Difficult family (Long)

Specialties MICU

Published

Hello,

This is my first post here and I suppose I just need to vent/hear some words of wisdom and encouragement :)

I have been a MICU nurse for about 7 years now. I have never worked anywhere else. Due to our large cancer population in my MICU, end-of-life care is something my co-workers and I are quite used to.

Quite often, we encounter families who are not ready to let go, even long after modern medicine and technology become futile. Getting these families to accept the death of their loved ones can be quite trying on us, as we agonize over the suffering of our patients. We do, however, treat these circumstances with extreme patience and respect.

Less often, we encounter families who take out their frustrations on the nursing and medical team. These are people who, quite frankly, can be mean and hateful. I am currently dealing with one of these situations. It is the worst for me yet and I have found myself perseverating on it throughout the entire duration of my weekend off!

I initially could stand the dirty looks, the eye-rolling, the heavy sighs. I grew more unsettled under the weight of the passive-aggressive comments. *For example: It is the evening. Family is visiting. Patient is barely interactive except for an occasional silent scream. Family member states as they pat patient's forehead, "I know, I know. THEY are just putting you through so much.* Yesterday, however, was the icing on the cake.

We have a 2-3 person visiting policy in my ICU. Mostly because I am scared of these people, I said nothing as 5 visitors hovered around the bedside all evening. Four of them sitting in chairs pushed up against the wall. Our patient rooms are SMALL. It was very hard for me to squeeze around the bed to provide care. I was asked to bring another chair into the room. I said no. I explained there was not enough room. I admit, I was rushed, I was scared of them, I was annoyed. I may not have smiled when I said this. Suffice it to say this did not go over well.

Family member #1: "Well, you could be nice about it. You don't have to be so snooty."

Me: Trying to not make this personal, trying to pretend I didn't hear the name-calling, I attempt to again explain why I can't bring in another chair. This may or may not have been the right approach. Hindsight is 20/20, but now I wish I just apologized and left. So, here I go, "It has been hard for me to walk around the bed..." Not sure how much I got out.

Family member #1: Just stop.

Family member #2: Shhh. Just shhh.

Family member #3: Heavy sigh.

Me: OMG. Cut off mid-sentence. Basically told to shut up. Have NEVER felt so demeaned, disrespected, and disregarded in my entire career.

I admit that when I told this family that I could not bring in another chair, I may have been rushed and short. However, I will back this up by saying that overall I have been trying really hard to suck up to them because of how much they scare me. This is definitely not a case of me being witch-nurse (and I know we all know those kind of people). Regardless of how I said this one comment, the name-calling and complete dismissal of me was completely inappropriate and I can't seem to shake it.

Thank you to anyone who has listened.

Specializes in MICU, SICU, CICU.

Take your charge nurse and security and ask them to step out. If they refuse call the police. They are endangering your patient by interfering with care.

Have housekeeping remove all but two chairs. I hope your unit is locked. I would let them in two at a time and call security if they act up again.

Thank you everyone for your advice, support, and encouragement. I do feel like I can let go of the bad feelings finally!

Specializes in oncology, MS/tele/stepdown.

I feel like this scenario is more and more common on my floor. Some people are never ready to let go and it breaks my heart to call the RRT or transfer them to the unit but it can't be helped.

I would have told them it was against hospital policy to have so many people in the room as it interferes with the care you provide, this way to the lounge, thankyouverymuch. If they object, here let me get my charge nurse for you. And then tell your charge nurse the patient needs to be rotated.

Specializes in Quality, Cardiac Stepdown, MICU.

Yeah, agree with everyone, it's the charge nurse's job. If he/she won't, the house supervisor is a good person to bring in, a "buck stops with me" final ruling of no, you can't have more than 3 in the room, it's essential you leave room for the nurse to give the necessary care, etc.

I had a pt's significant other bring their dog to his room. "Oh, I love him, he keeps me calm!" Meanwhile the dog barked so loudly at me during report I literally jumped, and then he was pawing at the Foley bag! I didn't even need to ask. The opposite shift charge heard the bark and walked right in and said, "I'm sorry, but the dog's got to go."

Pt satisfaction is one thing, but there can't be an unsafe environment. Even restaurants have fire codes and customer limits.

Specializes in SICU, trauma, neuro.
This is what we call a twelve hour patient. Everyone has to take their turn.

This is exactly what I was thinking. Everybody shares the wealth (at the very least.)

Not sure what the culture on your unit is, but where I am--and our NM backs us up on this--but if they are obstructing nursing care and making threats, they will be invited to leave by security.

If it's not to the point of actually interfering w/ anyone's work though, i find sometimes it helps to just tell myself "There are some people who will NEVER be satisfied. It's not about me."

Specializes in MICU.

That is ridiculous. I usually mention "fire code" when people ask for chairs and that shuts them up. Although I don't know if it would have worked for that family.

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