Family members make me nervous

[Florence NightinFAIL, BSN, RN]

Hello,

It's been four months as a new grad and thinks are going well so far. Floor is crazy busy but staff is helpful, so I'm grateful for that. Even my patients aren't that bad - medical or personality wise

The problem I've had, starting as student, is with family members who ask a lot of questions - esp if they are somehow in the medical field (doc, nurse, whatever). As a new nurse - I'm still learning things every single shift, asking A LOT of questions myself, and generally feel like I'm overwhelmed with information and things that I have YET to learn.

I hate looking stupid in from of family members/pts when they ask me questions that I don't know. I say "I'm not sure right now, but I'll look it up". Some are OK with that but others keep on asking questions - saying "Well, why not?" etc. This mostly happens at the beginning of the shift when the only information I know about the patient is from report - I don't have a chance two look at the chart, sometimes until around noon.

I know that even nurses who work 20+ years, don't know everything and are still learning stuff themselves - however, my questions is how to look professional while still saying "Gosh darn, I have no idea".

And speaking of incessant questions - how do you handle docs who main purpose is questioning to death just to see how much you know and pounce on you the moment you say "I don't know". One day I am going to snap and say "Listen buddy, you are the one who went to school for ten years to learn to diagnose and treat. Now go do your job and leave me the heck alone to do mine!".

[Nurse_Hagatha]

I trust people more who admit that they do not know everything, and are willing to "look into it" for me. And to those doctors who grill us and pounce on us when we say we don't know, I've perfected a "look" that I give them that works like a charm. Lol.

[Double-Helix, BSN, RN]

Try saying, "I've had a few patients with this condition, and I don't want to mix them up, so let me check in his chart so I make sure I'm givin you the right information." You can adapt that statement depending on the type of question.

[msn10]

I trust people more who admit that they do not know everything, and are willing to "look into it" for me

I totally agree with that statement. If you do in fact get back to the family, they will trust your information because they will feel as if their family member was important enough to have the right information.

[tokmom, BSN, RN]

My biggest fear is confusing pt's and then really looking like an idiot. I tell them I am going to get the chart and find the information they need and get back to them in a few minutes. I keep it pretty neutral.

If a family member gets cranky because they think I should know it off the cuff, I tell them I have X amount of patients to keep track of. I can't do it off the top of my head, SAFELY. That always make them stop.

[Missphillynurse]

Confidence is the key. Though you are a new nurse or even just new to the shift, most of the "annoying" family member type are looking for signs of weakness. Though I dont necessarily agree with telling them about how many other pts your dealing with or giving them a "look". I think there is a way to explain that rather than misinform them, you'd like the opportunity to quickly review the charts so that your able to give them the most accurate and up to date information about what's going on with their family member. Dont give false promises..ie..I'll be right back or just a few minutes. Let them know what your doing..ie..med pass, treatments, whatever and give yourself a reasonable amount of time to get back to them. And as far as Doctors are concerned, I try to keep it basic. Be prepared especially if this a doctor your working with often. Know what information he/she requires and have it readily available when speaking with them.

[mustlovepoodles, RN]

One thing I learned early on is to NEVER talk about a patient without his chart right in front you, not to his doctor, his family or even the patient himself. It's too easy to get things mixed up and REALLY look like an idiot. Some families like to intimidate the nurses, especially if the nurse is young and seems inexperienced. The trick is to keep calm and use the broken record technique: " I'm not sure, but let me look that up and get back with you. " The family keeps it up, whine whine whine "I will look that up and get back with you." they keep at it: "I will get back with you after I do some research." I can go on all day...

[Nursey103, ADN, RN]

Yup....I have this problem too!! The most frustrating question I get all the time: Is this normal?? I never know how to respond to that one!! We get lots of post ops on our floor & it's always some random symptom.... Or another one I get.....do you see a lot of patients with my problem?!? I guess with that one, they probably need to be reassured they're not alone.

I think confidence is a huge thing like someone already mentioned.....but being in your shoes, it's hard to display that confidence when you don't really have it!! I just remain honest & do my best to seek out the info they're requesting..

[kiszi, RN]

Yeah, "Is this normal?" trips me up too. What I want to say is no, according to the textbooks this is not a "normal" finding but all "abnormal" means is just that whatever is going on here doesn't fit the definition of an ideal human being, which is someone without a mark or blemish, in other words none but Jesus himself. Given my limited knowledge, your family member's symptom is probably nothing serious and may be something that's been going on for years that you just noticed today because you are watching him like a hawk and interrogating him after every sniffle. However, I don't want to tell you it's probably not serious because A) that would be diagnosing, which is not in my scope of practice, B) you will most certainly remember me telling you that if it does end up being the 1% that is serious, and C) you probably won't believe my answer and will continue questioning me anyway. So instead I'll just blurt something about being sure to let the Dr. know of your concern when I see him and be on my way.

[canesdukegirl, BSN, RN]

As Missphilly nurse stated, you must be confident in your answers. If you don't know the answer, simply state that you will collaborate with the pt's MD and get back to the pt with a concrete answer. Try to set a deadline (2 hours is reasonable) so that the pt is not left to worry. I have been a pt as well, and the WORST part about being a pt is not knowing what is going on, or what my plan of care will be. Waiting for an answer is very stressful.

It's ok if you don't know the answer. I had much more respect for the nurse that looked me in the eye, sat down right next to me and said, "Canes, I have been a nurse for a while now, and I don't know the answer to your question. But trust that I will find out. I will be coming back in an hour to administer your morning meds. I will page the doc now for you, but understand that they may be tied up in clinic or in the operating room and may not call me back within the hour. If that is the case, I will keep trying." than the nurse that looked like a deer in the headlights while muttering, "Umm..I don't know. Maybe you should ask your doctor? I don't know. I have to go now."

The key is NOT what you do or don't know. The key is telling the patient that you will find out for them, and that you will get back to them in X amount of hours. This tactic instills trust from the patient, and also sets boundaries for yourself in recognizing time lines. I can't tell you how much easier I rested when my nurse told me that she would ask my doc and then get back to me in an hour or two. I didn't give a hairy rat's ass that she didn't know the answer to my question...I cared that she understood how stressed I was that I was concerned and had questions. She was my lifeline, and she made good on her promise to get back to me in a timely manner. She was truly looking out for me, and that is what comforted me the most.

The signature line at the end of all of my posts is something that I learned when I was sick, and something I carry with me in my practice as a nurse. If you can put yourself in your patient's shoes, the least common denominator is showing that you CARE. Of course you will not know all of the answers to questions that patients and families pepper you with. But you DO know where your resources are, how to get in touch with them, and when to collaborate with them. Remember to keep your pt in the loop at all times, no matter how much or how little information you have. YOU ARE THEIR LIFELINE. I can't stress enough how important communication is to your pt.

I hope I have shed some light onto how to deal with questions from family members and pts. I feel that I may have gone off on a tangent a bit because I was speaking from both a pt's standpoint and a nursing standpoint. Your most valuable asset as a nurse is communication and collaboration. Be confident in yourself, and when you get a question from left field, simply state that you will ask the pt's doc about the question and then remind the doc before rounds that your pt has concerns about XYZ.

[Nurse_Hagatha]

Though I dont necessarily agree with telling them about how many other pts your dealing with or giving them a "look".

I was not suggesting to give patients or their family members a "look." I was referencing doctors who rant and rave and try to intimidate nurses. I treat them professionally, and if they cannot do the same, then I look at them like THEY are the fool and walk away. They can come seek me out when they are willing to act reasonable. I am sick of foolish behavior from people who should know better.

[cherrybreeze, ADN, RN]

To me, it depends on the question the family asks....I can think of two ways that I usually answer if I don't know it off the top of my head:

1) If it's something from their chart, I will say, "Let me go look at the chart and double-check, so I can make sure I'm giving you the right answer." This tells them that I DO know, but just want to look again (which is usually the case...if it's say, for lab results, I may not have written anything on my sheet if they were WNL). It also instills confidence that I want to be as thorough as I can be.

2) If it's a question regarding their condition or a new symptom but it doesn't warrant a call to the doc at that moment (non-emergent), I tell them I'll make sure I leave a note for the doctor and pass the info along to the next shift, so the MD can address it when they come around next. It prevents me from having to "diagnose" the problem, and reassures them that I'm listening to them, and making sure that the doctor will be aware.

I find that these two answers can deal with most questions asked that I don't have the answer for immediately.