Do patients/families that are hostile, rude affect your morale?

Nurses General Nursing

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Do patients and families affect your morale? Have you encountered situations which left you feeling demoralized, insecure or denigrated? For example, how many of you have had family members write down everything you do, from the moment you come in to the room? Do you feel harassed? Are there resources available to you such as debriefing programs, one on one counseling, unit meetings or managerial back up? Does the nursing staff provide support for one another? Or do you just "suck it up", being that the "customer is always right" ? Have you left a facility due to these type of experiences? Do you think this is a problem in the nursing profession?

I have to agree that families can make our jobs difficult, if not impossible at times. I used to work nights so I wouldn't have to deal with families very often. Unfortunately, the ICU I worked in had open visiting hours and we would have families in/out all night long, at the bed side of the comatose patient, shaking them and yelling, "Speak to me! Wake up! Open your eyes!" I used to explain to the families that the best thing for the patient at this time was rest (okay, so I was simplifying things) and that they could visit only if they didn't disturb the patient - and all the others on the unit in the process. I would further explain that they wouldn't wake up someone with the flu at 2 am, which is relatively minor compared to being in the ICU, and this would put things in perspective.

Families are getting very abusive and demanding. And management/corporate don't give a damn b/c they aren't at the bedside dealing with these people 24/7. They just think it's great "customer service" to have "family-centered" care. It's a great marketing tool. (Wonder how they'd feel about it if they had to deal with the abuse and BS on a daily basis?!) I understand that it is a trying time for families to have a loved one in the ICU, but treating your nurses poorly isn't going to help anyone. And I've noticed that when families are allowed at the bedside continuously they become more and more demanding and seem to think that their loved one is the only patient in the unit. And, if the patient is awake and alert, they tend to adopt a helpless/whiney attitude. I had a patient the other day whose family was allowed to stay at the bedside 24/7 (wouldn't even leave for report/rounds - despite being told this was a HIPPA violation. Not sure what managment is going to do about that.) The patient was relatively stable and just awaiting surgery for c-spine stabilization. My other patient, however, was sick as snot. She was on multiple drips, with BP and ICP issues. I also had a nursing student that day (and I remember what it was like to be a student so I like to teach them and help them get a positive ICU experience). My 2 patients were side by side - family could see me working my butt off on the other patients, but they were still pretty demanding. They even had the stones to complain b/c I hadn't yet changed a dressing covering some minor abrasions. They were sure it was "infected" because it had been on for 2 days. (It wasn't dated so I have no idea how long it was there, but it wasn't infected. They were seeing the xeroform under the gauze.) I was so fed up at that point with their constant questioning of everything I was doing and constantly telling me the patient was in pain (visions of Shirley McClain in 'Terms of Endearment') even when he would deny it that I just wanted to ask where they had gotten their nursing degrees. I didn't, I managed to keep my cool. But I was sooooo ready to leave at the end of that shift.

I don't have the solution to this problem. But I do agree that managment needs to stick up for the nurses. And I don't think that families should be allowed at the bedside 24/7 in the ICU. That is usually the beginning of a very long journey for the patient. If the families are at the bedside constantly, wearing themselves and the patient out, who is going to care for the patient when they get home? The families should be updated to help ease their fears/worries, but they need to also take care of themselves. I don't agree with "family-centered" care - but that's just my opinion. The day they are allowed in the OR is the day I leave nursing forever - and I am unanimous in that!!! (Wonder if anyone will get that random bit of BBC humor...)

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Yes, it does. I go home and wonder if I'm picking the right career. Right now I'm choosing between nursing and criminal justice - crime scene investigator. I joke with my mom that the dead don't b****. Not too long ago I walked out of a patient's room crying because she had degraded me because I did not know the breed of dog of Toto.

I may get flamed for this but I have noticed that fellow nurses and aides who visit family members can be hostile. Just last weekend I encountered one. Family member (an aide that did not work there) wanted a new bed for her grandma. I immediately stopped what I was doing and brought in a new bed. Not fast enough. Got yelled at and then the granddaughter proceeded to help me bring the bed into the room. I explained to her that I couldn't let her do that for liability reasons. She yelled "everyone else let's me do it." I replied that I wasn't everyone else and I wasn't going to allow it. Also, she wanted her BP taken and I explained the liability issue again. I guess I must be a stickler for rules. Sure, sometimes you have to break them but I'm not losing my certification as an aide for her.

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I don't have the solution to this problem. But I do agree that managment needs to stick up for the nurses. And I don't think that families should be allowed at the bedside 24/7 in the ICU. That is usually the beginning of a very long journey for the patient. If the families are at the bedside constantly, wearing themselves and the patient out, who is going to care for the patient when they get home?

Yes, the real problem is knowing that nobody gives a damn when you're getting abused. After having a real time of it with a retired doctor and his really nasty wife, the nurse manager says to me, "It must have been the way you presented yourself." It's so ironic that nurses give one hundred percent, and I suspect it's just the nature of people who go into nursing. I really feel sorry for people who are so mean, but it's pretty hard to not be affected by it.

Diahni

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I have to agree that families can make our jobs difficult, if not impossible at times. I used to work nights so I wouldn't have to deal with families very often. Unfortunately, the ICU I worked in had open visiting hours and we would have families in/out all night long, at the bed side of the comatose patient, shaking them and yelling, "Speak to me! Wake up! Open your eyes!" I used to explain to the families that the best thing for the patient at this time was rest (okay, so I was simplifying things) and that they could visit only if they didn't disturb the patient - and all the others on the unit in the process. I would further explain that they wouldn't wake up someone with the flu at 2 am, which is relatively minor compared to being in the ICU, and this would put things in perspective.

Families are getting very abusive and demanding. And management/corporate don't give a damn b/c they aren't at the bedside dealing with these people 24/7. They just think it's great "customer service" to have "family-centered" care. It's a great marketing tool. (Wonder how they'd feel about it if they had to deal with the abuse and BS on a daily basis?!) I understand that it is a trying time for families to have a loved one in the ICU, but treating your nurses poorly isn't going to help anyone. And I've noticed that when families are allowed at the bedside continuously they become more and more demanding and seem to think that their loved one is the only patient in the unit. And, if the patient is awake and alert, they tend to adopt a helpless/whiney attitude. I had a patient the other day whose family was allowed to stay at the bedside 24/7 (wouldn't even leave for report/rounds - despite being told this was a HIPPA violation. Not sure what managment is going to do about that.) The patient was relatively stable and just awaiting surgery for c-spine stabilization. My other patient, however, was sick as snot. She was on multiple drips, with BP and ICP issues. I also had a nursing student that day (and I remember what it was like to be a student so I like to teach them and help them get a positive ICU experience). My 2 patients were side by side - family could see me working my butt off on the other patients, but they were still pretty demanding. They even had the stones to complain b/c I hadn't yet changed a dressing covering some minor abrasions. They were sure it was "infected" because it had been on for 2 days. (It wasn't dated so I have no idea how long it was there, but it wasn't infected. They were seeing the xeroform under the gauze.) I was so fed up at that point with their constant questioning of everything I was doing and constantly telling me the patient was in pain (visions of Shirley McClain in 'Terms of Endearment') even when he would deny it that I just wanted to ask where they had gotten their nursing degrees. I didn't, I managed to keep my cool. But I was sooooo ready to leave at the end of that shift.

I don't have the solution to this problem. But I do agree that managment needs to stick up for the nurses. And I don't think that families should be allowed at the bedside 24/7 in the ICU. That is usually the beginning of a very long journey for the patient. If the families are at the bedside constantly, wearing themselves and the patient out, who is going to care for the patient when they get home? The families should be updated to help ease their fears/worries, but they need to also take care of themselves. I don't agree with "family-centered" care - but that's just my opinion. The day they are allowed in the OR is the day I leave nursing forever - and I am unanimous in that!!! (Wonder if anyone will get that random bit of BBC humor...)

AMEN!! I can't tell you how many times I have asked a family member to leave so I can bathe a pt. Who really wants to see their grandpa's member? I also hate when I answer a call light, ask the pt what he/she needs and the family jumps in. "Mom is in pain." Well, mom can speak for herself and it's up to her if she wants pain medicine. And I love the family members of the fresh surgery patient who come running up to me complaining that dear dad won't wake up. If you had been knocked out with enough drugs to kill an elephant you'd want to sleep too.

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I agree - sometimes the worst families are those in the medical field. I had a patient's daughter complain b/c I made her put on gown/gloves to enter an isolation room. She said that no one had made her do it the day before and that she lives with the patient so she wasn't worried about the infection. I told her that she might live with the patient, but the rest of the patients on the unit did NOT and we wanted to keep the infection contained. After she was in the room (properly gowned/gloved) she kept questioning everything I was doing and remarked that she didn't know how long I had been a nurse, but SHE had been one for 25 years. I wanted to say, "You're a nurse and you were arguing with me about infection control?!" Jeez...

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I work in a community hospital with a 6-8 bed ICU. Our facility serves a primarily Hispanic community.

God help me, but I am becoming intolerant of cultural norms.

Every family seems to have at least 10 members who INSIST on being in the hospital at all times, and since our waiting room is so small, obviously they spill over into the halls and other areas. They also seem to have no problem with being in the hospital all day and night with REALLY young children, and ignore our suggestions that a germ laden hospital is the least desirous place for a youngster without a fully developed immune system. It sometimes seems I spend more time answering the waiting room phone and screening visitors than I do with my patients! And EVERYONE wants all the updates, no matter how often I cite HIPPAA polcy.

Of course, we have posted visiting hours which are ignored by families and

interpretated differtently by every staff member.

And the "visitors" really seem to do nothing but stand at the bedside and stare at the patient, ask intrusive questions; put on the light and are all concerned about why the "machine" is making that noise or want to know why the doctor has'nt been in yet.

AND are totally put out because I don't speak much Spanish.

I'm just tired tonight..

Cate

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And the "visitors" really seem to do nothing but stand at the bedside and stare at the patient, ask intrusive questions; put on the light and are all concerned about why the "machine" is making that noise or want to know why the doctor has'nt been in yet.

Cate

I feel your pain, sista! And WHY is it that they only ever want info from the docs - who spend mere minutes with the patients and usually paint an ridiculously positive picture (who cares if that's brain matter coming out of the ear) instead of being a little more realistic?! But the nurses, who are at the bedside in 12 hour blocks, aren't viewed as competent professionals capable of giving updates/information.

Don't get me wrong - I love being a nurse, I love being at the bedside, and I really don't mind dealing with families (in very short interactions).

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AMEN!! I can't tell you how many times I have asked a family member to leave so I can bathe a pt. Who really wants to see their grandpa's member? I also hate when I answer a call light, ask the pt what he/she needs and the family jumps in. "Mom is in pain." Well, mom can speak for herself and it's up to her if she wants pain medicine. And I love the family members of the fresh surgery patient who come running up to me complaining that dear dad won't wake up. If you had been knocked out with enough drugs to kill an elephant you'd want to sleep too.

I think anybody who gets through nursing school knows that patients and their families can be a real pain. But we all need support when these things happen, and this is where the trouble begins. As somebody with one more year of school before taking the NCLEX, I'm dismayed at the lack of support I have received from both clinical teachers and nurses around me. Does anybody have any ideas about how to create a more supportive work environment? Not to sound arrogant, but nursing is God's Work - it's an important job, but it is very discouraging to feel there's no respect or appreciation for what we do. Much of the tales we've told has to do with a general breakdown of civility in our culture. I've been on the other side of bed, when a guy came in to change the wastebasket when my mother was actively dying. I yelled at him to get out of the room - he was just doing his job, but it seemed so invasive and rude to be making a bunch of noise while we were watching my mother die. Perhaps the same lack of appreciation can be said for teachers, and I understand it's getting worse with demanding parents. Does it sound silly to say we need some "bonding" workshops to appreciate we're all in this together?

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As much as Florence Nightingale did for nursing, she also was a big part in setting the tone for nurses to be treated this way. She could be unmerciful to her nurses. Read some of her writings.

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As much as Florence Nightingale did for nursing, she also was a big part in setting the tone for nurses to be treated this way. She could be unmerciful to her nurses. Read some of her writings.

At least these days, we have lots of options. If you can't take the heat (mea culpa!) there are other options, Thank God!

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Specializes in med-surg.

I'm only in my second year of nursing school and I haven't come across any really rude family members yet. Although, I do have a lot of experience serving, and I know that customers often take out their frustrations on the server... if everything isn't perfect. I imagine it's the same situation with nurses. However, as a waitress I had to put up with abuse or be fired. Can nurses stand up to rude familiy members and demand respect, or do they have to take the abuse?

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Specializes in OR.

Feeling very lucky that in the OR, my patients are unconscious and the families are in the waiting room. Don't know how the nurses on the floors deal with some of these people. As far as I'm concerned, you deserve medals. I would get written up my first week on the floor for telling them where to stick it!;)

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