Families

kaseysmom, LPN · Jan 19, 2005

Any advice on how to deal with families that don't feel that you do anything right? I just left a situation this morning where the family is angry over the care and took it out on me, even though I had never had the patient before last night. Even the doctors were going at it with each other. It was really tough to sit there and get yelled at for things that you have no control over. I really wanted to cry, and did a little when I got to my car.
I know this won't be the last time this happens, so how do you deal?
I'm still a newbie, even though I have been a nurse since May, so I'm still not sure what to do.

If it were me in that situation - I would consider the source (don't take that the wrong way). When families are in a situation where there loved one is in a position that is not ideal for the person - or the family - they are going to automatically react in ways that they may not normally react, or maybe that is their normal demeanor. I would probably explain to the family that you are not necessarily doing ALL of the care provided for the patient, but that you will discuss the issues with the parties involved ASAP, and apologize for what they may feel liek are wrongful doings on your behalf. I would ask the family what they feel could be done to better the situation that you/they/the pt is in from this point on. Just a suggestion =)

ICUsleep · Jan 19, 2005

Any advice on how to deal with families that don't feel that you do anything right? I just left a situation this morning where the family is angry over the care and took it out on me, even though I had never had the patient before last night. Even the doctors were going at it with each other. It was really tough to sit there and get yelled at for things that you have no control over. I really wanted to cry, and did a little when I got to my car.
I know this won't be the last time this happens, so how do you deal?
I'm still a newbie, even though I have been a nurse since May, so I'm still not sure what to do.

Hi, there! Sorry you had a crappy day. I think what you did (cry in the car) is exactly what you should do. That is "how to deal". It is important to let toxic feelings out. Doing it in the privacy of your car or home is also good. It is unfortunate that an act as natural as crying is looked down on....so it is probably not the best thing to do while you're still at work.

If you are in a hostile environment, go to management or get a new job. In your case, it just sounds like it was an emotional day for everyone....and that will happen from time to time. Realize that people in pain are like animals that bite when you try to help them....they don't know what else to do (and some people are just jerks, period). Don't take it personally....also, try not to engage in any type of argument or challenge the family....that never helps.

The fact that you could "keep it together" during work and "let it out" when you left shows that you are a very capable, professional nurse who is also a human being. Hold on to your sensitive side, don't push it out and become jaded. It is easier in the short run to shut things out, but your sensitivity is exactly what makes a great nurse!

Keep your chin up, it can't rain all the time:)

kim1234 · Jan 19, 2005

Believe me through out your career, you will run into many families such as this one, not even the best of the best is good enough. I personally dislike the ones that take notes on everything.....Please dont be so hard on yourself. In the future there will be plenty of clients who appreciate you. Keep your head up and good luck to you.

Kim

11:11 · Jan 19, 2005

This just may be the hardest part of nursing.

Experience will help in the long run.

I found reading up on de-escalation helped me. As a male coming from a military and construction background I wasnt well equiped to deal with high stress situations like you have just experienced.

If your facility offers it take a work place violence course and get certified if you can (CPI nonviolent crisis intervention etc). Its geared towards a somewhat different scenario but it can help tremendously as families in crisis are a part of the escalation continuum.

Once I became educated in these types of situations I could look at them from an interventional point of view rather than get tangled emotionaly. Its not always easy but it has helped me.

If your employer does not offer anything of this nature investigate on your own. Perhaps even another facility in your area offers training and your education dept may reimburse you. I do know quite a few hospitals certify their ED and psych staff-

HTH

11

cannoli · Jan 19, 2005

Is your unit manager aware that the family is angry over the care?

If not, she needs to be told so that she can intervene and try to resolve things with the patient and family.

Also, it's better that you tell her now about any problem, or perceived problem that the family has with you, in case they complain later about you specifically.

Good luck.

DutchgirlRN, ASN, RN · Jan 19, 2005

I apoligize to the family for any care they received that they were not pleased with. I ask the specifics and offer to arrange for a different nurse for them for the next shift. I tell them that I will report this to the night charge nurse and ask if they would like to speak to the supervisor. I also clue the doctor in on what has been going on. They are 99% wonderful about it, if they know your side ahead of time. This diffuses the family and the doctor to the point that they realize that it was another nurse and not me, not the hospital, who did not properly care for their loved one. I take good care of them for the rest of my shift, like I would for any other patient and make sure they know to call for me by name if anything comes up. It works for me. Families can be very difficult to deal with. I've had to bite my tongue more than once. I love the ones who say they are going to sue me. My response? If that's what you feel you need to do then that's ok with me. And you really gotta love the patients who threaten to leave AMA, like it's hurting us in some way? :rotfl:

cannoli · Jan 19, 2005

I apoligize to the family for any care they received that they were not pleased with. I ask the specifics and offer to arrange for a different nurse for them for the next shift. I tell them that I will report this to the night charge nurse and ask if they would like to speak to the supervisor. I also clue the doctor in on what has been going on. They are 99% wonderful about it, if they know your side ahead of time. This diffuses the family and the doctor to the point that they realize that it was another nurse and not me, not the hospital, who did not properly care for their loved one. I take good care of them for the rest of my shift, like I would for any other patient and make sure they know to call for me by name if anything comes up. It works for me. Families can be very difficult to deal with. I've had to bite my tongue more than once. I love the ones who say they are going to sue me. My response? If that's what you feel you need to do then that's ok with me. And you really gotta love the patients who threaten to leave AMA, like it's hurting us in some way? :rotfl:

This scenario puts the blame on another nurse, what if you are the one that they are unhappy with, what if you are the one that they perceive "did not properly care for their loved one." It happens, even to excellent, experienced nurses. Some families are irrational and unreasonable.

bobnurse · Jan 19, 2005

I find many of these families are the families that have been away from their mom or dads life for some time. So they come back and nothing is right. They try to make up for all the years they've been gone by expecting everything to be perfect. You answer the call light within 30 seconds. The patient is always clean and dry, so you should check them every 10 minutes..They should be fed exactly when their tray gets there, and so forth..........Its all a coping mechanism. The nurses get their backlash, which is sad.

I dont know how many times ive seen a family that hated every aspect of thier family members care, but when the family member passes, they are very thankful of the care provided.

You just need to understand their feelings and their mechanism for dealing with their family members situation. We not only care for the admitted patients, but do a lot of nursing care to the family members as well....Its just free for them at the time.

madwife2002, BSN, RN · Jan 19, 2005

I apoligize to the family for any care they received that they were not pleased with. I ask the specifics and offer to arrange for a different nurse for them for the next shift. I tell them that I will report this to the night charge nurse and ask if they would like to speak to the supervisor. I also clue the doctor in on what has been going on. They are 99% wonderful about it, if they know your side ahead of time. This diffuses the family and the doctor to the point that they realize that it was another nurse and not me, not the hospital, who did not properly care for their loved one. I take good care of them for the rest of my shift, like I would for any other patient and make sure they know to call for me by name if anything comes up. It works for me. Families can be very difficult to deal with. I've had to bite my tongue more than once. I love the ones who say they are going to sue me. My response? If that's what you feel you need to do then that's ok with me. And you really gotta love the patients who threaten to leave AMA, like it's hurting us in some way? :rotfl:

In my experience just by listening to their gripes is all they want sometimes. I always advise relatives that I will look into their complaints and then i investigate where the misunderstandings have occured and try to get an acurate picture of what has happened. Then if I feel comfortable with the situation I explain why such things may have occured and give them reassurance that if the complaint is justified will hopefully not happen again.

First point contact is used here in Uk and that if a complaint is dealt with first hand, explainations are given this tends to take the heat out of the situation. Relatives are worried, concerned people who sometimes dont always understand or appreciate why we do certain things.

If there is a justified reason for the complaint we all have a duty to ensure it doesnt continue to happen. You have to remember that they are often not angry with the nursing/medical staff they are angry with their current situation, and the loss of control. Nobody asks to be in hospital, if given a choice they would want their relative or themselves t be fit and healthy, so I find when faced with angry relatives or patients I try to put myself in their place and have lots of sympathy and understanding.

Relatives when faced with calm, sympathetic, understanding nurses often quickley calm down.

Remember dont take it personally, if you find yourself in a situation you cant handle remove yourself from the situation have time to think and return, obviously make an excuse to go but always go back.

I have been nursing for 15 years and have found myself facing angry relatives often nothing to do with anything I have done myself, and I have used the above mentioned tactics which have worked.

On my ward we have been opened for 3 years and have no written complaints in all that time, but we all take a responsibility to listen to all.

Hope you feel better

askater11 · Jan 19, 2005

I've had a lot of difficult families/patients in the past. The unit I used to work at would give me difficult pt/families. ("supposedly" they said I worked well with them)

The biggest thing I do is go in the room. Introduce myself to the patient or family. Tell them what the Dr. has ordered. Explain to them the plan of care. Example--explain all test, when first give meds (explain all meds--if the times are correct) I try to be flexible in a "reasonable" way.

I'll tell the PM nurse EVERY little thing they want. Example--turn a certain way and that yep the family/patient is very particular. Knowing ahead of time what to expect helps you a lot.

Last time I worked I had 3 out of 5 patients which were challenging.

#1 was a angry CAPD patient. He yelled at everyone that entered his room. He yelled at me at first. Ugh I dreaded going back in that room. But after 6 hours of care--he "softened" up with me. He was actually "borderline" pleasant. Never got to the bottom why he was angry. Kept being prompt as possible, as I am with all patients. And asking how I can help him.

#2 Very on edge lady. She questioned "everything" After 1 full day-- a lot of talking--I have learned some "incidents" that occured during hospital stays. By day #2 she was very calm and open with me. I explained to the following shift--explain everything to a detail--it helps and about her experiences.

#3 I was told was very anxious about meds. I entered the room--we went through every med. Got the times correct. Answered all questions immediately before I started my AM meds. He ended up being a lot calmer after hearing good news from the Dr. (the patient also had recent lg. complications at another hospital)

I guess what I try to do is be reasonably flexible, prompt, ask all concerns and thorough at explaining to patient and family can expect during the day. SInce I'm on day shift, I try to find what are the concerns patients have and how we can be more accomadating. I leave a lot of notes to dr's/talk with DR's (sleeping pills, pt. concerns etc.)

If someone voices they're upset what another nurse did. I keep my ears open, I listen to both sides and remain non-judgemental.

Most times I don't need supervisors to talk with the family. I can usually workout the problem. I do tell the supervisor concerns patients might have. Give them the heads. And give the family and patient supervisor #. (so they know I'm not brushing it under the carpet and that at anytime they have a number for someone above)

Sometime situations you will not make a patient happy. And in most circumstances it's not anything you've done. Hospitals are a very traumatic scary place for patient and family.

Keep your head up--you're doing a great job!!! You are a very concerned nurse--I can tell by the post you typed!!!

huffmans98 · Jan 19, 2005

I work with a lady that almost quit due to a families complaints. We all tried to explain to her that anywhere you go, your gonna have problems such as these. Families can be so inconsiderate when it comes to their loved ones, and they don't seem to understand anyone elses feelings but their own. All you can do is try to comfort them, and if needed, trade assignments with another nurse. Sometimes new faces can calm families down.

Good luck