Fired By Patient Family

I had a very difficult weekend at work. Very high acuity patients. One of my patients' family members asked the doctor for me not to take care of the patient anymore. The doctor was really apologetic, agreed totally with me, but we agreed it would be best for me to switch assignments. I KNOW I didn't do anything wrong. I have gone over it with several other staff members and the doctor. I made the mistake of asking for family to come stay with the patient because he was increasingly anxious, impulsive, and erratic.

Have you ever been "fired" by a patient/family member?

I have had this happen and it can make you question yourself. I now see it as the family looking for a better outcome of a situation they cannot control or change. You were correct in requesting family sit with an anxious patient. Your intervention was correct . Many times the unfamilarity of an enviornment or people escalates anxiety.Family can provide a familiar comfort.

Asking the family to come in and stay with the pt, in order to calm him down wasn't so much of a good idea. I mean that gives the family the impression that you don't know how to do your jobs, since you can't even restrain your pt. Believe it or not the family expect you to do everthing for the pt once in the hospital, so I can see why they fired you. But get over it though it happens

Specializes in Neurosciences, Med-Surg-CNA.

yeah this is going to happen. The best advice I can give, and I don't mean this in any type of rude way, is to just get over it. Laugh about it with your colleagues, and move on. I have a friend that I work with that is very hard headed, but she is a stellar nurse, but she often butts heads with her patients. She gets fired probably once a month. We also have a few frequent fliers who tend to fire nurses. One in particular has fired everyone but me and just a few more nurses. On some days, I am tempted to do things that she will fire me for, but it hasn't happened yet =(.

My point is, don't let it get to you. Just move on from it and continue to give care to the rest of your patients!

You are too quick to assume that. The doctor in question, this patient's doctor, is my father. We decided it would be best for me to switch assignments because it would become a giant ethics issue if he even attempted to back me up. For the record, the family did NOT know the doctor is my father.

I think it is best to switch assignments in every situation.

If the patient doesn't want me as the nurse, then I don't want to have to take care of them. I think it sets the nurse up big time if something were to happen with that patient.

Unfortunately, that doesn't always happen due to staffing or lack of.

Your father backed you up, another doctor probably wouldn't have.

I didnt realize that I was under the nurses tab, but I have some experience on this topic and Im not even a nurse yet. In my clinical last semester I had two of my patients "fire" me. It was not anything that I had done but the first patient had changed their mind about having a student to care for them. The second patient was actively dying, the family thought that I would learn nothing from having this patient so they requested that I "not bother" their loved one. This was hard not to take personally. Even my clinical instructor was not helpful, she gave me a different assignment each time and told me atleast they told you in the first 2 hours of being on the floor! So difficult at times...BUT I have learned A LOT form these type of situations so early on. We are here for the patients, what ever else we encounter on the way... can be added onto "life experiences" I guess. :)

As a clinical instructor, your instructor had no choice but to change your assignment. You can't go against a patient's or family's wishes. Don't blame your instructor for being of "no help" to you. :eek:

Specializes in Trauma Surgery, Nursing Management.
I'm not saying by ANY stretch of the imagination to get confrontational, but once you find out who your relief will be, I personally would enter into the room and say in a way that is as nice as you can muster, "I heard from Dr. (x) that you were possibly unsatisfied with the care I was giving (patient). I just wanted to come in and see if there was anything that I can do next time to improve myself? Did I say something that was offensive or was my care in any way not to your liking?" This is typically where the family will talk it out with you. If they're rational, you can sometimes talk it out and possibly make a so-so or bad situation better.

This is a very fine line to walk. Take my Mom's scenario for example (post #6 in this thread). If the nurse had come in to ask if she had done anything offensive to Mom, it immediately puts her in a very awkward situation. What is Mom going to say to this sweetheart of a nurse, "Your breath was really stinky after you ate lunch and it made me nauseated"? Sometimes it is best to let it go. Most of the time patients will confide in their new nurse and then you can get the scoop from the new nurse. Patients rarely want to face a confrontation with their healthcare workers, as they already feel vulnerable.

I totally get what you are saying, though. Sometimes you can diffuse a situation that was a simple misunderstanding. My view is that it is best not to involve the patient any further. If you see them or their family members in the hallway, just wear a smile, ask if they are feeling better and comment on their progress. Short, sweet, and leave a positive impression.

Our jobs are difficult because we must provide excellent patient care, we must be maids, politicians, referees, nutritionists, teachers, leaders, mentors, fact checkers, advocates, and paperwork experts. We are held to high standards both in our working environment and in public. We have a great deal of responsibility on our shoulders. But the priority for us all is to deliver safe and effective patient care. Sometimes families do not understand what our job entails, and nor do I expect them to. Much of what we do is behind the scenes. You must have the confidence in your profession and in your practice to know that families don't always understand...and be ok with it. If there is something that a family member is complaining about that you should have done differently, then you will know the next time around. If you have no idea why the family wanted another nurse, then talk to your NM about it and get rid of the anxiety of doubt.

HUGS to you OP!

Specializes in Trauma Surgery, Nursing Management.
Asking the family to come in and stay with the pt, in order to calm him down wasn't so much of a good idea. I mean that gives the family the impression that you don't know how to do your jobs, since you can't even restrain your pt. Believe it or not the family expect you to do everthing for the pt once in the hospital, so I can see why they fired you. But get over it though it happens

Why do you feel that this intervention was incorrect? A patient already feels incredibly vulnerable, out of sorts, in an unfamiliar environment and stressed out with the fear of the unknown. Do you believe that after reading the OP's post that she should have restrained this pt? Do you think that restraining this pt would have escalated or calmed the pt's anxiety?

Yes, family members often do expect the staff to do everything for the pt once they are in the hospital, but in my experience I have understood and acknowledged that family members are feeling quite helpless and WANT to do something to help calm their loved one. Simple teaching to the family members on calming techniques go a long way. For example, I had pt who was Stage IV ovarian ca who was becoming disoriented and panicked in the early stages of dying. She was thrashing around in her bed and was crying. The husband was pacing the floor, not knowing what to do. He was crying and wringing his hands. I took him in the hallway and told him to take her hand and speak to her in a calm voice. I suggested that he talk to her about some of the highlights of their life together, remembering fun times, trips, vacations, anniversaries, etc. He went back into the room and did just what I suggested. He engaged his wife in this calming reminiscence. Pretty soon she was talking to him, making sense and both of them were able to have a moment of clarity and of peace before she passed. He was so grateful for the suggestion, and it made the road easier for both of them.

There are times when it is absolutely appropriate to ask family members to stay with the pt and there are times when it is not. We can use our critical thinking skills in order to make the correct assessments and interventions.

do not feel bad about it,you know in your heart and mind you did the best you can to serve the patient.Family members are irrational a lot of times,they can even fire their doctor.

Happened to me many times in 17 years. Everything from race, gender, hairstyle, age and even my height (short, male pt.). You just never know with people. Sometimes this is their first opportunity in life to "demand" something and have their request granted. It goes to their head. I got over it pretty quickly.

Specializes in Med/Surg.
You are too quick to assume that. The doctor in question, this patient's doctor, is my father. We decided it would be best for me to switch assignments because it would become a giant ethics issue if he even attempted to back me up. For the record, the family did NOT know the doctor is my father.

I wouldn't jump on anyone for being "quick to assume." I don't think anyone here would have had reason to guess that the MD in question was your dad, unless you said so (which you didn't to start off).

Asking the family to come in and stay with the pt, in order to calm him down wasn't so much of a good idea. I mean that gives the family the impression that you don't know how to do your jobs, since you can't even restrain your pt. Believe it or not the family expect you to do everthing for the pt once in the hospital, so I can see why they fired you. But get over it though it happens

It actually is VERY appropriate to ask for family members to come in and sit with their loved ones. No, not all will understand it, and think that we can magically control even the most confused, combative patients. Others WILL understand that the presence of someone familiar can make a world of difference. Even when they don't get it, doesn't make the request inappropriate, especially when the rationale is explained. It doesn't make it the OP's fault that they "fired" her. THEY were in the wrong, period (not to mention just ignorant).

Specializes in Adult Oncology.

My response above was the assertion that the doctor, administration, etc had not backed me up. I felt supported, not only by the doctor, who was doing what was in his limited power to protect me, by NOT defending me to the patient and have it later found out that I was his daughter, and therefore I may have had done something that NEEDED defending. The charge nurse definetly backed me up, as she took over care of that patient.

I thank you all for your words of encouragement. It's sad that finding out that this is *somewhat* common is reassuring, but reading these stories only reaffirms what was replaying over and over in my own head. I guess it hurts worse because it was the first time, I didn't do ANYTHING wrong, and yet I was found unacceptable. But honestly, I hope it never stops hurting, because then I'd worry that I no longer care enough.

On the other quote above, asking family to come stay is first in our protocol to avoid restraint. I've never had a family member react the way this one did, but whatever. It takes all kinds.

The patient passed last night surrounded by family instead of strangers, and I am thankful if that one phone call I made made any difference to them in order for them to be there for him.

Specializes in Med/Surg, Acute Rehab.

Hi Solaire Solstice!

I just finished reading all the posts and was about to say the exact same things that you just said in the above post! You should not have had to defend or explain yourself, as you stated quite clearly in you original post, that the doctor agreed with you and was apologetic. Why highlandlass1592 went off on a tangent about whether the doctor just agreed with you to your face, but not to the family, is totally irrelevant to your post! Some people just do not read the posts carefully before they post their comments.

As for this statement:

"Asking the family to come in and stay with the pt, in order to calm him down wasn't so much of a good idea. I mean that gives the family the impression that you don't know how to do your jobs, since you can't even restrain your pt. Believe it or not the family expect you to do everything for the pt once in the hospital, so I can see why they fired you. But get over it though it happens."

It comes from a 17 year old, who isn't even a nurse yet! He has sooo much to learn about nursing, and life, as well :rolleyes:

It is definitely the right thing to ask a family member to sit with any patient if they are posing any kind of risk to themselves or others. I would think that is standard procedure in any hospital for the safety of all involved. It's just important to request it in the right way, which I am sure you did. Some family members, unfortunately, do not want to be bothered. Others, are more than willing to do whatever they can to help.

One day, hopefully, you will laugh about this and be telling your story just as others have on this thread, to make someone else feel better.

+ Join the Discussion