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 fired a nurse, years ago. My husband was critically ill with cancer, in the ICU. A nurse came in to give him a med. I asked her what it was and what it was for. She couldn't answer, admitting that she didn't know.
I didn't make a stink at the time, but that evening called and requested that my husband not have that nurse again. He did die a few weeks later, sadly.
I fired a nurse, years ago. My husband was critically ill with cancer, in the ICU. A nurse came in to give him a med. I asked her what it was and what it was for. She couldn't answer, admitting that she didn't know.
I didn't make a stink at the time, but that evening called and requested that my husband not have that nurse again. He did die a few weeks later, sadly.
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 see this so often in extended care home health that I can almost sense when the musical chairs change is going to take place. It can be very obvious, like the time the family member made her pronouncements about the desirability of the fill in nurse, after the first shift. Not surprised that I called that one right.
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.
Huh, not familiar with that dx.
Anyway, as many have already said, I believe this has very little to do with you, and much to do with her. I also share the opinion of those who believe you dodged a bullet by getting OFF that assignment: a complaint of "we didn't connect" is far better than "I think she's incompetent and I won't allow her anywhere near my husband!" If you stayed with her, you might just have found yourself on the receiving end of something along those lines.
I once saw a spouse reject the ONE nurse who would've been the BEST nurse for that patient: she was top-notch, well-experienced, and cared about her patients. She was someone I went to for guidance, suggestions when I couldn't figure something out (when I was new) and someone I knew I could rely on for the really heavy-care patients when I did charge (and for some reason she wasn't).
The spouse got, instead, a nurse who overwhelmed easily and wasn't nearly as knowledgeable. Which led, of course, to yet another complaint, and good luck trying to find a nurse who would pass muster with these people!
Everyone, at some time, gets someone who just doesn't want them back for another shift. And for those patients who make life a living hell for all the nurses? They become One-Shifters (patients for whom no nurse will accept the assignment two shifts in a row). They get to rotate through everyone, in turn, because either no one is "good enough" for them, or no nurse wants to deal with them any longer, regardless of their standing with the family.
I fired a nurse, years ago. My husband was critically ill with cancer, in the ICU. A nurse came in to give him a med. I asked her what it was and what it was for. She couldn't answer, admitting that she didn't know.
I didn't make a stink at the time, but that evening called and requested that my husband not have that nurse again. He did die a few weeks later, sadly.
You must be wonderful to work with. I can not think of another instance where someone calmly rectified a problem without making a world war battle out of it. I am certain that the nurse knew exactly why that happened. Sorry that you lost your husband.
I wouldn't stress out about it. I don't think you did anything wrong clinically that your charge is keeping from you. Anytime something like that would happen you need to know about it so that you don't make the same mistake again. It sounds more like a personality clash. I have seen absolutely wonderful nurses be refused by patients not because they did anything wrong clinically, but because they just didn't have the type of personality that the patient was looking for to take care of them. It sounds crazy, but some patients are extremely picky about who takes care of them. Your nursing skills can have nothing to do with it sometimes (which isn't a smart move by the patient, but if it's what they want....). Some patients don't want a lot of medical information given to them about their condition, others want to know so much about their condition that they research it like crazy to the point that they are worried for no reason about something that "may" occur. There are some patients that don't want you to enter their room unless you have to and there are some that will try to keep you with them your entire shift. Some want to be left alone, others want to be comforted. And lets face it, some are looking for someone who is chatty and can have a conversation with them. What they don't realize sometimes is that the nurse could have a heavy patient load and would love to listen and talk but really needs to tend to his room mate that is going south in a hurry as well as the elderly lady down the hall who keeps trying to pull out all her lines and get out of bed and fall. Relax. It's just a personality preference. You made it six months and your first patient complaint wasn't even a clinical situation. You're doing fine.
Wow! I didn't think this thread would blow up so much! Thank you to everyone that has responded. Most of your comments are very reassuring and I appreciate them.
To those who questioned my decision to educate the patient on the plan of care and indications for meds/gtts, ect., this family happened to be well versed in the hospital environment, without going into specifics, this patient had already had very recent, extended stays in our critical care areas. The wife was extremely knowledgeable about all of his routine medications and explained that she managed his care very precisely at home. She was familiar with quite a bit of jargon as well. I noticed that intermittently she was asking about the ECG waveform on the monitor, pacing spikes, and what I was doing when titrating pressors. She did not present with any serious "red flags" (like families that seem to be gearing up for a lawsuit) and was very polite and non-probing. No quick picture taking, no massive notepads, no constant use of an electronic device. She even went so far as to apologize for asking questions and didn't want to insult my intelligence; she simply wanted to be knowledgeable. I try to keep my explanations short and sweet, but thorough. I have used this method for many of my patients families (when appropriate), and I have gotten very good feedback from many of them.
Overall, as many of you mentioned, yes, the wife obviously had a very high level of anxiety. She talked about how she has been unable to sleep. I find this completely understandable and I tried to empathize with her often. As I think about my interactions more, I think that the wife may have been looking for some kind of validation about how well she knows her husband and his situation. She was the expert on him and I respect that. Unfortunately, I was just way too busy to stand around and discuss every detail of his past medical/surgical history.
Also, I do think it is possible that at some points I may have let my thoughts about her show through a little bit. I want to point out that in my particular ICU, the nurse remains at the bedside for constant observation. My desk is right at the bedside. We do not sit at the nurses station for charting/down time. I know this differs from some ICU settings. So, unless I was on a short break or getting meds/supplies, I practically spent 12 straight hours with her. And while I tried desperately to keep my nonverbals in-check, I can only imagine that after so much time with her I may have slipped and not noticed.
Also, to follow up on some comments regarding the need to "grow up" or else I will be sucking my thumb in the corner... or something along those lines? Considering my area of work, I feel that if I were that type of nurse that can't handle minimal stress without extreme emotional trauma, I don't think they would have continued my employment after completion of orientation. Yeah, I know that I can grow some thicker skin. And yes, the patient and patient's families feelings ARE more important than mine... when I'm at work. Maybe you aren't aware that nurses do have to also take care of themselves to be able to care for their patients. So, thank you for your less than helpful comments.
To those who questioned my decision to educate the patient on the plan of care and indications for meds/gtts, ect., this family happened to be well versed in the hospital environment, without going into specifics, this patient had already had very recent, extended stays in our critical care areas. The wife was extremely knowledgeable about all of his routine medications and explained that she managed his care very precisely at home. She was familiar with quite a bit of jargon as well. I noticed that intermittently she was asking about the ECG waveform on the monitor, pacing spikes, and what I was doing when titrating pressors. She did not present with any serious "red flags" (like families that seem to be gearing up for a lawsuit) and was very polite and non-probing. No quick picture taking, no massive notepads, no constant use of an electronic device. She even went so far as to apologize for asking questions and didn't want to insult my intelligence; she simply wanted to be knowledgeable. I try to keep my explanations short and sweet, but thorough. I have used this method for many of my patients families (when appropriate), and I have gotten very good feedback from many of them.
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I am just suggesting more possibilities here, but it sounds to me that it is quite possible that your patient's wife could be trained as a nurse and be intentionally downplaying her knowledge so as not to appear threatening, asking questions but taking care to be respectful and not overly demanding, deferring to you, etc. It appears possible to me that she may have been astutely observing the care you were giving, while paying attention to the data generated by the waveforms, pacer spikes, etc., and at some point (the point where she requested another nurse) had put together all the information she had gathered about the care you were giving, including how she perceived your attitude, and about her husband's condition, and saw fit to ask for another nurse. You mentioned that you are a new grad; possibly she determined that you are not an experienced nurse based on everything she observed, and this factored into her decision to ask for another nurse.
I am just suggesting more possibilities here, but it sounds to me that it is quite possible that your patient's wife could be trained as a nurse and be intentionally downplaying her knowledge so as not to appear threatening, asking questions but taking care to be respectful and not overly demanding, deferring to you, etc. It appears possible to me that she may have been astutely observing the care you were giving, while paying attention to the data generated by the waveforms, pacer spikes, etc., and at some point (the point where she requested another nurse) had put together all the information she had gathered about the care you were giving, including how she perceived your attitude, and about her husband's condition, and saw fit to ask for another nurse. You mentioned that you are a new grad; possibly she determined that you are not an experienced nurse based on everything she observed, and this factored into her decision to ask for another nurse.
It is entirely possible; however, another staff member actually blatantly asked her if she had professional medical knowledge. She stated that she did not and she worked within corporate America and explained her position. While it is entirely possible that she could simply lie, I seriously doubt that this is the case.
I didn't read through all 6 pages of responses, but just from my impression of the original post, I think it's possible that you may have been TOO accommodating. People that are too nice and too accommodating can often come across as insecure or pretentious. Plus some people (like myself) just get flat out annoyed with overly nice or accommodating people (liking hovering servers at restaurants or pretentiously chipper baristas).
Of course I have no idea what your personality is like, but I know plenty of nurses that are like this. Those who think that wearing a big smile and constantly bending over backwards for your family and patient's every demand is the best way to be a good nurse. Sometimes what families and patients need is just a solid, confident nurse who doesn't mind politely drawing lines and putting their foot down with them and who gets straight to the point without kissing any backsides. Especially if the lady worked in corporate America........
Also being a new nurse, I often see them "going the extra mile" to try to do everything just right when it may sometimes be overkill.
Again, to the OP, you may not be that kind of person but I just kind of got that impression from the way you described the situation. You seem to be intelligent and well spoken, I'm sure you'll move on just fine. It may have been a good thing in the long run that they didn't want you back, those kinds of family members can be more exhausting and emotionally taxing than deathly sick patients sometimes.
Replying to the 3 or 4 replies above this, I have learned ( and am still learning) that there is a fine line between explaining what's going on to the family, and giving them too much information where they get anxious. What I mean by this is to be absolutely honest about the patient's condition, the treatments, what you are watching for, etc.-- however you don't need to teach them all the fine nuances of how to read the monitor or exactly what your technique is for zeroing the art line or other nurse skills.
A parent with a chronically ill child is very good at micromanaging them and I don't mind the expertise and insight, and I treat them as an important team member. When they try to do my job I gently but firmly draw some boundaries. I also don't want them to know all the fine details because it adds to their anxiety over things that they don't need to be anxious about- like all the false alarms that a wiggly baby might cause on the monitors. They need to be focusing on supporting their child, not on helping me to monitor the EKG.
Emergent, RN
4,300 Posts
I fired a nurse, years ago. My husband was critically ill with cancer, in the ICU. A nurse came in to give him a med. I asked her what it was and what it was for. She couldn't answer, admitting that she didn't know.
I didn't make a stink at the time, but that evening called and requested that my husband not have that nurse again. He did die a few weeks later, sadly.