Difficult Patient/Family

Ruby Vee, BSN · Apr 18, 2017

Ok, so I'm new to this forum and I've had a pickle of an issue on my mind regarding a "fabricated" parent complaint about me (and every other nurse that came in contact with the patient) and I don't know how to shut off so I can actually live my life, not my work, at home. I need some nurse wisdom out there to help me not feel like going above and beyond to provide best care was for nothing.
The short of the story is I was assigned a patient that nurses caring for them warned me in advance that the mom was extremely difficult to the point that security had been called and the house supervisor was going to be on her way to talk to her once they got to my floor. So I already knew I needed to up the level of attention I needed to show this family so that they "hopefully" didn't feel anymore animosity once they got to the floor. Well, fat chance. The mom was very aggressive and kept making phone calls on her cell telling people how she was never bringing her child back here again, etc etc...all the while, I'm trying to get admission questions and education done in between calls. I kept taking deep breathes and when I finished, the HS arrived and had taken mom in the hallway to speak with her to help resolve the situation. The issues were pretty typical that most nurses have to deal with (such as ER wait times), but I won't go into all the other things that made her mad because that is not the point here.
That night I had made sure to check up on the patient more frequently even though they were very comfortable and in no pain, but I didn't want the mom to think someone else was not paying attention. I even found her something to eat and brought extra blankets and found a recliner in another room so that she could sit next to the patient instead of on the parent sofa. I know...overboard...but I was trying to recover the impression she had even though I have no doubt my coworkers did everything they were supposed to do, she was just one of those unable to please types. I made sure the patient had PRN medication so that they were not in pain and everything was fine.
When I came in the next day, the previous nurse had said the patient was supposed to go home but the mom wanted to wait until later in the shift. Fine by me...gives me
more time to get other things done. But it was while I was in the middle of getting report on my last patient (at the bedside) that this mom came and found me and told me as I exited this patient's room that they wanted to leave now! I was taken back by her behavior and told her very nicely that I was in the middle of report talking about other patients and that I would be around to go over the discharge once I've seen everyone.
O...M...Gosh!!! Was that so totally out of the question. The mom was already mad that the doc wouldn't give her a script of a certain medication for the patient and I apparently nailed the coffin shut by telling her to wait in her room so that other patients had their privacy. When I did eventually get there (and I'm talking less than 10 minutes) she asked that I bring one more dose of the medication she couldn't get a script for because they had a long drive and I told her the patient would need to wait at least an hour after it was given to make sure there were no unexpected side effects. So med was given and I sent mom down to pick up a different script at the hospital retail pharmacy and when it was all said and done, I had helped get the patient dressed and into the wheelchair, offered to help carry anything since it was just her and the grandmother, and I helped them to their vehicle.
***Side note, only 2 nurses and a charge working the unit because of census, no assistant or secretary available. I'd asked the mom and grandmother to bring the car around before leaving the room so that I wasn't leaving only 2 nurses on the unit. When I escorted everyone outside, there was no car and it took 25 minutes for grandmother to get her vehicle first and then the mom another 10 minutes to get hers before the patient was transferred to the car and they were on their way....I even got a thank you.
So I get a call from my manager a few days ago (I've been off for 4 days!!!) and she asks me about this patient and tells me that risk management is involved because of a complaint that the mom made about me. I'm thinking...here we go.
Her complaint was that I had given the patient a medication and told her that they wouldn't be allowed to leave and had to stay an extra night. She also said that I "appeared" like I had made some mistake and that the medication I gave made them very in and out and that she felt that medication was meant for a different patient with the last name *******, even though they were getting this medication throughout their stay without any problems. I made sure they stayed an hour (almost two because of tending to other patients) and they were very with it and snap chatting when I helped them to the car. She said I was "shaking" the entire time I was waiting for them to get their vehicles and she felt I made a serious error. What boggled me about this was the fact that she was able to use a different patient's name which really concerned me because I'm very tight lipped about saying any name anywhere except to those that need to know...I usually only say the room number. But then I realized after talking with my manager that the name she used was the same name of the patient in the room she was standing outside of when she demanded they be discharged and I asked her to return to her room. Last names/doctors names are on all the door signs.
And so here I am now attempting to twist my own head off because of how hateful this mom was to everyone and how I thought I could turn things around and then have her make a false complaint on me that has me so nauseous I can hardly eat. I know my manager understands what happened and I'm sure she has talked with the other nurses that were involved in this patients care, but the actual thought that someone would take the time try and get someone in serious trouble for no reason just blows me away. Anyone can say that I was rude or didn't do the best I could for them and I'll dust that off my shoulders no problem. But to go as far as lying that I breached patient confidentiality, administered a wrong med (that had to be consigned by another nurse btw), and claim they couldn't leave and had to stay an extra night despite doctors orders, that is just distasteful, immature, and in some hospitals would lead to serious consequences for the nurse if their own management team was not as diligent in investigating and only pleasing. That can cost a nurse their job!!!
So I'm left NOT wanting to go back to work for the next 3 days because of how far this mom has gone and how awful she had made me feel. It seriously makes me not want to go the extra mile anymore for difficult patients because the taste left in my mouth tells me it won't matter.
I know I'm not the only one that has experienced something like this and so I need to know how to overcome this perception I'm developing. I want to grow as a nurse, not sit stagnant and bitter because of mean people.
What would you do? How could I have handled this better? Was there a positive ending to this or was it just the way the cards were dealt? Any suggestions or feedback would be appreciated.
Miserable and hungry

Oh, Goodness! You're not the only nurse to have experienced this. Fortunately, your manager understands that the complaint was bogus because this family was just toxic. Count yourself VERY lucky there -- I've had managers that take the family's word over the nurse's even knowing that the family has issues with behavior, manipulation, "alternate facts", etc. There will always be mean people out there; many of them will be your patients or their families. You cannot please everyone, no matter how great your customer service skills. Instead, devote your energy to pleasing those folks who CAN be pleased and just do the best you can with the time/resources you have available for those who will NOT be pleased no matter what. And then tell yourself that you did the best you could; the problem lies with THEM, not you. (My special technique is to think to myself what a great story this will be in six months or two years when I can laugh at it. Laughing is the BEST way to deal with those folks, not that you let them know you're laughing.)

You didn't ask for stories, but I'll bet that our members can give you stories that will make your hair stand on end and make you grateful that you had YOUR family issues instead of THEIRS.

Two stories of mine come to mind:

Years ago, I was working in CTICU and one of our long term patients had just been approved for a heart transplant. Everyone was so excited -- she'd had repeated admissions and readmissions and we all knew her well. I went to the hairdresser that day (I was off work and hadn't heard about the transplant) and the hairdresser (who who was a close friend of the patient's mother or sister-in-law or some such) knew where I worked and was sharing all the details of the patient's heart transplant: where she was and what she was doing when she got the call, how many of her family members were in the waiting room, etc. Details such as the name of the nurse who was prepping her for surgery, which resident was writing the orders -- all very specific (and HIPAA protected) information. I participated to the extend of "Uh huh," and "That's great" and "I really don't think I should be discussing this." I didn't share any information with the hairdresser because I didn't HAVE any information. I wasn't at work that day.

The next day, I was called into my boss's office to discuss my continued employment and possible risk management issues. It seems that the boss used the same hairdresser, had stopped in for a cut after work and had seen me pulling out of their parking lot in my car when she was pulling in. The hairdresser was just as chatty with my boss -- and my boss thought *I* had given her all the details. In fact, she was so convinced that she wouldn't listen to me when I tried to tell her that I wasn't even at work and didn't KNOW any details. She was in the midst of firing me when another nurse, a close friend of the manager, called the manager's office to tell her that someone in the family was sharing too much information with the hairdresser, among whose clients were hospital administrators and physicians. And nurses.

And here's another one:

I was standing outside my patient's room adding up the I & O when the assistant nurse manager walked by and said something to the effect of "Have you seen General Hospital this week? Is Robin really going to be HIV +?" So we stood there and chatted for a few minutes about Robin's possible HIV status, where the storyline was going, and whether any of the actors involved had elected not to renew their contracts." The assistant manager walked on, and I went back to my totals. Suddenly the patient's wife burst out of the room, race-walked past me and went straight to the waiting room. I thought that was odd, but OK. A few minutes later, ANOTHER patient's wife came out of the waiting room to visit her husband, saw me, and stalked on over saying "I can't BELIEVE you would discuss a patient's HIV status right out in the open!" She didn't believe me when I told her we were discussing General Hospital, which ironically was on TV in the room I was standing outside of. Meanwhile, the first patient's wife had gone straight to my nurse manager who, unlike YOUR nurse manager, didn't believe me either. Finally, she said "I'll see what Tricia has to say about this." Tricia being the Assistant Nurse manager I had been talking to. Tricia backed me up, which resulted in the manager deciding it was funny. She went to talk to the patients' wives. They didn't believe her, and for as long as those two chronic (stays of 6 months to a year) patients were there, their wives HATED me. Wouldn't speak to me, wouldn't look at me, asked that I not take care of the patients, and shared their dislike with every new family who took root in the waiting room. It was a YEAR before I was finally rid of the toxic results of that innocent conversation!

You're not the only one, and hopefully more members will see your thread and share their stories. Some of them will make you laugh!

serenity1 · Apr 19, 2017

You did everything you could have to make this patient/family happy and provided excellent care. At the end of the day, that is all we can do. We cannot control other people. Thankfully, your manager knows you did your best and that the mom was lying. It just sucks because that mom is going on with her miserable life thinking nothing of what could have happened to you and your career, and you are dreading going back to work. It has been my experience that when I bend over backwards for someone like that, the outcome is positive. Now and then there are just those people that cannot be pleased and want to make everyone suffer. I hope you feel better. I would love to have you as my child's nurse. :)

Pediatric Critical Care Columnist · Apr 19, 2017

Toxic people are toxic people. They don't care who is hurt by their behaviour and often can't even separate truth from fiction. Quite a few years ago now I was assigned to care for a toddler with a congenital cardiac defect who had suffered a cardiac arrest on the ward and had also stroked. At the time I was assigned to her she was on ECMO and her future was uncertain. Her mother had been reminded multiple times to be very careful around the ECMO circuit; she would lean on the bed and at times also lean on the blood-filled circuit, or she'd pick the circuit up and move it around. The ECMO specialist in the room with me cautioned her early in the shift that she needed to be more careful around the bed. Later on in the morning the mom and I were chatting about what could happen next for the little girl. I gave her my standard pep talk about children and expectations. The way I phrased it was, "Kids want to please. The more we expect from them the more they achieve. Ask for the moon, and they'll try their darnedest to get if for you. But if you expect nothing, you'll probably get nothing." After lunch, the mom again was handling the ECMO circuit and caused the flows to drop significantly. The ECMO specialist told her to leave the circuit alone, unless she wanted to harm her child. She moved away from the bed and shortly after that she left the room. About an hour later I was called to the patient care manager's office where I was asked why I told the patient's mother that looking after her child was a waste of my time. Now, my patient care manager KNEW very well that I have a brain-injured child of my own and that I would never say any such thing. But she was quite prepared to believe this mother's version of what I said over mine and that I would not be assigned to that patient again. Fine with me! The ECMO specialist was also summoned to the office and was likewise removed from the case. The child eventually went home and we've never seen them again. (Sidebar: I had a few more run-ins with that PCM over the next couple of years for totally bogus reasons, but was vindicated when she was fired unceremoniously. The ECMO specialist and I are still there.) Moral of the story - don't take this incident too seriously. As long as there are other people who have been on the receiving end from parents like that you'll always have back-up.

JayneC84 · Apr 19, 2017

Wow, how awful for you that you had to deal with a manager that didn't support you. I'm so sorry for that. Thank you for sharing. My manager is very new to her role and I'm hoping that she takes the right steps to resolve the situation. The support from here does make me feel less anxious about it all though, but I still haven't heard the outcome. Trying to stay positive until I do.

JayneC84 · Apr 19, 2017

I would love to have you as my child's nurse. :)

You are so sweet and gave me exactly the boost I needed to keep trucking along. God Bless you!!!

Zyprexa · Apr 20, 2017

You sound like an excellent nurse. I could never work in pediatrics, thank you for what you do!

JustBeachyNurse, LPN · Apr 20, 2017

In your favor, you said it was a drug that required verification from a second nurse.

This one parent went bonkers. At first the director did as she is required call me in for a meeting, however by the time she called and I arrived the story had turned into such outlandish bs claims that even the non-clinical director knew she was full of it and making crap up as she went along. She took every problem, mistakes she made, and started blaming me even if I wasn't there for 3+ days!

Finally2008 · Apr 28, 2017

I don't work in the hospital, but I'm a school nurse. In cases like this, there are some parents who are not going to be happy, no matter what you do. I was told something very important when I first started working in the school setting after my first episode of a parent screaming at me---my principal told me, "Don't take it personally. This is just where some people live." Essentially, some people appear to love living in a state of aggression, anger, and lies. Chin up! Go back to work and remember why you went into this profession! Good luck!

MHDNURSE · May 9, 2017

That mom sounds like she has Borderline Personality Disorder or at least some similar mental illness. I feel for her child.

Crystal-Wings, LVN · Jan 17, 2018

Right?! Poor kid!

I'm so sorry you are going through this OP! You sound like an excellent nurse.