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Families from Hell

Nurses   (22,513 Views 149 Comments)
by traumamomtx30 traumamomtx30 (New) New

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You are reading page 8 of Families from Hell. If you want to start from the beginning Go to First Page.

woody62 has 27 years experience as a RN and specializes in icu, er, transplant, case management, ps.

928 Posts; 5,188 Profile Views

Your post gives me pause Woody, and shames me actually. I've been complaining alot recently--maybe these few days off will help.

I hope that they will. I understand that there are some patients and some families that can really get on staff nerves. But I thought that all the eduation we received was aimed at long past our irritation and trying to figure out how to help the patient, how to help the families. Perhaps I am old fashion but I was taught that I had to not only meet the patient's needs but their families as well. One would be surprised, if you look beyond your own irritation and see what is really brothering the patient, really brothering the family, you can see the problem. And most of the time it can be fixed. And by fixing it, you get the family on your side.

Enjoy your days off.

Woody:balloons:

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286 Posts; 4,571 Profile Views

And I think back, on the three months I spent in the hospital after being hit by a big rig, back in 1989. I remember the nursing staff answering my call bell promptly. Giving me my pain medication. Washing the blood out of my hair. Helping me get out of bed, even with a long leg cast and an arm cast. Helping me every three days to get ready to go to the operating room. I often wonder what happen to those nurses. Then I remember, they were all about my age when I was hurt, more then likely they have retired. And a whole new generation has taken over nursing care. A generation that apparently views families as the enemy. And patients as only a step away from that classification.

But maybe it isn't nurses, or patients, who have changed so much as the health care culture. Nurses seem to have worse working conditions now than they did in the 1980s, and this impacts both nurses and patients/families for the worse.

Managed care and $-driven care has helped contribute to a vicious-cycle nursing shortage since then, and hospitals are being advertised as de facto Ritz Carlton's, while the pressures being placed on nurses make that kind of standard all the more difficult to live up to.

It's hard for nurses to really be nurses anymore, it seems.

Maybe the increasing patient-to-nurse ratios and patient acuity levels, increasing documentation requirements, and hospitals placing all kinds of pressures on nurses just makes for an impossible situation for all humans involved - nurses, patients, and families alike.

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6 Posts; 523 Profile Views

But maybe it isn't nurses, or patients, who have changed so much as the health care culture. Nurses seem to have worse working conditions now than they did in the 1980s, and this impacts both nurses and patients/families for the worse.

Managed care and $-driven care has helped contribute to a vicious-cycle nursing shortage since then, and hospitals are being advertised as de facto Ritz Carlton's, while the pressures being placed on nurses make that kind of standard all the more difficult to live up to.

It's hard for nurses to really be nurses anymore, it seems.

Maybe the increasing patient-to-nurse ratios and patient acuity levels, increasing documentation requirements, and hospitals placing all kinds of pressures on nurses just makes for an impossible situation for all humans involved - nurses, patients, and families alike.

I totally agree. I think that most (if not all) of us have an innate desire to help others. We truly want to help. That's why we went into nursing in the first place.

In nursing school, I took care of two patients at a time. Granted, we were just learning skills and medication names then... but I had time to sit down and talk to the patient... to understand their frustrations and see where they were coming from. When I graduated nursing school and started working in the ER, I tried my best to continue to check in constantly with my patients.

That didn't last long.

Unfortunately, when you've got 4-7 patients (depending on how the charge nurse feels that day or if it's a freakin MONDAY), you have a multitude of orders to carry out and tests to take the patient to. I have to find those tiny veins in nursing home patients and drug addicts. If I sat down and talked to family members the way I'd done in nursing school, nothing would be accomplished.

And even through increasing nursing-to-patient ratios, the hospital administration wants us to improve our patient care satisfaction ratings... Slavery with a smile. Wonderful, eh?

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jbp0529 specializes in CVICU, CCU, MICU, SICU, Transplant.

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Speaking of familes from hell... delt with one tonight.

Pt's wife is a physician on staff at my hospital (she works OBGYN and has little clue about ICU stuff and is not involved in her husband's care in our unit). Spoke with her on the phone several times tonight giving her general status updates. Boy was she a trip! Rude and demanding as could be. "What is his BP?!! Has he gotten his meds? Why didn't XYZ happen today!! Make sure ABC gets done!!" yada yada yada. Of course I remained as polite as I could be, but when she tried to ask for more specific details, I told her that her husband (the pt) would have to speak to her, or tell her the primary docs would have to give her more info. That pretty much shut her up, but still...just no appreciation for the care we are providing or understanding of our rules.

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woody62 has 27 years experience as a RN and specializes in icu, er, transplant, case management, ps.

928 Posts; 5,188 Profile Views

Speaking of familes from hell... delt with one tonight.

Pt's wife is a physician on staff at my hospital (she works OBGYN and has little clue about ICU stuff and is not involved in her husband's care in our unit). Spoke with her on the phone several times tonight giving her general status updates. Boy was she a trip! Rude and demanding as could be. "What is his BP?!! Has he gotten his meds? Why didn't XYZ happen today!! Make sure ABC gets done!!" yada yada yada. Of course I remained as polite as I could be, but when she tried to ask for more specific details, I told her that her husband (the pt) would have to speak to her, or tell her the primary docs would have to give her more info. That pretty much shut her up, but still...just no appreciation for the care we are providing or understanding of our rules.

I'm afraid I don't understand your 'rules'. His wife is his next of kin. I am assuming that when he was admitted, he was able to indicate this and authorize her to receive information, so I don't understand your providing her with the answers to her questions, rather then directing her back to her husband and/or his physicians. When I spent twenty-one days in ICU, back in July of 2006, I never talked to my daughter on the phone. And she had no problem getting updates from the staff taking care of me.

And I'm sorry but I am happy you were not my nurse. Your own attitude just very clearly demonstrates the lack of understanding in today's nurses, for the most part. It makes no difference that she was a physician herself, she was a member of his immediate family. And she was apparently suffering, as demonstrated by her attempts to take control of your actions. Instead of the yada, yada yada, perhaps a little understanding, on your part, would have gone a long way.

Woody:balloons:

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Ruby Vee has 40 years experience as a BSN and specializes in CCU, SICU, CVSICU, Precepting & Teaching.

11 Followers; 66 Articles; 13,948 Posts; 172,001 Profile Views

i find it amazing that so many nurses have such poor relationships with their patients and their families. i have yet to see anyone start a thread or post that a family has not been demanding or a patient has not been demanding. that a patient has been willing to wait, wait and wait, for someone to come into their room or answer their call light.

i have been a patient more times then i like to remember, in several different states, often with a roommate. i don't call the nurse unless i truly need something. nor have any of my roommates. i have waited and waited for pain medication, longer after it was due and not complained. i have waited for my blood glucose to be checked and to receive my insulin, all the while my meal is getting cold. and had a nurse come in, give me my insulin and leave. never asking me if my breakfast or lunch or dinner need to be warmed up. and i have had the same nurse come in a scold me because i couldn't eat a cold meal but forgetting that she never asked me if my meal needed to be reheated.

and i think back, on the three months i spent in the hospital after being hit by a big rig, back in 1989. i remember the nursing staff answering my call bell promptly. giving me my pain medication. washing the blood out of my hair. helping me get out of bed, even with a long leg cast and an arm cast. helping me every three days to get ready to go to the operating room. i often wonder what happen to those nurses. then i remember, they were all about my age when i was hurt, more then likely they have retired. and a whole new generation has taken over nursing care. a generation that apparently views families as the enemy. and patients as only a step away from that classification.

when i had a patient who was demanding, i often looked for the reason that the patient was demanding. was some how his/her needs were not being addressed or met? and instead of viewing the family as the enemy, i tried to enlist them to help me meet the needs of their relative. i didn't dismiss their concerns or worries. if they had them, i was taught it was my responsibility to figure out the problem and solve it. i was taught not to bring my problems to work.

but this is just my point of view.

woody:balloons:

first, this is a vent thread. we come here to vent.

 

second, i guess i'm wondering how long it's been since you were at the bedside. evidently, it's been awhile. nursing has changed since 1989. staffing has gotten tighter and tighter and nurses are asked to take over more and more duties that once belonged to the ancillary personnel we no longer seem to have. or have enough of. at the same time, patients and their families have become more self-centered and demanding, less polite and grateful. and it's all about customer service now, not about good, safe nursing care. i remember 1989, and it was the rare family member who sat at the bedside with a notebook, recording every name, every med and every vital sign and telling you up front that "if something happens, i'm gonna sue and your name is right here," tapping the notebook. unfortunately, that is no longer the case.

 

we no longer have the time to figure out why a patient (or a family) is being demanding and even if we did have, the reason is often merely that their parents never taught them how to behave in public. people seem to take their cues from tv dramas. the way to demonstrate that you really care about granny must be to throw fits, demand special favors and curse and scream at the nursing staff because that's now they do it on tv. the way to demonstrate grief must be to shriek like a banshee while tearing at one's clothes and hair because they saw it on "er." or take a swing at the doctor -- also seen on "er." and if one's husband is having a heart attack, by all means threaten to sue the staff -- just like on "general hospital." nevermind that these are dramas and expected to be dramatic.

 

i think we all went into nursing at least partially because we want to help people, but the nurses you knew in 1989 have been abused by patients and family members and sometimes we just need to vent. and that's what this is -- a vent thread. i find in unhelpful and unsupportive of your fellow nurses for you (or anyone) to come into a vent thread and tell us how awful we all are for having negative feelings about the families from hell. is that what you meant?

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HelenofOz has 23 years experience and specializes in Recovery (PACU)-11 yrs, General-13yrs.

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Maybe one of the reasons we are so angry and frustrated with the demanding and impatient patients and families is that while we are bending over backwards to answer them and see to their needs we are unable to give the care we should, and would if we could, give to the less demanding, patient, polite patients, who are often sicker than the ones that we are spending time with.

I have worked on wards where all the staff have been accommodating, gone the extra mile, and basically bent over backwards for a patient/family, only to have them write a letter full of complaints after discharge. Meanwhile the sick little old lady in the corner, who really does need as much help and attention as we can give her is unfailingly polite and appreciative, and then writes a beautiful letter thanking us all for looking after her. I always felt guilty about that as I knew she could have had more of my time, if only I wasn't pillow fluffing etc etc for the self important patient in the other room.

As they say-the squeaky wheel gets the most grease.

And why do we reward grown-ups who have temper tantrums, when we won't accept them in children?

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woody62 has 27 years experience as a RN and specializes in icu, er, transplant, case management, ps.

928 Posts; 5,188 Profile Views

first, this is a vent thread. we come here to vent.

second, i guess i'm wondering how long it's been since you were at the bedside. evidently, it's been awhile. nursing has changed since 1989. staffing has gotten tighter and tighter and nurses are asked to take over more and more duties that once belonged to the ancillary personnel we no longer seem to have. or have enough of. at the same time, patients and their families have become more self-centered and demanding, less polite and grateful. and it's all about customer service now, not about good, safe nursing care. i remember 1989, and it was the rare family member who sat at the bedside with a notebook, recording every name, every med and every vital sign and telling you up front that "if something happens, i'm gonna sue and your name is right here," tapping the notebook. unfortunately, that is no longer the case.

we no longer have the time to figure out why a patient (or a family) is being demanding and even if we did have, the reason is often merely that their parents never taught them how to behave in public. people seem to take their cues from tv dramas. the way to demonstrate that you really care about granny must be to throw fits, demand special favors and curse and scream at the nursing staff because that's now they do it on tv. the way to demonstrate grief must be to shriek like a banshee while tearing at one's clothes and hair because they saw it on "er." or take a swing at the doctor -- also seen on "er." and if one's husband is having a heart attack, by all means threaten to sue the staff -- just like on "general hospital." nevermind that these are dramas and expected to be dramatic.

i think we all went into nursing at least partially because we want to help people, but the nurses you knew in 1989 have been abused by patients and family members and sometimes we just need to vent. and that's what this is -- a vent thread. i find in unhelpful and unsupportive of your fellow nurses for you (or anyone) to come into a vent thread and tell us how awful we all are for having negative feelings about the families from hell. is that what you meant?

let me share something with you. in may of 1998 my eighty two year old father was admitted to the hospital with acute pancreatitis. he was also found to need surgery for gall stones. it was suppose to be a simple one hour procedure, done thru a lapscopy. after three hours, i asked the volunter to please find out what was going on with my father. she was unable to obtain any information from the or staff. i waited another hour then i went to the door of the or suite. i opened it and demanded, yes i demanded to speak to a supervisor. and if i was ignored, my next stop would be the administrator of the hospital. we finally learned that they had been unable to remove his gall bladder as planed and had to due an open exploratory procedure. i was willing to forgive and forget.

the next day i came to see my father. he was confused, in a great deal of pain and asking me to take him home. i went to the nurses station, to find out when he had last had pain medication. i was told he was on a self administrator pump. my father, confused, on a self administering pump. i asked that the surgeon be called and asked for a change in the manner in which his pain medication was administered. mind you, he had not had any medication since his time in the rr the evening before. i had to call the doctor myself and tell him what was happening. he had not yet gotten a call from the staff and i had waited thirty minutes before making my call. i also overhead the staff complaining about my father's daughter, who claimed she was an rn and was a real pain in the ass. since my father only had one daughter, they were talking about me. and i was a licensed nurse, here in sw florida, at the time.

you want to vent. let me vent about the poor care my father received. but you wouldn't like that would you.? i know what it is like to be on both sides. all i am pointing out, is a lot of the time, family members are under a great deal of strain. and rather then vent about them, some nurses need to examine their own attitudes and behaviors. i am very mad right now. i cannot and will not excuse bad behavior by anyone, patient, family or nurse. but the patient and family have reasons to be upset. nurses because of our education do not have the right to complain about a patient or family especially when they can be overheard by any visitor passing by the station.:nono:

and i have said enough.

woody:balloons:

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5 Posts; 693 Profile Views

I hope that they will. I understand that there are some patients and some families that can really get on staff nerves. But I thought that all the eduation we received was aimed at long past our irritation and trying to figure out how to help the patient, how to help the families. Perhaps I am old fashion but I was taught that I had to not only meet the patient's needs but their families as well. One would be surprised, if you look beyond your own irritation and see what is really brothering the patient, really brothering the family, you can see the problem. And most of the time it can be fixed. And by fixing it, you get the family on your side.

Enjoy your days off.

Woody:balloons:

I'd really like to meet the families whose problems you or other nurses are able to "fix." Nursing is rooted in helping, caring, "fixing," but there is so much out there that is simply unfixable. The families who tend to be so difficult for me are the ones who are acting out of dysfunctional family and social patterns that may go back for years in that family unit, and think its okay to be nasty. I listen and am kind and compassionate, and I do what I can but my priority is patient care and safety, not "fixing" the family problems. I so rarely have the time to sit and talk/listen with patients or families. I also was taught that treating the family is part of treating the patient, but the simple REALITY in hospital nursing at this time doesn't allow the time or energy for that, especially when the family thinks that abusing the nurses is acceptable behavior. I also think that the vast majority of nurses are compassionate and caring people who want to do their best. Having a work culture that allows abuse of the caregivers is a good way to burn out alot of great nurses.

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canoehead has 30 years experience as a BSN, RN and specializes in ER.

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I had a psych pt in the ER a few days ago and was able to spend 30 minutes listening to her. If I hadn't had the time we would have had her in 4pts much longer, and given IM's instead of voluntary po meds. she had a history of sexual assault in restraints. Without adequate staffing we would have retraumatized her, just RT the lack of time to have her open up and take an adequate history.

A LOL came in for the 5th time for urinary frequency. She was getting confused and irritable from lack of sleep. We had time to do a full exam and found a cystocele- saving countless more ER visits, and psych meds.

Some of the compliants are very much related to inadequate time to spend listening to patient concerns.

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262 Posts; 3,806 Profile Views

And why do we reward grown-ups who have temper tantrums, when we won't accept them in children?

What a great point!

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Boy can I relate to this topic!! I work in L&D and of COURSE we are promoting this "family centered care" crap. I'm all for patients having support and people around that can help them, etc. But some people take it entirely TOOO far. They disregard what we say "only 3 people allowed in the room at a time" They WON'T get out of your freaking way, when there IS a problem, they TRASH the room, with their garbage and god knows what everywhere. They get mad at us because we're not feeding them and the cafeteria isn't open, they want a "bed" to sleep in, etc, etc, etc. It makes it really difficult when you need to do an exam or procedure on a patient, and the family doesn't get the hint that it's not SHOW TIME.

Freaking family members standing at the door, while a patient is pushing, with their ears pressed up against the door, tyring to listen. Are you freaking kidding me?

My theory is, if you weren't there when it was conceived you don't need to be there for the birth!

I could go on and on, but out of everything, Visitors is my biggest pet peeve, EVER.

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