Difficult to please patients and families

[McGyverRN]

I just wanted to pick your brains on this subject. I work on a very busy medical unit. Our patient population is comprised of many elderly and noncompliant patients. It seems that family members and patients are becoming increasingly more difficult to please as each year passes. It seems the more noncompliant a patient is, the more they expect us to "fix" them with very little effort on their part. The family members are sometimes the worst to deal with. They can be so demanding and inconsiderate of the nurses' time. They are very critical of the nursing staff and that we "aren't doing enough." We try our hardest. Recently one of nurses answered her patient's call bell and the family member stated " you need to get off of your butt and take care of my family member." That statement was totally out of line. Our butts see very little chair time. I wonder what these people think we are doing when they can see us running our tails off.

Another nurse was told by a family member that having a 6 patient assignment (on a day shift) was not a lot. Most of these patients are either complete care or confused and need constant redirection. We have only one nurse's aid (if we're lucky, two) for the entire 27 bed unit.

It's ironic that the public is becoming more informed about medical care and their rights but are less compliant and so oblivious to what nurses need to do in the course of the day.

Does anyone else see this happening in their facility?

[thumperRN]

It seems the more noncompliant a patient is, the more they expect us to "fix" them with very little effort on their part. The family members are sometimes the worst to deal with. They can be so demanding and inconsiderate of the nurses' time. They are very critical of the nursing staff and that we "aren't doing enough." Does anyone else see this happening in their facility?

Yes!!! I see this all the time!! I have tried to get more proactive instead of just taking it!! If patients think they can walk all over me, they are wrong. I let them know from the start that I am willing and capable of giving them the care they need and deserve, but I expect them to help themselves as well - it's the only way they are going to be able to make it at home when they are discharged. I am not about to give a person a bath who is capable of bathing themselves!! I will get them all the necesarry supplies they need, and will help them with their backs, but I'm not going to to do it all for them. (there are always exceptions) I do not work in a Hotel, and I won't pretend that the hospital I work in is. As for the families, if they are going to be directly involved with the patient's care when they leave, they can be involved with the care while they are in the hospital. I'm not going to have them pass meds, but they can don a pair of gloves and experience a dressing change. Especially if they are gonna be in charge of it at home. I have had it with some of the all-deserving, wait on me hand and foot attitudes that come crashing through the doors. I have found that you end up neglecting the patients who really need you because your trying to pander to the the whiners. Boy, this probably makes me sound sooo uncaring as a nurse, and I assure you I'm not, it justs frustrates me to no end and is one of my BIGGEST pet peeves!!! :argue: :angryfire :angryfire :angryfire

[Pepper The Cat, BSN, RN]

YES YES YES! Some people are impossible to please and expect miracles! I had one family member strip a freshly made bed because she did't like the colour of the spread! I work in a rehab unit - we have people come in for a knee replacement who expect us to cure everything else at the same time - ie while I'm here, I'd like CT scan, my liver checked, my eyes examined, etc etc etc. One family kept insisted that their mother was turning "jaundice" and we should keep her another 2 weeks to investigate. MD said NO.

Times have changed- patients used to appreciative of things, now there seems there is no pleaseing them!

[McGyverRN]

Thank you for your response. I can so identify with your "coping" skills. I am much the same way. There are times when I dread going into a room where I know there is a demanding, PIA family member just waiting behind the curtain to pounce on me. If only they knew that their loved one would get better care if they would just sit down and shut up!!! ( I'd actually be happier if they'd just leave!! lol) And, that they would be more likely to get information if they would ask for it politely rather than approaching me with the " I deserve this" attitude. For those people, HIPPA becomes my "I only live by this" bible. Also, I am sick and tired of these people asking me "when is the doctor coming in?"

[thumperRN]

Times have changed- patients used to appreciative of things, now there seems there is no pleaseing them!

Precisely!! There was a retired nurse that came to visit a pt of mine one time, and she said almost exactly what you just said. She said that she couldn't believe some the behaviors that pt's and families exhibited to nurses and doctors. She was appalled and said that people were much more respectful AND compliant when she was still practicing. She said though, that nurses weren't "run to death" when she was a nurse. She said that she only would have 4 patients a day, and most were independent. She said she was able to do so much teaching and spend time getting to know the pt and family. Wish that were the case today. People are so rude anymore. Oh, for the good ol days.

[McGyverRN]

Thumper--Thank you for your response. I can so identify with your "coping" skills. I am much the same way. There are times when I dread going into a room where I know there is a demanding, PIA family member just waiting behind the curtain to pounce on me. If only they knew that their loved one would get better care if they would just sit down and shut up!!! ( I'd actually be happier if they'd just leave!! lol) And, that they would be more likely to get information if they would ask for it politely rather than approaching me with the " I deserve this" attitude. For those people, HIPPA becomes my "I only live by this" bible. Also, I am sick and tired of these people asking me "when is the doctor coming in?"

[McGyverRN]

YES YES YES! Some people are impossible to please and expect miracles! I had one family member strip a freshly made bed because she did't like the colour of the spread! I work in a rehab unit - we have people come in for a knee replacement who expect us to cure everything else at the same time - ie while I'm here, I'd like CT scan, my liver checked, my eyes examined, etc etc etc. One family kept insisted that their mother was turning "jaundice" and we should keep her another 2 weeks to investigate. MD said NO.

Times have changed- patients used to appreciative of things, now there seems there is no pleaseing them!

Yeah, It happens all the time. When a pt is ready for discharge and the family tries to find something wrong to keep them in the hospital. When a dementia patient (who is of course, more confused in the hospital) is ready for discharge, the family objects because "but she's so much more confused than when she came in."

Another one is when they try to squeeze in the podiatry consult to cut toenails that haven't been cut in years. "she can't go home with toenails in that condition" Thankfully, many docs will refuse to give in. But many more subcomb.

[thumperRN]

When a dementia patient (who is of course, more confused in the hospital) is ready for discharge, the family objects because "but she's so much more confused than when she came in."

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Ain't it the truth!! Families do that constantly!! Especially the ones who care for the person in their home. They treat the hospital like a babysitting service so they can go on vacation for a week. I know some people can get overwhelmed, but come on!! This is not daycare!! :selfbonk:

[meownsmile, BSN, RN]

I see it more and more too. Its a direct result of the publicity that surrounds hospitals and malpractice and all they press they have given "patient rights" etc over the last couple years. Only problem is, all they are hearing is "i have the right" which in most people's book means "my way or the highway". That said,, it leaves us nurses to be viewed as "public servants" instead of "health care partners" and we are treated as such.

I by no means mean to hijack this thread, but in my book its not really the patient or families fault. Its the press and the hosptial administrations either sending the WRONG message and/or ALLOWING the wrong message to be recieved .

[McGyverRN]

Thumper --If I didn't know you lived in the show me state, I would think you worked with me at my facility!!!! So many times I have been the victim of the "Dump and Run" admission. They don't even stick around long enough to answer the admission questions.

Also, like we discussed before, the public is more informed about their rights, but have no idea what their RESPOSNIBILITIES are. They don't even know that they should bring a current med list with them.

[StNeotser, ASN, RN]

Yes it's happening in mine too and the only way to solve the problem is to have more staff. It's not going to happen. Luckily I work night shift so see less of the families than day shift.

What bothers me the most is how families want so much input into their parents care (which is fair enough) but want us to do things their way which clearly do not work. I'm sure that their parents do not do certain things when they are around but they do things with us because we do not always have round the clock sitters.

One I'm frequently being asked about is non medication ways of getting Mom to sleep or not to sundown or not to try to walk by themselves. I cannot rock Mom to sleep if she sundowns. One family that refused their dad to have a bed alarm saying that the only reason we wanted it is because we didn't answer his light now have a dad with a broken hip. The trouble was he didn't always remember to use his call light and we were about to get a sitter for him. He really wasn't very confused, just would wake in the middle of the night and forget to ask for help.

There isn't really a solution other than having more staff around. Can an older nurse tell me that there was a time when some families didn't behave like this?

Some families by the way are wonderful and I too feel we neglect the quieter patients for the squeaky wheels.

[thumperRN]

Thumper --If I didn't know you lived in the show me state, I would think you worked with me at my facility!!!! So many times I have been the victim of the "Dump and Run" admission. They don't even stick around long enough to answer the admission questions.

Also, like we discussed before, the public is more informed about their rights, but have no idea what their RESPOSNIBILITIES are. They don't even know that they should bring a current med list with them.

You are so right!! Boy, we are gonna make the best patients, aren't we Mcgyver?! That's not always true - nurses can sometimes make very bad pts (lol). I guess it just goes to show that sometimes you make it to the commode and then sometimes you ARE the commode. :rotfl: