Patient's Demanding Family *Vent*

[Ms Kylee]

I came on shift yesterday afternoon, got my paperwork together, and was heading down my assigned hall when an RN stopped me and asked me to check on a patient on the other wing. When I get there, of course, it's a MRSA isolation room. I start with the mask and gown and patient's wife yells at me that I'm not moving fast enough. I asked what the problem was.... problem was there was air in his IV and it was beeping. According to her, it has been beeping for half an hour. I'm sure that wasn't the case, but I told her I would let her nurse know and have the nurse come and fix it. She got all huffy and demanded that I fix it RIGHT NOW and asked for my name. I explained that I could not fix the IV as I am not permitted to touch them and that the nurse would be in to fix it. Got stopped in the hall by another relative who demanded I fix the IV. Again I explained that this is not in the nursing assistant's scope of practice and I could not touch it, and I'd let the nurse know. As I was walking away, I heard her saying "This hospital does nothing but pass the jobs off to someone else, and he's not getting appropriate care."

I found this patient's nurse and told her what was going on. Then I found out that the nursing assistant on daylight was in there at least 6 times to change his bed and do other appropriate nursing assistant care.

I am irked by the comments made to my back because I know that isn't the case. I know my coworkers, and they're not the type to not take care of their patients. My question is should I have been a bit more reinforcing with the explaination that I cannot touch an IV? With my luck, I'll get stuck on this wing tonight and have to deal with this family. I just have a feeling that these are the type of people who are going to complain with a fistfull of hundreds..... But I also don't want to see my coworkers get called on the carpet for this cause they did nothing wrong.

[Sue Damonas, BSN]

People can certainly be rude!! I took care of my mother for a number of years and had her in the hospital a lot and was very respectful and undemanding. I kept on top of things with my mother but was not a pita about it. Mom ended up being a frequent flyer and the staff always liked seeing the 2 of us.

[UM Review RN, ASN, RN]

Kylie, when I have that problem with a family, I will go into the room and say:

"Hi, I'm Angie. I'm your nurse. I'll be taking care of giving you medications, your IV pump and line, and the doctor orders. This is Kylie. She'll help you with getting your meals, helping you to the bathroom, and taking your blood pressure."

Sometimes it helps to get the family to understand who we are and what we'll be doing.

And I agree, you did just fine. The nurse aides (or sometimes students or grad nurses) who turn off a beeping pump really will draw my ire -- I've had someone turn off cardiac drips just because they were beeping, seriously jeopardizing the patient's life. Turning off a pump is the one thing that's guaranteed to tick me off immediately and for the rest of the shift and possibly earn someone a writeup.

[Scrubby]

I work in the Operating Room, not more annoying and demanding relatives YAY!!!!!!!!!!!

I've had similar issues. Sometimes you do need to tell family members to behave themselves. I once had a very difficult family member who was a doctor (surprise surprise) yell his head off at about 4 in the morning in a busy surgical ward because his daughters eye drops were being put in her eyes on the wrong angle or something. I had to threaten him with security.

What is wrong with these people, surely they realise that a hospital is not a hotel, and nurses are not mindless slaves. I understand that they want the best for their relative, but i have very little patience with outright rudeness.

I would have done similar in your circumstance. I maybe would have asked the relative if they wished for an unqualified person to fix the I.V line.

[Dolce, RN]

"This hospital does nothing but pass the jobs off to someone else, and he's not getting appropriate care."

I have heard this a few times myself. A great response is, "I'm so sorry that you feel that way. It is certainly your right to use a different hospital. No one can force you to stay here. You have every right to leave." Usually when a family realizes that they can't "threaten" staff into complying with them they will back off a little.

Demanding family members are a nightmare sometimes!!!

[al7139, ASN, RN]

I always refer any family or patient care issues to my team leader imediately. I know that I cannot make everyone happy all the time, but I also know that the majority of the pts and families I deal with are NOT health care workers (and knowing a friend whose cousin's sister is a nurse does not make you an authority!), so it is my responsibility to educate them on who does what.

Amy

[Sabby_NC]

When a loved one is sick and in hospital there are so many raw emotions floating around.

You did a great job within your scope of practice.

You notified the correct people involved with this patient's care.

You were polite to the family.

You cannot stop these comments and they will always continue. This is a sad part of life that there will always be those negative comments.

[TazziRN, RN]

My mother was in the hospital for 2 months, being treated for end stage liver disease. While my father and I were very emotional about my mom, we always respected the staff. We never made unreasonable demands, and we certainly never screamed at employees or tried to coerce them into doing something immediately. By the way, I was not yet a nurse back in these days, so I had no idea of their daily stressors and demands.

There's absolutely no excuse for family members to behave in an abusive manner.

Did you miss the part where I said "I'm not excusing them, this is inexcusable behavior, but it may be understandable."?

[Spidey's mom, ADN, BSN, RN]

Did you miss the part where I said "I'm not excusing them, this is inexcusable behavior, but it may be understandable."?

I had an experience where I work when my adult son was a patient. He had had an ear infection/nausea/vomiting/cold symptoms for days and showed up at my work one day in tears. This is not usual behavior for him. His ear was draining quite a bit of blood-tinged fluid. (He had chronic ear infections as a kid). I took him to the ER. The "doc in a box" for that weekend was someone I didn't know and gave him oral pain meds. Son went home and promptly vomited the meds up. (duh). Came back.

Now, something happened then that made me realize how I looked when I worked in the ER. Our nurses/doc station was right in front of the three beds in our ER. I watched them talk, gossip while my son lay on the gurney, in pain, nauseated, holding gauze to his ear catching the fluid draining. I became very angry - I knew he needed an injection - no oral meds. Why were they just standing there????

One of the docs I did know came in and I talked with him privately and got my son taken care of promptly.

I guess the lesson here is that until we are in the patient's and family's "shoes" so to speak, we may miss how things really look.

An IV beeping is a worrisome occurrence for a family - especially if it says "air". Even explaining that the IV pump is working correctly in stopping the fluid and beeping may not work.

I agree with Tazzi . .. . .being rude is wrong but understandable.

I think of the scene in "Terms of Endearment" where Shirley Maclaine goes to the nurses' station at first asking nicely for pain meds for her daughter and then finally YELLING.

Stress does stressful things to us.

steph

[AmericanChai]

Not to come to the family's defense too much, I will sheepishly admit to taking out my frustrations on some nurses when my baby was in the hospital. I was very very sleep deprived (having dealt with the stress of her situation for a couple mos with a doctor who didn't listen, before taking her to ER to get better care). I had PPD that was not being treated, and was stressed out that my baby had a feeding tube placed down her nose because it was just totally something I did not expect to be dealing with. I wish I could go back and say sorry to those nuses, if I knew who they were I would.

I guess being abused by stressed out, emotional people is part of nursing. It's not fun, and you do NOT deserve it. If it continues beyond a point I would go to the supervisor and ask what to do about the family. What finally happened in my case is the doctor closed the door and had a heart to heart talk with me about maybe seeking some help, that perhaps I was suffering from PPD. I didn't even recognize it at the time.

[Ms Kylee]

Thank you everyone for your (as always) wonderful insights, thoughts, opinions, and just plain making me feel good and warm and fuzzy. :)

[maconnurse]

Venting is just what they are doing. They are taking their frustration out on you. Unfortunately, families like this are extremely demanding and hard to please and their is very little you can do.

[pagandeva2000, LPN]

Bottom line is that if you did something that was out of your scope of practice, no facility or regulatory agency would have helped you. It is best to err in safety than to take the initiative and make a mistake that cannot be taken back.

For example, LPNs in my area cannot do IV push except for heparin or normal saline. If in an emergency, if I were to do it and there is an unanticipated reaction, then, suddenly, I would be brought up on charges because I acted out of my scope especially since this is not my scope, I would not have been taught.

You did the right thing. Believe me, if something had gone wrong, it would have gone even worse for you since dealing with IVs is not your job to begin with. And, I am sure that the family would have tried to crucify you.