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!
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."
Or enemies.
Congrats on good judgment, just that there is still great potential for a nurse to get in trouble, even having saved a life. You are just fortunate that a doctor and your manager backed you up. It doesn't often happen like that, it seems.
Congrats on good judgment, just that there is still great potential for a nurse to get in trouble, even having saved a life. You are just fortunate that a doctor and your manager backed you up. It doesn't often happen like that, it seems.
If they didn't back me up, I'd rather get fired than endanger a patient. I would walk away knowing I did the right thing. Let someone else deal with that lawsuit and/or loss of license and/or loss of life by catering to the unsafe demands of the patient's family member.
In my workplace, we often do. If there is a reasonable request to not have a patient anymore, we consider the request seriously. For example (these are all real)
-- patient is a 400 pound total care and they had their turn already with this patient
-- patient is a female, flirtatious, biobehavioral case and the male nurse feels uncomfortable based on patient's behavior towards him
-- patient becomes combative towards pregnant nurses
-- patient's family is incredibly needy, talktative, and time-consuming
-- nurse has had same patient every shift for last 3 weeks and needs a break
-- patient or family has made racist comments towards nurse of a certain race in another language that they assume (wrongly) that nurse didn't understand
As an added tidbit, apparently she really liked the reassigned nurse. I am concerned that maybe the family member did cite a specific reason but the charge nurse didn't want to disclose that information to me?
But overall, thank you everyone. No, I'm definitely not losing sleep over this, and I'm just surprised that I'm not brushing this off as easily as I thought I would.
Eh, ya know what? Perhaps your co-worker is doing more "doting" than anything else. If you say the wife is excessive, perhaps you were all "too business" for her taste. And that's ok. When the next nurse and the next nurse and the one after that is "fired" by the wife, perhaps she will get a private duty nurse at home or something.
Literally had a patient's wife want to be "actively present". And had to give the illusion of asking "permission" for just about everything. That was so COOL. Not.
In any event, you may find with family members who are used to completely "taking care" of their loved one, the loss of control they feel comes out in the strangest ways. And if there is a nurse who is of course competent, but otherwise doting as opposed to all business but nice, the former always "wins". And that's ok. Takes all kinds.
Brush it off as "Our Lady of Perpetual Demands has got some weird family dynamics going on there" ....
Let it go. If you know that you did a good job, then she just had a "nitpicky" reason to ask for someone else. Perhaps she just likes to create controversy; perhaps this is her way to have some sort of control in a stressful situation. You are confident that you did well--move on and be done with it. Plus, if she was "firing" you for a serious offense, your charge/manager would have talked to you about that reason.
This is spot on. And I mean, if you think about it, we are just as guilty of this in reverse - horrible assignment, we ask for a new one the next shift if our unit if keen on continuity (which my unit is, especially since I tend to work 2-4 day stretches). You can't get along with everyone!
Sometimes family members play staff against one another using a technique called splitting. They'll complain about other nurses, or fire a nurse. Then the favored person gets to be the hero, and the family member can play that person like a piano.
Children use this technique a lot, especially when there's been a divorce. It's really important for us, as a health care team, not to play into this.
I'm so sorry about this whole situation! I kind of feel like people who are or who want to be nurses tend to be "people pleasers". The sad truth is, is that sometimes, no matter how wonderful you may be, there's always going to be a person you don't "vibe" with. That's totally not your fault.. just kind of the way it is. It sounds like to me you did an excellent job and were very thorough, so please don't be so hard on yourself; you did the best you could! If I had to guess, maybe she just wanted someone to talk to as in just shoot the breeze with to take her mind off of the current situation? It sounds like you were discussing a lot of the medical aspects with her and maybe although you thought she seemed intelligent and wanted to hear about this stuff, perhaps she'd rather discuss something else? Just a thought. In no way did you do anything wrong, though!
I'm also a nurse in a cardiac surgical ICU. I've found this environment can be especially overwhelming for family members, because a lot of these patients are less likely to have spent extensive time in the hospital, let alone in an ICU. They see all these drips hanging and the tubes and lines coming from EVERYWHERE, units of blood and platelets, the vent, all these beeping machines, you running back and forth...now here comes a chest x-ray, drawing some labs off an a-line...CI is a little low, so you call the doc and now you're hanging epi ("But I thought you said the primacor would fix it?!" they say)...epi shoots the heart rate up and he's throwing PVCs left and right, so here comes an amiodarone drip. Oh and his potassium is 3.4 so you hang a bag of that...
So to you, me, and other nurses who recover open hearts, that's just the way it is, no big deal, we'll wean him off the drips, start some PO amio, and before you know it you'll be pulling the swan, transferring him to step down, and he'll be using his little heart pillow to get in and out of bed. But all these family members see is a crisis happening and their loved one narrowly escaping death, no matter what you tell them. While we might be having a great time (an unstable CABG/AVR is my favorite way to spend a Friday night), they're panicking. And since you were the one who was there, they might associate that negative feeling with you.
The fact that her husband was still alive 24 hours later, allowing her to request another nurse, means you did a good job taking care of your patient. Focus on that.
Additionally, the fact that she used the term "didn't connect" jumps out at me. I get the feeling that you were probably pretty busy, and even though you were talking to her, you were all business. If she's looking to connect with someone, the nurse taking care of a person right out of open heart surgery isn't going to be the one. Maybe she liked the new nurse more because there wasn't quite as much going on, so there was more time to feed him ice chips and fluff his pillows, which is more likely to be associated with a compassionate attitude and "connection" making than telling her how all the pressors being infused into her husband are working.
Additionally, if she's the kind of person who cites a lack of connection as a valid reason to request a new nurse, then if you had actually done something wrong, you better believe she would have let it be known.
I'm still trying to figure out why the wife is a NUTTER because the nurse wasn't her cup of tea.
Someone replied on here saying the wife was a "nutter" and that OP should be happy she was not reassigned this patient. I personally don't think the wife is a "nutter" and most likely just stressed and upset?
Specializes in Critical Care; Cardiac; Professional Development.
I have been on the other side too, being one of a handful of nurses a complicated family felt comfortable with and thus got assigned to them every shift I worked, for four flipping weeks! I listened to them complain most bitterly that I and the other "chosen ones" had days off and how care suffered. I ultimately had to write a note to my manager that I refused the patient from my next shift forward and would understand if there would be consequences for that (there wasn't as it turned out), but that I was no longer comfortable caring for them after they started trying to get personal info from me and threatening to sue the hospital. I had this patient for four weeks and it was physically and emotionally exhausting to the point that I dreaded coming in to work. I was wishing I had been one of the ones who got "fired"!
Kooky Korky, BSN, RN
5,216 Posts
Or enemies.
Congrats on good judgment, just that there is still great potential for a nurse to get in trouble, even having saved a life. You are just fortunate that a doctor and your manager backed you up. It doesn't often happen like that, it seems.