Difficult family members/visitors

jrbl77, RN · Sep 17, 2009

To me, this is just a sign of the times. Society in general wants everything a half hour ago. I have been a nurse for over 30 yrs and have seen patients, visitors, doctors and staff change. Years ago, some md's did not want to be spoken to and staff would have to stand at attention while they made rounds. I don't miss those days. Once the horse is out of the barn- bad behavior- it is hard to curtail it. I myself know that when I go to the grocery store, the baggers are usually discussing their afterwork plans or how long their day has been. As others have said, I try to treat bad behavior with the sweetest and kindest words that I can muster. It usually drives them nuts. I too have been told that I don't smile while I am working. I take my job seriously and don't usually think about my facial expressions. And when people think they are funny and joke about jumping out of the window- I take them serioulsy. They give me an odd look when I tell them the I don't joke about their Lifes or care. These are just my ideas and some may not agree with them, but that is too bad.

crownurse · Sep 17, 2009

I tell them to please step out while I assess the patient even if all I'm doing is flushing a medlock. If they say, it's OK with her if I stay, I tell them it is the law that the patient has privacy. If they still refuse, I say I will just have to help the patient later. Then they leave.

kindaquazie · Sep 17, 2009

I have never had a problem with a visitor, ever. Not sure why. Maybe because I work in an amazing and Magnet facility where the patients are treated with respect and received excellent care. Not talking private hospital here, level one trauma center, gang members, homeless, mentally ill, prisoners, the whole gammit. I think the original post contains language that is unprofessional and reflects a general ignorance of the dynamic involved. I suggest a brief review of the literature surrounding family visitation to determine what might be lacking in your facility that encourages these behaviors. You will find that what we think family members need is often quite different from what they say they need.

Also, using terms like "taking crap" and "these people" diminishes them and you. It does not define anything except your overly emotional state. The visitors likely do not act this way at McDonalds because they are not stressed that a mistake will do anything more than ruin their lunch, not cause a loved one bodily harm. I am not suggesting you need to be more empathetic, or try harder, but that evidence from the literature (this has been studied for over 3 decades) will help you be the force to turn this around in your facility.

kindaquazie · Sep 17, 2009

I went with my daughter-in-law for my grandson's first blood draw after DC from the hospital. When I asked the lab tech to wash his hands he replied, "It's ok, I'm wearing gloves." I asked him if that was the policy of the lab, to forego handwashing if gloves are used and he hung his head and said "no" and proceded to wash his hands properly. Many would say I was being a rude, overly critical family member. I call it being a good consumer.

Healthcare is complex. In my hospital, if the family members do not feel an RN is listening to their concerns about a family member, they can call for the rapid response team. It is rare, but when it does occur, the patient is usually hypoxemic or in early sepsis. We need to rely on those who know the patient best when they say "he isn't himself" even though the vital signs seem WNL.

Kudos for finding a balance between good healthcare consumerism and poor behavior.

Ruby Vee, BSN · Sep 17, 2009

i have never had a problem with a visitor, ever. not sure why. maybe because i work in an amazing and magnet facility where the patients are treated with respect and received excellent care. not talking private hospital here, level one trauma center, gang members, homeless, mentally ill, prisoners, the whole gammit. i think the original post contains language that is unprofessional and reflects a general ignorance of the dynamic involved. i suggest a brief review of the literature surrounding family visitation to determine what might be lacking in your facility that encourages these behaviors. you will find that what we think family members need is often quite different from what they say they need.
also, using terms like "taking crap" and "these people" diminishes them and you. it does not define anything except your overly emotional state. the visitors likely do not act this way at mcdonalds because they are not stressed that a mistake will do anything more than ruin their lunch, not cause a loved one bodily harm. i am not suggesting you need to be more empathetic, or try harder, but that evidence from the literature (this has been studied for over 3 decades) will help you be the force to turn this around in your facility.

i'm sure your facility is awesome, and that you're an awesome nurse who is ever so much better than the rest of us. this, however, is a vent thread. it is impolite and unkind to your fellow nurses to step on a vent thread.

kindaquazie · Sep 17, 2009

Then I sincerely appologize having had no idea of the ettiquette involved. Please forgive me and vent away.

groanup · Sep 17, 2009

one thing that i never want to forget in nursing..is think about what happens when you are in the hospital.

you miss work (if you work)...the lives of your family members get disrupted, you have the insurance company to deal with, and if you don't have insurance, the reality that bills are going to be mounting when you get home and is going to have a major devastating effect on your lifestyle.

they don't have privacy, they have people come into their room at all hours of the day or not to take vital signs, labs, they become the guinea pigs for nursing students, medical students and residents, etc.

these people are going through some of the worst times of their lives...even if it's just a "routine" test or a "routine" surgery...to us, it's routine, to them, it's a major life event.

people that have never worked another job other than nursing...have a hard time grasping the concept that it doesn't matter if you work in nursing, business, or another profession...you still have the public to deal with and your management will expect you to keep them happy...b/c if patients stop choosing the healthcare facility that you work at for their needs, you'll be looking for another job.

i saw a hospital shut down in my area...a major hospital, totally shut down because people just stopped going there...the level of care had been sliding for years...a new system moved into the area...provided better care, better staff, and people just stopped going to the other place.

the reason nurses, especially new grads, are having a hard time finding work right now is because when people lose their jobs, they lose their health insurance...when they lose their health insurance, they stop going to the doctor unless it's something major that cannot wait.

ask nurses on this board that work as travelers...many hospitals have simply stopped renewing these contracts.

new grads: some that graduated in december still can't find jobs.

i'm not saying that you don't have the occasional family member that is difficult..however at the end of the day, they don't owe us anything.

report

and you've been away from the bedside how many years now?

kindaquazie · Sep 17, 2009

................./wave

lucyo2 · Sep 18, 2009

Put your self in their shoes - what if your mother or brother was ill and yyou knew nothing about nurses and what they do- teach them and explain what you are doing and why. Iknow it wont work with everyone, but some are just frightened and it comes out as anger at the nurse.

maxthecat · Sep 18, 2009

If this is all a result of stress, then why didn't people act this way in public 20 years ago? Don't kid yourself that there wasn't stess back then, too. Rudeness and selfishness seem to have become acceptable in public places of all sorts these days. I think most of us who have been in the profession for a few years are well able to tell when a patient and family are truly stressed and scared, and we go out of our way to make them more comfortable. But I see more and more people come in with the attitude that they are the only ones who matter. The rules shouldn't apply to them. And they see nurses, store clerks, waitresses, etc. as targets. "I don't like it and you're gonna do it my way or else."

I hear more and more people claiming they have "anger management problems." But they're not ashamed--their attitude is one of bragging about it. And they know they can get away with it. Funny how they're able to control their anger when faced with somebody who can beat the c--p out of them.

I've heard the same excuse used for doctors. "Well, Dr X shouldn't have thrown that chart down the hall, but you know he's under a lot of stress. So go pick it up and put it back together." I've never seen a nurse scream and throw a chart. The nurse knows he or she will be in major trouble. The doctor knows nothing much will happen to him. Just so, the patients we are talking about here (NOT the stressed and scared ones) know that nothing will happen to them--instead the "bad" employee will be scolded and the hospital will fall all over itself apologizing and giving special privileges. We have just taught these people that bad behavior will be rewarded.

nursejoy1, ASN, RN · Sep 18, 2009

one nite I had a pt near death, while at the smae time trying to pass meds on 32 others. I answered the phone and the son of a very demanding pt was on the phone and stated snidely that his mother was having difficulty getting her hemhrroids "doctored" I told him that I assumed she was - I was not her nurse, but that we had med pass to do and as soon as one us was free we would take care of it. He just kinda backed down. This same pt usually gets her way w/ everything. Don't get me wrong, I even like her and I do what I can when I can, but I will not stop doing the priority things because she (or her son) are griping.

abbaking · Sep 18, 2009

I had a traumatic experience as a CNA with a extremely difficult family. At this facility I was told by the RN to tell the patient in room 204 that she was going to be NPO at midnight for surgery. I did so and politely explained the rationale behind being NPO. A few minutes later I was approached in the hallway by 3 large men - all family members I had seen in the room. I was told to "Watch my back and be careful" and a few other 4 letter words and physically intimidating moves they made towords me - In there redneck white trash minds (Yes I said that), mommy dearest needs to eat and be well fed prior to surgery and I was tourturing her. Long story short, I had security escort them out of the building and called the police. I filed a police report - Much to the displeasure of the management but my life is more important than kissing someone ass.

Since then I have learned that if I am in a position where i perceive threats of violence or anything remotely close to it - I do not hesitate to call the police. Luckly, my hospital is a realistic facility and does not tolerate any BS from anyone