I'm just looking for some "pats on the back" and to hear about similar experiences, because I know this not the first time this has happened to a nurse and I'm sure I will experience this again.
I am a new grad in a very intense cardiac surgery ICU. I've been working there about six months now. I think I have been doing very well. My co-workers like working with me and they tell me I'm doing a great job, especially for a new grad. Literally on this same day, I had my first review with my manager who told me I am doing a great job and have fully met all expectations (apparently, this is somewhat unusual for a review with our managers). Many times I have had patient's families express how happy they are with my care and I make them feel comfortable and confident. Many patients want me to stay with them as their nurse when I transfer them to stepdown. I'm working hard to try to build up my confidence in this intense environment.
Anyways, I had it happened to me for the first time.
My patient's wife didn't want me back has his nurse!
As a background, my patient was very sick, intubated, and sedated. The night before my shift, the charge nurse specifically chose me to work with this patient assignment because both families were very demanding and they felt I work very well with difficult families. I worked hard for this patient all day and I spent more time in his room than I would have liked to because I felt like my other patient wasn't getting appropriate attention. The main reason that I spent so much time in his room was because the wife obviously liked information. She struck me as an intelligent woman. I explained every medication I gave, I explained every drip, I constantly reinforced my plans for my shift, and let her sit in the cramped room all day even though I constantly had to jump around her to reach machines, the patient, and drips. The wife was outrageously doting. Like, excessive, (if I'm allowed to have an opinion).
Anyways, as I left that night, the charge nurse took over for me, and asked if I wanted this assignment again. I told her that would be fine. Well, I come in the next day, and I had a completely different assignment. According to the charge, the patient's wife felt like she didn't "connect" with me and requested someone else. She didn't cite anything specific. Ironically, the person that was reassigned to this patient has just about as much experience as me and sometimes comes to me for advice on situations.
At first, I felt like I was just going to brush it off my shoulder. But as I think about it, I'm finding myself upset. I'm irritated that the wife didn't seem to understand how hard I tried to keep everyone happy, including her. And I also feel like my confidence is hurt. Did I appear incompetent to her? DID I make a mistake that I don't even realize?
Just looking for similar experiences and maybe some humor!
If you thought this as you were taking care of your patient and explaining the care you were giving to your patient's wife, it is possible that the patient's wife picked up on your thoughts/body language and felt uncomfortable with you providing care for her loved one. Hence her request for a different nurse.
From personal experience, having a dearly loved family member in the ICU is a massively stressful experience. I sometimes read on AN how suddenly much more understanding nurses become of family members once they have experienced their own loved ones acutely or critically ill, and are visiting or staying with their family member in the hospital. I do not find it at all surprising that the patient's wife stayed in the room continuously, wanted to know all about the medications her husband was receiving and the plan for the shift, and "doted" on her husband. Those are behaviors of someone who cares deeply about their sick spouse.
I suggest trying to put yourself in the place of the family member; this may help you to have more patience with these kind of situations, and may prevent the family member from perceiving your thoughts about them (if that is what happened) and feeling the need to request a change of nurse.
Best wishes to you.
Having been a critically ill patient myself, I still believe limits must be set.
I had this happen when I was a student; the pt was difficult, and I tried to accommodate her every whim while still getting my assessment done. Came in the next day to have my instructor ask me if anything in particular had happened with that patient. I described my interactions with her, and my instructor merely said the pt wanted someone else today and she wanted to see what had happened with me to avoid any problems on this shift. She assigned a (male) classmate (I'm female), whom the patient LOVED.
Turns out this pt had issues with several female nurses on the floor, most of whom looked something like me. Oh well.
BTW, I totally agree with the fact that if you had done something wrong and your boss was aware of it, you'd know what it was. They want you to learn, and they don't want to be fielding avoidable complaints! :) Shake it off, and be happy your boss is doing the same.
I had a colleague who used to always say "the patients who fire you are the ones you don't want to be taking care of in the first place." The wife had a reputation for being difficult. She will probably complain about the other nurse assigned to her too. I had a patient whose parents said they didn't want me back once because I took too long to bring them water for their kid's G tube (there was a functioning sink in the room and a fully stocked kitchen with filtered water that they had access to on the floor). Well, my other patient was critically acidotic with a bicarb level of 9 so yeah, sorry about that water, I'm sure your kid was doing to die in the extra 10 minutes it took me to bring it to you.
You will probably never know exactly why this patient's wife feels she "didn't connect" with you, and it's probably better that way. It's possible that you'll get reassigned this patient again sometime during his stay, and she'll be completely fine with it. I had a patient once who didn't want me back a second day, and I was a little confused as to why, but ultimately I was OK with it. Later on in the week, I had her again, and it turned out she thought I was awesome and even gave me a hug. Confusing, I know, but as you know by now, the wife likely did you a favor since you had an easier time on the next shift, but it doesn't always take the sting out of being asked NOT to be a patient's nurse.
In any case, it's absolutely impossible to be compatible with every single patient and family, and similar things will probably happen in the future. Just the opposite will likely happen as well - you will probably have a patient that you don't want back for a second shift, and that's OK too. When that happens, just make sure you're not "passing off" patients on a routine basis. In 18 months, I have probably had 3 patients that I did not want back for a second consecutive shift, but they were frequent fliers that were well known on our floor to be a "one and done." We had to pass them around to prevent burnout.
I worked hard for this patient all day and I spent more time in his room than I would have liked to because I felt like my other patient wasn't getting appropriate attention. The main reason that I spent so much time in his room was because the wife obviously liked information. She struck me as an intelligent woman. I explained every medication I gave, I explained every drip, I constantly reinforced my plans for my shift,
While that's not a red flag for me, it's a yellow flag. Anybody else feel that way? For some families, providing more information seems to cause problems later. There are times when the more you say is the more that can be held against you.
It rattled my confidence the first time that this happened to me, too :) And I wasn't even a new grad, so don't worry! Seriously, her reason was that you didn't "connect"? It wasn't a date! From what I can tell, you performed your job effectively and professionally, and at the end of the shift her husband had been well cared for. So the wife didn't feel you were her kindred spirit. I think that was a little silly of her, and a very petty reason to ask for a new nurse. Get on with your bad self, girl. You are a new grad in a cardiac ICU - trust me, you are doing good!
meanmaryjean, DNP, RN
7,899 Posts
Now if only WE could fire THEM..........