This is the hardest part of my job. I don't have any trouble with my co-workers or patients....just the families. I seem to never know what to say when the families are beligerant or abusive. I either say nothing or say something that could have been worded "a little better." Any suggestions? Is there any nursing position that doesn't require dealing with the families?
Apr 7, '04
It helps me to keep in mind that when families or even patients themselves over react it is because they are scared.
They often have been given insufficient information to ease this fear. Which is usually fear of the unknown.
This is when I listen attentively. Ask questions about what thier understanding of the situation is. Validate what they are feeling. Let them know I would most certainly feel the same way if I WERE THEM. ( If I was them I would not be me with my knowledge base)
Let them know that I can understand thier concerns and begin to address them. This is where information and education comes in. They may have been told what they need to know that does not mean they understand it. If they understand that I really do care and are not ignoring them I can usually get their cooperation and understanding when they see that I don't have all the answers and that I am working on getting them. If I need more information from another source to address their need then I tell them exactly what I am doing to get that information and keep them updated on my progress and the problems that I am encountering in getting it.
This makes them an ally. If I just tell them I am working on it it often is not enough. If they understand specifically what I am doing and what I am up against and that I am continuing to try even if I meet obsticles then they are more cooperative and even supportive of me in my efforts to help them.
Placating does no good. Reacting to thier outbust does no good.
Then there are the folks that you just cannot talk to. Those who no matter what are going to attack. With these I get someone else to deal with them. I do not talk to them alone in anycase. I may even have to be firm and state that I will not address thier issues until they address me with respect. Then walk away and get my charge or a supervisor, social worker, security or some other person or persons.
One thing that I have found is VERY important in listening is do not interupt thier diatribe. Let them completely finish. Let them talk themselves out. If I interupt or try to answer before they have completley stopped it does no good.
Let them vent. Sometimes that is all they need. but if they are not allowed to get it ALL out in its entireity then it will continue to spew forth as you are addressing the issue. If they can get to all out and you did not interupt. There is nothing left for them to say and they usually do not.
Of course not every family encounter is one where they are spilling venom. Nearly every situation where they are difficult though it is because there are thing they do not understand and are fearful for thier loved one. We can often ease that fear. If you do not have time let them know you are getting someone who can spend the time and do it.
I have had to get someone else like a charge nurse to deal withfamily issues that I simply did not have time to deal with then I would explain the reason I was getting someone else. that is this is important and I am getting someone who can give you time needed to resolve this, I have another patient that needs immediate attention right now and I don't want your concern to go unresolved.
Last edit by Agnus on Apr 7, '04
Apr 7, '04
Agnus's suggestion are great. May I just add one more thought or perhaps I should say one of my favorite "lines" to a pt. family (when I see their pain and frustration) and wanting to help is to say: Of the three jobs going on here, pt. family, and nurse.. your is the hardest, pt. family. I, as a nurse, usually know what is need to help the pt or do the right thing by the pt, the pt. takes the help or asks for help and is treated, but the pt. family wants to assist and is often at a loss of what to do to make the family member feel or do better.
I will often assign tasks or provide education to pt. and family when I can. The family feels better (often) when they are involved in the car.
Hope this helps you.
Apr 7, '04
I agree with Agnus, very good ideas. Always try to put yourself in their situation and go from there. Being scared and out of control of the situation are two of the hardest things to deal with. If you can't talk to them and help them get someone else. Arguing will only exhaust both of you. I have never hesitated to get my charge nurse/coordinator involved with family issues. If they become abusive call security before it escalates out of control.
Apr 7, '04
I learned by watching nurses who were skilled at this. I still have my moments where I have to let someone else do it. I can't handle every situation well. If I just keep in mind they are scared it helps.
Apr 7, '04
Many many years ago there was a man who was extremely verbally abusive to all the nurses and nursing assistants. We all tried to be nice and helpful but nothing worked. This was in an LTC facility. One night when he was yelling at me I had had enough. I finally said "OK. If your wife is receiving such horrible care here Why don't you take her home and you take care of her yourself? After I said that to him he never bothered me again. He was speechless. I am returning to nursing in August and I am going to work night shift only so I can hopefully avoid most of the family members.
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