (because said nurse enforced the rules regarding visiting policies, cell phones, etc.). How do other units deal with this type of thing?

Its hard... I believe management feeds on the behavior you described.it happens on my unit too. I just try to understand with clenched teeth that there are people from all walks of life, and paired with having a child in a nicu, its worse. But in no way will I let them interfere with nursing care. For example, I had a mom of a microchip , vented,, pressers, etc... caressing the babies head, back, cheek... I explained to her very nicely in detail why these kids hate that... they desat, brady, etc... she told me in no uncertain terms that she would not stop, it was her kid, if she wasnt allowed to hold her , she would do whatever she wanted. ( even after giving her other examples of how to touch) Well, after the third time of "saving" her child due to this, I asked her to leave, and to have her talk to the manager about it further, as I allready explained the rationale, and she refused to stop. The manager backed me up fully.... But she transferred the baby to another NICU!!!! You cant win with some people. In one NICU I worked in,one set of parents actually made a list of which nurses were to take care of their child... the list was based on what nurse the kiddo didnt have a "bad night" with in the past...nobody wanted to be on the list.... they were even rotten to the listed nurses....management totally catered to them... right down to the point of switching assignments at the last minute, making others have an unsafe assignment, as these parents only would stand for just one other very stable child on the assignment with their kid....it was a nightmare. Management went right along with it, instead of sticking by the staff... so they were allowed to do it.Then you have the compliant parents, but seem to be obviously raised by wolves, as you said, and bring these dirty old stuffed animals to be put in isolettes, yell out across the bay about how ugly that kid is over there..... how do you respond to those people!!!!!!! I could go on and on.... I hear you.

BittyBabyGrower, MSN, RN · Apr 21, 2005

We don't change assignments, that is for sure. I have to say, our nurse manager and asst UM don't have a lot of tolerance for nutsos. We have them sign a copy of the unit rules and if they don't abide by them we ask them to leave. This way, they can't say they haven't been told, etc. If it is the extra visitors that are causing a ruckus, we take that privledge away too and only allow the parents. We have really cracked down on these kooks. If they are really unreasonable and it is an off shift we call the supervisor.

Makes our job oh that much more fun, doesn't it? :rolleyes:

VEVINA · Apr 21, 2005

We don't change assignments, that is for sure. I have to say, our nurse manager and asst UM don't have a lot of tolerance for nutsos. We have them sign a copy of the unit rules and if they don't abide by them we ask them to leave. This way, they can't say they haven't been told, etc. If it is the extra visitors that are causing a ruckus, we take that privledge away too and only allow the parents. We have really cracked down on these kooks. If they are really unreasonable and it is an off shift we call the supervisor.
Makes our job oh that much more fun, doesn't it?

Can I ask what does your copy of unit rules consist of? And are the parents allowed to keep the paper or is it filed into the baby's casenotes?

**canoehead, BSN, RN** · Apr 21, 2005

If management changes assignments then your coworker should be enforcing the rules the same way the first nurse did. That way the parents get their way, but they don't manipulate the staff. Bring it up in a staff meeting...that you will back each other up in these situations even if you wouldn't normally make the same decision. You should have each other's back.

allnurses Guide · Apr 21, 2005

If management changes assignments then your coworker should be enforcing the rules the same way the first nurse did. That way the parents get their way, but they don't manipulate the staff. Bring it up in a staff meeting...that you will back each other up in these situations even if you wouldn't normally make the same decision. You should have each other's back.

This happens in other areas - when I first started nursing there was one nurse who would always give Demerol to a frequent flyer self-described drug addict who would be admitted acutely for n/v or something . . . . he didn't want to deal with her abrasive personality and sometimes disruptive behavior so he gave her what she wanted. When the subsequent shift came on we would give the med but not a frequently . . she would get so angry. Definitely didn't have each other's back and it made caring for her even more difficult - this wasn't a pain issue completely - she would admit needing it just for kicks.

Regarding families - I've had some bad experiences in OB too . . . . amazing how differently we are all raised.

steph

NoCrumping · Apr 21, 2005

If management changes assignments then your coworker should be enforcing the rules the same way the first nurse did. That way the parents get their way, but they don't manipulate the staff. Bring it up in a staff meeting...that you will back each other up in these situations even if you wouldn't normally make the same decision. You should have each other's back.

Oh.....deff... but with this particular family, it wasnt that they were breaking rules that certain nurses werent enforcing, its that they only wanted nurses taking care of their baby that was on a list, created by the family..... and management indulged them. The whole unit was livid, morale was terrible. They admited that the list was comprised of nurses that the baby didnt have a bad night with in the past.

(sorry if I confused)

LilPeanut, MSN, RN, NP · Apr 22, 2005

When I was a NICU parent I barred a nurse from care of my son because of a totally inappropriate comment she made to me. She had basically said that if I had been more responsible and gotten prenatal care, my son wouldn't be there. She had assumed because I look young and perhaps because I wasn't wearing my wedding ring because of swelling that I was an unwed teen mother who had had no prenatal care.

I'll admit it pissed me off. I had just come off of 4 months of complete bedrest, 1 month of it in the hospital, mag, terb, you name it, we did it to try and prevent him from needing the NICU. And if that nurse couldn't be respectful to me, I did not need to deal with her during a very stressful and emotional time.

t2000JC · Apr 22, 2005

we have this same problem on our unit and it has been brought up that we need to be MORE CONSISTENT in what we tell the parents regarding the set-up of the unit. we also found that when we mention things like stress of the babies, etc. soon after admission parents are okay when we mention it later versus when we tell them right at the bedside because they may get defensive, so I like the idea of having them sign something before. usually when they understand that there is a reason behind why things are done for the benefit of the baby they are okay. i mean, if it's for the good of the baby...BUT, there are some parents who do seem unreasonable (i didn't make your baby desat! Prematurity did!) but they are in an out of control situation that they need to control because it's their child. That being said, that is why medical professionals should be consistent in their stand on the care for the child b/c it shows credibility.

so..to answer your question, I would talk to the manager, and brainstorm at the next unit meeting. sorry i am rambling but i am tired :) t.

BittyBabyGrower, MSN, RN · Apr 22, 2005

We go over the visitation rules with them and then they sign the bottom of the paper to acknowledge that we have gone over it with them. Then we copy it, give them a copy and the signed original goes on the clipboard. We also make a note on our teaching sheets that we did this. It has cut down on some of the bull we usually put up with.

NoCrumping · Apr 22, 2005

When I was a NICU parent I barred a nurse from care of my son because of a totally inappropriate comment she made to me. She had basically said that if I had been more responsible and gotten prenatal care, my son wouldn't be there. She had assumed because I look young and perhaps because I wasn't wearing my wedding ring because of swelling that I was an unwed teen mother who had had no prenatal care.
I'll admit it pissed me off. I had just come off of 4 months of complete bedrest, 1 month of it in the hospital, mag, terb, you name it, we did it to try and prevent him from needing the NICU. And if that nurse couldn't be respectful to me, I did not need to deal with her during a very stressful and emotional time.

You were right in that instance, she should have never said that. We (nurses) are not even supposed to be saying things like that EVEN IF we KNOW the whole situation. I have had many babies in my unit where the moms admit drug use, no prenatal care, prostitition, while pregnant. All while having supervised visits with social workers, and I would NEVER make any such comment.......I want to , but dont. ( in these circumstances) Seems to me that you were better off, not only because of the comment, but if she was taking care of your baby, she should have known prenatal/medical/social histories. (at least in my unit, we are required to know and give all that on report).... did you get an apologie? just curious.

nekhismom · Apr 24, 2005

We have parents that say who can and can not take care of their kid all the time. Usually it is because one nurse enforces the rules when others let the parents do whatever they want to do. Of course, there are notes at the desk saying "do not assign baby boy BB to nurse XX per parent request" all the time. SOme patients even have "parents request that only the following nurses be given baby girl GG." Everyone LOVES not to be on that list, because those parents can be so demanding.