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!
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.
I am reminded of why I loved the OR - no family members. I think I'd go nuts if I had to deal with visitors for 12 hours straight. Their presence right in your face is another good reason to enforce the rules re: limited visiting. They just don't care or maybe don't realize that you have other patients. They might, as you said, be looking for validation of their care of their loved one. Who knows? But I know I wouldn't last if I had to repeatedly or incessantly explain, re-explain everything to them.
OP, hopefully your okay with this now.. No can really know what made the family member request another nurse. I think its very mature of you to reflect and try to figure out why you werent requested. But at the end of the day, you did everythying you could, was patient and treated them respectfully... let your mind rest... It will happen again, and next time hopefully it wont shatter your confidence. For every one that doesnt want you, 20 will!!!
Specializes in NICU, PICU, Transport, L&D, Hospice.
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
"both families were very demanding"
demanding
the failure in the professional relationship was not yours, it belongs to the family. there is a pattern
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
I'm going to disagree with you here -- I've been a nurse for a long time, but I've also been the family member sitting at the bedside AND I've been the patient IN the bed. Staying in the room at all times, pestering the nurse with questions (and rejecting unsolicited information) and "doting on" the family member is equally likely the behavior of someone experiencing guilt because the relationship is dysfunctional. Or someone who is finally extracting a measure of control from her situation. Putting yourself in the place of the family member is useful if the family member is sane and healthy and just under stress given the loved one's illness, but it will never work if she's crazy and demanding or difficult ("crazy" as opposed to having genuine mental health issues she is working on). An increasing number of families are just crazy: entitled, unrealistic, demanding, controlling, difficult, abusive, what have you.
Looking for a 'reason' to be asked not to come back is understandable, but probably not going to be ultimately helpful. Some folks are just not willing to be pleased. It could have been that she didn't like your accent, your skin color, your overbite or that your hair is or isn't curly. It could have been she wanted a younger nurse/older nurse/more easily manipulated nurse/nurse who left her alone more . . . .
The nugget in this post is that usually when the family starts "firing" nurses on one pretext or another, you are lucky in the extreme to be the one "fired" so you don't have to deal with them anymore.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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).
I thought it was harsh, and I'm usually the one who is accused of harshness.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
I hope you're not BRAGGING about your nasty behavior.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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?
She may just have been stressed out and upset. It is equally (or perhaps more likely) that she's a nutter. If she's known as being difficult, she's probably managing her stress by being demanding, dramatic and difficult and in my book, that's a nutter. I'd just as soon avoid those types of families myself. The non-nutter family member will, no matter how high their stress level, focus on something other than micromanaging the nursing care or manipulating the nursing staff to manage their own emotional issues.
As long as the nurse is competent and not a complete ass (I work with a couple of those), the family ought to figure out how to cope. Firing every nurse with whom you "don't make a connection" is not going to serve you well, especially when your loved one becomes a frequent flier or a chron.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Or it's more possible that she throws around a lot of jargon without really understanding it. Especially if her husband is a frequent flier. We see this all the time, and it's difficult to deal with. They want to be respected because they "know all about it" and since they really DON'T, you want to educate. But since they already know all about it -- or think they do -- they don't want the education. They want validation on how smart they are.
Kooky Korky, BSN, RN
5,216 Posts
I am reminded of why I loved the OR - no family members. I think I'd go nuts if I had to deal with visitors for 12 hours straight. Their presence right in your face is another good reason to enforce the rules re: limited visiting. They just don't care or maybe don't realize that you have other patients. They might, as you said, be looking for validation of their care of their loved one. Who knows? But I know I wouldn't last if I had to repeatedly or incessantly explain, re-explain everything to them.