Difficult family members/visitors

mlbnocnurse · Sep 18, 2009

PERSONAL ACCOUNTABILITY!

what in the heck has happened to personal accountability.

the fact that we see people at the worst stages in their lives is true. that gives the patient an out to act like a jerk and most of us would just let it roll off our backs in empathy.

that, in no way, explains the behavior of their family members/visitors!

society has turned into a group of 'give me' type mentality. it's all about "what are you going to do for me" crap. no longer do people have to be accountable for their own actions.

so dont tell me that people get a free ride to act how they want because it's a stressful time in their lives.

you still know right from wrong and you still know how to act like a decent human being.

there is NO excuse for bad manners.

You are so right, no one takes any responsibility for their actions these days, there is always an excuse, it is always some one else's fault. The trick is to hold people accountable for their actions, making sure they are held to the rules, while still trying to understand why they behave the way they do. Without the back up of managers & administrators it is an impossible task. If families only knew that they were chasing the best nurses away from their loved one, they might be more motivated to change their behavior.

The best answer is that there is no answer. We are all doomed (unless we win the lottery)!!

abbaking · Sep 18, 2009

society and the world as a whole have turned into slime - we are nothing more than the hunters and the hunted - we expect to get what we want when we want it - Nobody cares anymore about fellow humanity or has any decency. 9/11 is the only time i can remember when the country as a whole and the civilized world stopped to think about there actions and the consequences.....we have lost the ability as a whole to communicate - Cell phones and Ipods are now being made in the placenta -(joke lol).

The worls is going to hell in a handbag and in nursing its no exception - I will be glad to see the day when robots are the new nurses.

morte, LPN, LVN · Sep 18, 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.

inre the bold...OF COURSE THEY DO! they owe us the same respect do any other human being....and no less than they expect in turn!

and....as Ruby noted...THIS IS A VENT THREAD!

RNinCA · Sep 20, 2009

First, I try to remember that, oftentimes, difficult family members are dealing with feelings of helplessness, fear or anger which has nothing to do with me, but with the situation, especially if the patient is suddenly ill or injured. Often times, they will take out those feelings on us.

Most of the time, actively listening to family members and repeating what they are trying to say, goes a long way to defusing a situation. If they feel like they are being acknowledged and their concerns have been/ are being addressed, it does a lot to calm and reassure them, easing fears.

If they are feeling helpless, I like to listen to them, validate their feelings, and give them small tasks to do. In my opinion, if family is going to stay at the bedside, they are going to work. If that is the expectation, then it helps weed out the freeloaders. Help me turn, help me boost, help meet the patients needs, as appropriate. Be clear what they can and cannot do. Turning off alarms is not acceptable! Oftentimes, giving the person things to do gives them a feeling of contribution and like they are helping to care, a sense of purpose. This calms them enough to stop being a pain in your behind.

For the angry, they may be dealing with grieving, feelings of guilt if they had anything to do with the pt's condition, or other complex emotional issues. For them, I can listen actively, acknowledge their anger by saying, "It sounds like you are feeling angry," and validate the feelings. Often times they don't know that they are angry, or don't understand why. Then it's time to call one of our awesome social workers!

If none of these tactics work, it may be that the family member needs to be medicated and that is outside my scope of practice.

At this point, good boundaries, clearly verbalizing expectations (it is not acceptable to have a party in the room, you may not call the staff names, you may not hit the staff,) and consequences, (you will be escorted outside by policemen and taken to jail, you will not be able to visit the patient anymore,) can work wonders. A written contract has been used where I work, as well, with the especially difficult visitors, usually family.

Hope this helps.

Ruby Vee, BSN · Sep 21, 2009

first, i try to remember that, oftentimes, difficult family members are dealing with feelings of helplessness, fear or anger which has nothing to do with me, but with the situation, especially if the patient is suddenly ill or injured. often times, they will take out those feelings on us.
most of the time, actively listening to family members and repeating what they are trying to say, goes a long way to defusing a situation. if they feel like they are being acknowledged and their concerns have been/ are being addressed, it does a lot to calm and reassure them, easing fears.
if they are feeling helpless, i like to listen to them, validate their feelings, and give them small tasks to do. in my opinion, if family is going to stay at the bedside, they are going to work. if that is the expectation, then it helps weed out the freeloaders. help me turn, help me boost, help meet the patients needs, as appropriate. be clear what they can and cannot do. turning off alarms is not acceptable! oftentimes, giving the person things to do gives them a feeling of contribution and like they are helping to care, a sense of purpose. this calms them enough to stop being a pain in your behind.
for the angry, they may be dealing with grieving, feelings of guilt if they had anything to do with the pt's condition, or other complex emotional issues. for them, i can listen actively, acknowledge their anger by saying, "it sounds like you are feeling angry," and validate the feelings. often times they don't know that they are angry, or don't understand why. then it's time to call one of our awesome social workers!
if none of these tactics work, it may be that the family member needs to be medicated and that is outside my scope of practice.
at this point, good boundaries, clearly verbalizing expectations (it is not acceptable to have a party in the room, you may not call the staff names, you may not hit the staff,) and consequences, (you will be escorted outside by policemen and taken to jail, you will not be able to visit the patient anymore,) can work wonders. a written contract has been used where i work, as well, with the especially difficult visitors, usually family.
hope this helps.

i'm sure you're an absolutely stellar nurse and all that, but this is a vent thread.

AngelfireRN, MSN, RN, APRN · Sep 21, 2009

i'm sure you're an absolutely stellar nurse and all that, but this is a vent thread.

could not have said it better if i tried!

jrw03282009 · Sep 21, 2009

I can remember way back when, my grandfather insisted on being at the dr office an HOUR before an appt. When he was dying in the hospital, he asked very few questions of the dr b/c PawPaw said that the Dr is a busy man, the nurse will know more. He would hold everything in b/c he didnt want to disturb those busy gals. After a particular sx to remove a lung, Pawpaw wouldnt ask for pain meds until the nurse asked b/c he didnt want to impose. He was on a pump to begin with but when he was taken off, he wouldnt ask. He waited. I am not saying people need to do this but he knew how busy the "gals" are trying to save lives. (And guys too, there just weren't any taking care of him.) There arent many like him anymore...

MedSurgeMess · Sep 21, 2009

I can remember way back when, my grandfather insisted on being at the dr office an HOUR before an appt. When he was dying in the hospital, he asked very few questions of the dr b/c PawPaw said that the Dr is a busy man, the nurse will know more. He would hold everything in b/c he didnt want to disturb those busy gals. After a particular sx to remove a lung, Pawpaw wouldnt ask for pain meds until the nurse asked b/c he didnt want to impose. He was on a pump to begin with but when he was taken off, he wouldnt ask. He waited. I am not saying people need to do this but he knew how busy the "gals" are trying to save lives. (And guys too, there just weren't any taking care of him.) There arent many like him anymore...

PawPaw sounds like he was a gem. Every now and then we get someone like him at my hospital and that patient usually gets a lot of attention just d/t the personality. We try to take excellent care of everyone, but those who act like horses a$$es just tend to run off the help. Even though I wasn't a nurse back then, I still remember no one under 12 was allowed beyond the lobby of the hospital, and there were set visiting hours for general areas, ABSOLUTELY NO EXCEPTIONS to either rule. ICU was only exception d/t nature of illnesses. I wish this was still in effect. It would help so much in helping patients rest and allow nurses the time to do patient care and treatments.

Jennie1 · Sep 23, 2009

Yes there are those who may come across as rude because they are genuinely scared/stressed/grieving, whatever. And as another poster has said, we tend to recognize and deal with these as the situation calls for. However there is no denying there are simply some rude pigs out there who seem to get off on being horrible, and if there's one thing I remember from a recent inservice on 'Dealing with challenging situations' it's "Never fight with pigs - you get all dirty and they enjoy it" (General Abrams).

Although no one should ever have to put up with violence/outright abuse, I do try to look on less serious situations as challenges. As I tell my kids (and I stole this idea from the Dalai Lama) - although it would be lovely to deal with nice, pleasant people all the time, rude, objectionale people are teaching you so much about patience and tolerance.

Good luck, and try not to let it get you down

belgarion · Sep 27, 2009

I don't necessarily agree with a return to highly restrictive visitation policies. A few years back my wife was in a hospital over 2 hours from home for 9 weeks. Since I had a "regular" job the only times I could go see her was weekends. Our daughter was 10 and therefore under the acceptable age at that time so she had to stay by herself in the lobby while I went and saw "Mom". This of course restricted my visits to just a few minutes. The stress placed on my wife by not being allowed to see her only child kept her continuously upset.Somehow I don't think being upset is conducive to recovery.

I was never rude or abusive to the staff during all this time but they decided that, since she always got so upset when I left, it would be in her "best interest" if we stayed away until she was ready to be released. Not wanting to cause problems, I agreed to this and skipped the next weekend. At 3:30 AM that Sunday morning, I got a call from the hospital telling me that she had become extremely upset because I hadn't been to see her that weekend and would I please talk to her on the phone and calm her down? They created the situation but wanted me to clean it up.

Keeping family away is not always the best thing for the patient.

When dealing with difficult patients, I try to keep my own experiences as a family member in mind.

cosmicsun · Sep 27, 2009

I don't think some people understand what type of patients/family members we are nicely referring to as "difficult." These are people whom we encounter first thing in the morning. We go in, all friendly, trying to help and get ATTACKED. There is NO PLEASING these people. That's what we're talking about.

Unfortunately, these more and more frequentl episodes are ruining it for the nice families that want to visit their loved ones. You might want to get the word out to families and patients to think about the poor nurse who is taking your abuse and how it will probably affect visiting hours.

ADPIE1 · Jun 4, 2011

I have been the one on both sides of the call bell...

I have had nurses that wouldn't answer a call bell for 15 plus min... on a man that couldn't breath... I have been the one trying to answer 3 call bells at the same time.

When you are the one there with your love one in the hospital... that cannot speak up for themselves, and the doctors rush in and rush out .. and the nurse comes in with the " going to do what I need to do and only that " attitude it is hard to sit and watch. I came to pick up my grandfather ... he was being discharged... they had let him lay in bed for 5 days... not even getting him up to go to the bathroom.. .and when I got there... he and the bed he was in was SOAKED... you would not have liked to be any of the nurses on the floor that day...

But I have also been the one that the family members thinks should be waiting on "them" and not the other clients.....

go figure...