Family member hurt my somewhat fragile new grad confidence

[BlueChocolateCat]

Hi all,

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!

Thanks everyone!

[jadelpn, LPN, EMT-B]

I'm still trying to figure out why the wife is a NUTTER because the nurse wasn't her cup of tea.

I would not go so far as to say "nutter", but I would say that if the OP's description of the hovering-used-to-being-in-control family member is spot on, I am sure that it IS driving her NUTS that a nurse has to control the situation. And loss of control makes people weird. And many hours staring at a loved one in the ICU and not being able to "DO" anything gives one time to really think.

Unfortunately, for this couple, things will not ever really be the same again. Sometimes, no one wants to hear that out loud. But never the less, part of the nurse's job is to continually educate. Sometimes it is just not what a family member wants to hear.

So a nurse doing their job and continually educating is most certainly what needs to be done, but may be too overwhelming for a family member to hear.

Put that in the cart with wife/family member feeling like they are not in control, that a nurse is not focusing hard enough on a loved one. Even dare I say in this instance, subtle/non-verbal in their "disapproval" or distaste of how the wife and patient interact (hence the OP's comment regarding the wife's doing everything for the husband and how it was "too much")

So no, I would not necessarily say the wife is a nutter, but what I do believe is that for some, a critical situation brings out one's inner nutter.

[THELIVINGWORST, ASN, RN]

Wow I forget just how judgmental nurses can be. I like how you assume nasty behavior from one post on a message board.

My bad behavior, you mean about not wanting the nasty ***** who accused me of leaving a patient in a urine soaked bed when I didnt? Or uttterly shat on me and totally disrespected my clinical tutor. How do you assume the nurse patient therapeutic relationship should work when I've seen the nastiness side of the nurse possible and trusted as far as I could kick them. FYI, I didnt yell about it, I wasnt rude about it and I certainly didnt use profanity because I do know what its like to be on the receiving end. I also know that when people start screaming and yelling those listening stop listening. The clinical manager having been involved with the bullying episode and knowing exactly what this nurse could be like very nicely obliged my request.

The result of not having the dressing done properly, leads to reformation of the abcess and potential further surgery. And after six days wasnt really down with that. Again, I was perfectly polite about it. Despite the fact that I'd been waiting 12 hours to be discharged. I requested that the dressing be done in a specific way to ensure the wound didnt close up and the abcess reform

And this is the problem, if a patient speaks up for their rights, they are accused of being nasty

It's not necessarily what you wanted that's out of line but the way you communicated what you said sounded like you were being nasty because you were tired of waiting to discharge. Geez, refusing a nurse or requesting the nurse re-do your dressing is one thing but your OP didn't make you sound like a very patient patient.

[icumufasa]

Sometimes giving your all is not good enough. Just work with a clear conscience and everything will be alright.

[icuRNmaggie, BSN, RN]

I am curious to know if the spouse asked the OP "how long have you been a nurse?" and then disqualified her based on that and only that.

I am not comfortable with sharing any personal information with total strangers and I will gently say so. They do not have a right to ask me where I live and when I graduated. I do not give out my last name or discuss my credentials. There are too many creepy stalkers in the world for me to do that. There have been times when I have told some very tall tales to protect myself from having some character stalk or track me online.

I do not want to connect; I am not cold but I am also not interested in making friends with visitors or listening for hours to every thought that runs through their heads. I just want to do my job.

This is not a social relationship, it is a professional relationship, I am in control of it and I put the focus on the patient. With free wifi, they can look up anything they choose. It does take experience with people to know how to alleviate a family member's anxiety and teach the plan of care at their level. Too much information can be overwhelming and you can always say that is a good question to ask the doctor, or what did the doctor say about this. Do not get sucked in by people who are looking for some discrepancy that they can use to create more drama. Learn how to nicely deflect intrusive questions and quickly change the subject to the patient or a neutral subject like the weather. Not "connecting" with an unstable person or a person with questionable motives is simply self preservation.

[RNperdiem, RN]

I imagine twelve hours at the bedside with a family member who never leaves makes for a claustrophobic day. Anxieties are magnified when you never get away.

[BlueChocolateCat]

Yes, the family member did ask how long I have been a nurse. I always struggle with this question. I usually respond by saying I've been working in the ICU setting for three years (including my time as a CNA). She probed. I told her I've been an RN for about a year.

This very well have been the sole reason for being fired.

[Ruby Vee, BSN]

Wow I forget just how judgmental nurses can be. I like how you assume nasty behavior from one post on a message board.

My bad behavior, you mean about not wanting the nasty ***** who accused me of leaving a patient in a urine soaked bed when I didnt? Or uttterly shat on me and totally disrespected my clinical tutor. How do you assume the nurse patient therapeutic relationship should work when I've seen the nastiness side of the nurse possible and trusted as far as I could kick them. FYI, I didnt yell about it, I wasnt rude about it and I certainly didnt use profanity because I do know what its like to be on the receiving end. I also know that when people start screaming and yelling those listening stop listening. The clinical manager having been involved with the bullying episode and knowing exactly what this nurse could be like very nicely obliged my request.

The result of not having the dressing done properly, leads to reformation of the abcess and potential further surgery. And after six days wasnt really down with that. Again, I was perfectly polite about it. Despite the fact that I'd been waiting 12 hours to be discharged. I requested that the dressing be done in a specific way to ensure the wound didnt close up and the abcess reform

And this is the problem, if a patient speaks up for their rights, they are accused of being nasty

There's speaking up for your rights, and there's being nasty. Both of your posts sound nasty. If your posts sound nasty, I suspect nasty.

[JustKeepSmiling, ADN, BSN, RN]

"You are not a jar of nutella, you cannot please everybody."

I really adore that saying.

If you provided good patient care, kept your pt stable or as close to stable as possible given his situation/orders and managed up for new orders, etc - then you were a GOOD NURSE.

Just because the family member doesn't jive with you doesn't mean you have a problem.

They are the one with the issue, you can only control your reaction.

If there was a genuine patient care/safety concern, I would sincerely hope your charge nurse would address it with you. And if not, allow your manager to share this with you for proper follow up/education.

[Julius Seizure]

Yes, the family member did ask how long I have been a nurse. I always struggle with this question. I usually respond by saying I've been working in the ICU setting for three years (including my time as a CNA). She probed. I told her I've been an RN for about a year.

This very well have been the sole reason for being fired.

This happened to me a lot as a new nurse. Really, for years, because I look kind of young. I would always say "I've been at this hospital for however much time". If they probed, I would play up the amazing internship program/preceptorship that I received when I started the job and how wonderful a team I work with, who offers their additional expertise whenever needed. Stuff like that.

[Susie2310]

This happened to me a lot as a new nurse. Really, for years, because I look kind of young. I would always say "I've been at this hospital for however much time". If they probed, I would play up the amazing internship program/preceptorship that I received when I started the job and how wonderful a team I work with, who offers their additional expertise whenever needed. Stuff like that.

I understand that some nurses choose to evade these questions (sometimes with good reasons) but the people asking the question very often recognize the evasion for what it is, and when they recognize this evasion this does not build trust. If as a patient or family member I felt the need to ask a nurse how long he/she has been a nurse, it would likely be because I have concerns about their competence. If they evade answering my question I am more likely to request another nurse. Also, patients and their authorized representatives have the right to request the patient's medical records, so if someone seriously wants to know how long their nurse has been a nurse, it is not hard to find this out once one knows the name of the nurse caring for them.

[icuRNmaggie, BSN, RN]

A young nurse in a Cardiac Surgery ICU should have an intelligent and concise anecdote about her qualifications, such as:

"I hold a bachelors degree. I was honored to be offered a year long residency in open heart surgery. My knowledge base is current because I have a passion for my specialty area. My Grandfather had a valve replacement and I was inspired to specialize in this area because of it. (segue to the pt) Your husband is in stable critical condition. My goal for this shift is to wean the medication that supports his blood pressure after he receives the unit of blood that was just ordered."

Your alma mater and date of graduation are irrelevant. Focus on the pt., check your equipment alarms and do a thorough assessment, reposition, mouth care, in a systematic way. Be courteous, graceful and efficient. Show her rather than tell her how capable you are as an ICU nurse in order to allay her anxiety. It is always nice to ask "how are you holding up" and when true, thank the family member for being helpful.

[Susie2310]

I understand that some nurses choose to evade these questions (sometimes with good reasons) but the people asking the question very often recognize the evasion for what it is, and when they recognize this evasion this does not build trust. If as a patient or family member I felt the need to ask a nurse how long he/she has been a nurse, it would likely be because I have concerns about their competence. If they evade answering my question I am more likely to request another nurse. Also, patients and their authorized representatives have the right to request the patient's medical records, so if someone seriously wants to know how long their nurse has been a nurse, it is not hard to find this out once one knows the name of the nurse caring for them.

I wanted to add that the original date of our licensure is public information. The public have the right to file a complaint with a State Board of Nursing about a licensed nurse. Our patients have the right to know the publicly available details of our licensure, if they so wish. So my understanding is that if a patient asks us how long we have been a nurse, they have the right to expect and receive a truthful answer.