Family Complaint... Why am I so bothered by this?

Nurses Relations

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I'm sorry if this is long. I don't know how to start my story. But I will try my best to give a good summary of what happened.

I've been a nurse for only 7 months. I'm working on a Tele Floor, and in this particular night I received an admission, patient has multiple fractures (hip and hand) due to a fall. The patient was put on NPO for a surgery the following day. That night, a family member (who is a nurse and works at the same hospital, different floor) came to visit. Everything went well, she went home after a few hours since she had to work the following day.

That night I kept asking the patient if he's doing okay, and if he is having any pain. I must have done this more than 10 times. His response was "I have pain, but I'm okay right now. It's not really bad as long as I don't move a lot." I told him I can give him pain medicine but he keeps refusing them. So what I did was to reposition and tried to keep him as comfortable as possible. This particular patient needed a few units of blood, and I had to hang them that night. So I had to sit with him multiple times, and most of my time must have been spent with him. And in those times I kept assessing his comfort and offering pain medicine and he kept refusing. And I told him that if he ever changes his mind, to just let me know. The charge nurse knows all about these since she had to witness the blood and she knows the patient was refusing the pain medicine.

Around 0645 in the morning before shift change, he told me he was having a really bad headache. I told him I can give him the pain medicine to take care of the headache. And he finally said yes. He was on NPO so I can only given him Morphine since that was the only pain medicine IV ordered, and it was for 2 mg. As I was drawing this, my charge nurse told me "Oh by the way, the family told me to just give him 1 mg he is afraid it will make him loopy". I said "the order was only for 2 mg, do you wanna call the doctor so we can have it changed?" And she said "That's fine, just give him 2 mg." So I did, and he was fine. Nothing "loopiness" happened. I gave report, and I thought my day was done. I was preparing to go home when the family came and wanted to talk to me. I told her he was doing okay, and he got his blood, and finally said yes to the pain medicine this morning. She got really upset because I let the patient go without pain medicine for 12 hours. She said the reason why he didn't want it because it makes him loopy and she said she told the charge nurse before she left to give him 1 mg to at least help with the pain. So I told her he kept refusing it, the charge nurse told me to give him 2 mg. She then asked for the day shift nurse.

I got a call from my nurse manager. This call came right after I got off work and I was literally running to the airport trying to catch a flight. I missed the flight and was so frustrated (the next flight leaves at 6pm, which meant I will miss an important family event). The phone rang, and my nurse manager told me she wanted to talk to me about a complaint by a nurse from another floor about her family member not getting pain medicine. She told me the nurse came to her and was very upset. She just wanted to know my side of the story. I was already pumped with adrenalin from running, plus the frustrations of missing the flight, and now this! I don't know if I told the story in a very calm way. But I tried to as much as possible. She told me she understand my side but she doesn't want the other floors to have this impression about our floor, that we don't take care of our patient's pain. She said I should have investigated more on why the patient doesn't want pain medicine. It's not a valid reason that I just accept when a patient says he's okay as long as he doesn't move a lot. And I explained to her that I repositioned him to make him comfortable and that I can't force pain medicine to someone who doesn't want it. I also told her that the charge nurse never informed about the family member's request until I was already drawing the morphine that morning. I should take this as a learning experience, and not to ignore someone's pain next time. She told me again that the family member was quite upset and she doesn't want this reputation on our floor.

So here's the part that really bothers me. I feel like I've stained my floor's reputation, and other nurses must think very negatively of me now. I can't stop thinking about it. I've had many other horrible families before but I've always tried to be the best nurse to their family and satisfy their expectations. I just couldn't get over the fact that a complaint was filed against me directly to the nurse manager. I'm very anxious to go back to work. It's already stressful as it is, but this one is adding to my stress big time.

I have had family/friends come find me at the desk to ask me to do something or the other for a patient (give pain meds, switch a consulting doctor, etc). If the patient is A&O, I simply walk back into the room and say to the patient "So-and-so asked me to get you pain meds (or whatever). Do you want something for pain?". I've gotten many a dirty look, but it usually takes care of the issue.

I do the exact same thing. I ask the patient their pain level and document this. I also document verbatim what the patient's response was when I tell them which pain medications they can have. I also document the family member approaching me about giving the patient pain medicine. I tell the family member that I can not force anyone who is alert and oriented to take their medications. And I make sure I tell them this in front of the patient. And I also document that I told the patient and the family member this tidbit too.

OP you did nothing wrong. If you documented that the patient was refusing pain meds then you did the right thing.

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Specializes in Oncology.

I just want to say that I am very sorry you missed your important event. :sniff:

Specializes in LTC Rehab Med/Surg.

It bothers me for a minute. Then, if I'm honest, I'll admit I'd rather be keel hauled than take care of that family again. (keel hauled:)it's amazing what pops in your head when you're sleep deprived)

Unfortunately, you've just learned a very valuable lesson.

Just as you don't marry one person, nurses don't care for one person.

It's all about the family.

Specializes in ED, ICU, PSYCH, PP, CEN.

I can't believe the "nurse" family member had the gall to tell you what dose to give the patient. Only a doctor can do that. You certainly did nothing wrong. Learn all you can from this job, then move on at the end of a year. You don't want to work for a place like this.

Specializes in PCCN.
Your NM approached this is a very unprofessional way and seems more concerned with her own reputation than supporting her staff. Bad sign.

Your NM is more worried about customer service and PG scores than what you guys may have discussed re: pain mgmt.

"The customer, or the customer's family member , are always right.

No, I don't believe this, but it sucks that mgmt does. So sorry you work in this type of setting .

Specializes in PCCN.

You know, I have had these situations before. They are very difficult. I find that I will bring it up with the pt in front of the offending family member ( nurse or not, i dont give a crap) and say, " I have asked "pt" 4 times last night if they needed pain meds, and they told me no". To the pt :"Did you know your family member wanted me to give you pain meds?" And then step out of the room. "let me know if you need anything ".

Don't let the fact that the fam. member is a nurse detract you . They could be the president for all that matters. If the pt is AOx3 and capable of making decisions, then that is how it is documented by you. If you gave the meds when pt didn't actually want them( especially a changed dose) wouldn't that be battery?

If you gave the meds when pt didn't actually want them( especially a changed dose) wouldn't that be battery?

It sure is and OP if your manager mentions this incident again you may want to mention this. The patient was A&Ox3 and refused pain medication the 4 or 5 times I asked him. If I would have given him pain medication as his family member directed after he told me he didn't want them then this would be battery. Double check to make sure but I'm almost certain it would be.

Another reason why I can't wait to leave the bedside.

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I had a similar problem. Taking care of a family member of staff from another department. (And considering I was on many occasions requested to take care of family members of staff from my department, I refused to take it too seriously.)

Patient wasn't doing well. I was ignoring all of my other patients to handle it. Charge nurse was having to do almost everything for the rest of my load. Part of what was taking so long was family member was talking to docs NOT ON THE CASE who would then call me. So on top of trying to appropriately care for patient, I was having to handle multiple docs that I couldn't take orders from, even if I wanted to take orders from someone that only knew what was going on from uninformed third-hand information. The entire time, I kept the patient and his wife informed of EVERYTHING that I was doing and what we thought might be going on.

Get a call from my manager that family member complained that I hadn't kept the family member informed.

Thankfully, my explanation was sufficient of, "I kept the patient and his wife informed, and would have been happy to tell family member if she had been in the room instead of running all over the hospital finding physicians to harass me and try to give me verbal orders even though their service isn't on the case."

You've got to think to yourself, "Did I do what I should?" If you need to, find a nurse at work you trust to ask their opinion. Don't go by family members' opinions (even if they work for your facility.) And take anything from management with a grain of salt since their opinion is colored by things like 'department reputation."

I'm overwhelmed by the amount of support I'm getting. Thank you so much. I've analyzed the whole situation, and I've learned a lot of things from this experience, here's a few of them:

1. Family members (especially those in the medical field) can sometimes be the hardest people to deal with.

2. I agree with my NM that if the patient is refusing pain medicine but is in pain, I should try to investigate more. Maybe theres a particular reason why they don't want it, and perhaps we could obtain a different order for pain relief. Next time I'll make sure I'll do that.

3. The nurse family member is the type of person who just loves to complain. That night when they came up to our floor with the patient, she also bad mouth Trauma Center (where the patient came from). She actually told me she likes working in our hospital (she's been there for a few years already) but she thinks we have a terrible trauma center. She said that there was no communication from the nurses, blah blah blah. I just smiled and said, "you don't like our trauma center?" And she went on about previous experiences she had with the nurses there. Bad mouthing the other floors should have been a red flag to me right away! I should have known she was trouble.

I also think that she already bad mouth me to her co-workers. If she can talk to me, who she just met, about how horrible trauma center is, you can just imagine how easily she can spread how horrible our unit is. And that's probably why my NM was so concerned. But like most of everyone here said, the floor's reputation wasn't on my shoulders especially that I didn't do anything wrong.

4. When the family member confronted me about not giving the 1 mg, the reasoning she gave was and I quote "it's okay to give 1 mg as long as there's someone who can witness that you wasted the other 1 mg" (our smallest vial of morphine come in 2 mg). Being a new nurse, I thought I didn't even know that's possible. I've never heard of that before.

I thought hard about what she said and I came to a conclusion that her suggestion was totally dangerous and unacceptable. First of all, she's not the doctor, she can't change orders. Second she's not the patient, she doesn't have the right to say yes or no to a pain medicine. She doesn't have the right to demand what the patient get especially that the patient is AOx3. Her request and her reasoning is invalid.

5. I wouldn't have felt so bad if my NM would have at least acknowledged some of the positive things I've done about the situation, such as repositioning, reassessing patient's comfort multiple times, offering pain medicine, making patient comfortable. But I never heard any of that. Most of what she said was about floor's reputation, and she said it repeatedly.

6. I have a very supportive team of co-workers on the floor! I love them. They're the best. They've totally supported me on this one!

7. Allnurses.com rocks! I just love the advice and support that members of this group give. Thank you all!

Specializes in ICU.

At my hospital, you would have to obtain a doctor's order to give less than the ordered amount. Like, you couldn't just give 1mg instead of the ordered 2mg, without a doctor's order. (It is all about "pain" being one of the vital signs, so they want you to give what is ordered, instead of a lowered amount.) I mentioned this solely for the new nurses who may be reading this. I know that sounds silly, but you wouldn't give a smaller dose of some other ordered medication, without an order, either.

Specializes in Emergency, Telemetry, Transplant.

I did not read every reply, so I apologize if this has been mentioned before....

What is going to cause a bigger "stain" on your floor's reputation--(a) a disgruntled family member (who was not there all night) thinks that you should have given pain meds or (b) said family member comes in and finds their loved one apneic because you snowed him based on some silly idea that you needed to keep her (the family member) happy?

Specializes in Ambulatory care.

its over and done at the end of the day no one died, you have your job and license. I feel that if you've documented correctly then that that it your covered legally there's nothing anyone can say after all patient's have a right to refuse. Document your observations, action, pt refusal, your evaluation of pt. (a piece of advice from one new nurse to another - ignore the gossips and what people think or say, learn to compartmentalize leave work at work and when you go home learn to relax and do not keep replaying work situs you'll stress yourself out). You see when one doesn't give a damm what others think or say it makes decisions alot simpler because your focus is which action is best for patient and protects your license.

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