Family member hurt my somewhat fragile new grad confidence

Emergent, RN · Mar 18, 2015

Sometimes loved ones of critically ill people are extremely stressed out. They feel powerless and helpless. They are not "nutters" for wanting to fire a nurse they feel somehow freaked out about.

Anxiety levels can really amplify when people we love are close to death.

iluvivt, BSN, RN · Mar 18, 2015

Here was my first thought....You actually did everything right and gave stellar care! Some people, and this sounds like one of them, often thrive on stirring the pot and look for anything to create drama. It sounds like the wife is going to continue to create this drama so I would consider myself very lucky to be reassigned to other patients. She may need a nurse that she CAN complain about and will manufacture that if no fault can be found!

You never really know all the details of the lives of the patients. This women may actually feel quilt over any number of things and this is her way of dealing with it. I have seen many family members become overly obsessed with their loved ones care as a way to ease their own feeling of quilt. Another possibility is that she is so fearful of losing her loved one that has clouded her judgment and she is not coping well. Families and patients do feel a tremendous loss of control and act out in an attempt to gain any sense of control they can gain. Yes, there are better ways to do this but you professionally intersect into someone's life at horrendously life threatening and life altering times . This is one of many reasons nursing is painfully stressful and can suck the life out of you if you do not have good coping skills and are emotionally healthy.

TexMex22 · Mar 18, 2015

"Grow up"? Really? A little harsh, don't you think?

No, it wasn't harsh. Re-read the OP. She's going to end up in a corner sucking her thumb if she doesn't get over situations like this. It's not all about HER and her feelings. It's about the patient (and the patient's family, obviously).

klone, MSN, RN · Mar 18, 2015

I read her OP. I get it. The first time I had a patient complaint, I stewed and ruminated over it, too. It's a trait of a conscientious nurse. Has nothing to do with immaturity and needing to "grow up".

sjalv · Mar 18, 2015

No, it wasn't harsh. Re-read the OP. She's going to end up in a corner sucking her thumb if she doesn't get over situations like this. It's not all about HER and her feelings. It's about the patient (and the patient's family, obviously).

Yes, it was harsh. The OP did not write "this patient didn't like me and I don't feel like I can go to work omg what do I do???". She posted a well-written account of the events that took place and her own reflection. That alone makes her more deserving of a "Grow up." Not everyone has '30 years of experience' like you do. This is exactly why they say there's a fine line between an older nurse being firm and an older nurse being rude to new nurses. This is a new grad who is seeking advice concerning her first negative experience regarding a patient's family member. The least you could do is avoid insults to her character.

TexMex22 · Mar 18, 2015

The wife is a nutter and you are well rid of her. Do not give her another second's thought.

This seems much more harsh than anything I said.

The patient and, by extension, the patient's family can request a nurse not return. Simple. It'll happen again. Might be personal, might be stress, who knows? Get over it. Move on. Use your energy more constructively (as should I in this case apparently). :speechless:

anon456, BSN, RN · Mar 18, 2015

I am sometimes charge nurse and I deal with families like this quite often. I have seen very good nurses get "fired" by families, when ironically that nurse probably was assigned to that patient because of the particularly strong skills they had to care for the patient the best. Most of the time it's either a personality mis-match, or it's a control issue as many previous posters have stated. It's not personal.

Another thing I see is nurses who are not as confident yet or experienced will have their boundaries crossed by demanding family members, where more experienced nurses will know where to draw that line and will do so respectfully but firmly. The families will often prefer nurses they can manipulate or order around instead of the ones who put their foot down.

I was once fired by a family who had up until that point had me on their preferred nurse list and loved me. They had been there for weeks and had fired several other nurses and therapists. The parent was very emotionally needy and I often talked her down off her cliffs. The child had complex medical issues and the mom managed them well. She knew her child best and I respected that, but she was not a nurse. I was. She fired me one night for refusing to give PRN morphine to her child. The child was already on a low-dose morphine drip, had had their full prescribed doses of PRN ativan, and was demonstrating excessive sedation and a depressed respiratory drive. I found this when I went in for my first assessment. The family member screamed at me about it being their right to ask for the morphine, and they were afraid the child would wake up in pain (the child was about 24 hours post-op and pain team was involved). Well, the child was not waking up at all, and was breathing at a rate of 8. I called the MD and they prescribed a low dose of narcan, and then they redid the pain med plan. I probably saved the patient's life, and I got fired for it. Oh well. Instead of being sad that I was fired, I gave myself a good pat on the back for a job well done-- and so did the MD and my manager.

As they say "I'm not here to make friends."

kungpoopanda · Mar 18, 2015

This seems much more harsh than anything I said.
The patient and, by extension, the patient's family can request a nurse not return. Simple. It'll happen again. Might be personal, might be stress, who knows? Get over it. Move on. Use your energy more constructively (as should I in this case apparently).

You seem a bit of a nutter yourself.

dah doh, BSN, RN · Mar 18, 2015

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." .

I totally agree! Sometimes you bend over backwards and the patient and/or family don't like you for whatever reason. The first time or so it happens you overthink the situation of what did you do wrong, what could you have done better, etc. Hopefully you grow a thick skin and don't take it personally...realize you are an awesome nurse who gives great care and if they don't appreciate you, you'll move on to someone who will!!!

Kooky Korky, BSN, RN · Mar 18, 2015

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.

The wife might have been feeling guilty, fearful, or God knows what. I don't agree that she necessarily cared deeply about her sick spouse.

OP, don't allow family being in the way to force you to jump over them, climb over them, or otherwise go out of your way for them. You see the thanks you get for it.

I think the reason you were "fired" will eventually come out. Meantime, don't do anything for this pt or his wife, short of an emergency. She wants a favor? Tell her you'll get the husband's nurse. I say this not for you to be vindictive, but to protect yourself. If you set foot in the room, she will find some reason to punish you for it, even if she initiated the situation and even if she smiles and thanks you & is all sweetsie and grateful to your face. She will turn around and stab you in the back. Don't trust her as far as you can throw her. Guess I'm pretty adamant. Can you tell I've been betrayed a time or two? Hey, good luck, OP.

Tenebrae, BSN, RN · Mar 18, 2015

If her reason for wanting to "fire" the OP is as vague as "we didn't connect" she sounds to me like a woo-woo trippy hippie nutter.

Its her prerogative. Patients and their families should be able to be involved in the healthcare decision making

As a student had the funness of being bullied. Fortunately because it was a small town I had the misfortune of being allocated this nurse when I was a patient on the medical ward. I believe my words were something along the lines of "it will be a cold day in hell before I allow that ***** anywhere near me, either I get another nurse, or I leave AMA and will be filing every complaint I can think of"

When I was a patient just prior to Christmas. When I was discharged the nurse redid my dressing and did it wrong for the type of wound. By that stage I had been waiting 12 hours to get discharged and told her that I wouldnt be leaving till it was done properly as it is my perogative to do so I knew there was a much better way of doing my dressing and could I have reached it would have done it myself.

We should always be looking at how we practice because there may be times when there was something we missed or could have done differently. However most of the time, the attitude of these patients is more to do with how they are feeling about themselves and their situation as opposed to anything we have done as a nurse. Also I've found it helpful to look at the patient with challenging behavior as someone who is trying to handle life with the best tools they have. It helps me to not personalise behaviors.

OP it sucks however dont allow it to sink your confidence. If your manager or colleagues felt you were missing the boat, they would have told you. From the sound of it you are doing really well.

sissiesmama, ASN, RN · Mar 18, 2015

Be glad you were not reassigned to this patient and his wife.
You are not going to please every person with whom you cross paths. Don't take these rejections so personally. I doubt the wife is losing any sleep over this issue, and neither should you.
Rejection is a form of protection. Be relieved that you no longer need to deal with this hovering family member. Good luck to you!

This!! I know it's hard not to take that personally, but believe me - from my experience, your shift would probably have been MISERABLE if u had that assignment that next day.

Like Commuter said, u won't please each pt and/or family member 100% of the time - try not to dwell on it -

Anne, RNC