So Burnt I'm crispy

[8daysaweek]

Before I dig in, I must give my unit credit and background: my coworkers, clin leaders, director.. all fabulous people to work with. My co-nurses and my techs, we all rely on team work and we are all happier off for lending a hand. We work a med-surge unit.

HOWEVER

I'm still burnt out. Bad.

I couldn't figure out why. My ratios were good, my coworkers awesome, I only work 3 days a week...

Then it dawned on me. It's not really the patients, or the work itself... It's the families.

Let me also add now that I enjoy the education aspect of my job and I have time to do it, and usually it's lovely to have the family in on the care plan and education as well.

But then there are the awful ones. The area my hospital is in is affluent. The patient population are people from the affluent area, or surrounding nursing homes - the attitudes I've seen from the families range from mild entitlement to flagrant verbal abuse - usually over things that have little to do with the patient care. I don't need to go into many details here, anyone who is a nurse deals with difficult people. Being sick is a stressful time for both the patients and their families, and I understand that normally any negativity they send my way isn't really meant for me, so I let them vent, we move on.

It's the ones that follow you around the unit, berating you with bull. The ones that think they can tell you how to do your job because they googled it. This is what really gets under my skin: the fact that nursing (and the other staff providing bedside care like the techs) is one of the few careers in which your clients are allowed to verballly abuse you, tell you what you already know, challenge hospital rules/protocols and threaten you for the Dr not ordering the d with NO REPERCUSSIONS. Is this just my hospital? We are supposed to be Stepford nurses at this place, no room to defend yourself. Is part of being a nurse accepting this level of disrespect and being okay with it? Did I miss something? My biggest concern is that I'm at a point where one day, I'm going to deadpan look one of these terrible people in the eyes and tell them to fck off. Am I not cut out for this, or is our culture truly one that favors a hostile environment by allowing such disrespect toward medical professionals? I'm not asking for an award. I'm just asking to feel human.

[NurseCard, ADN]

No, you don't have to accept verbal abuse, or be disrespected.

You just don't.

I feel your pain; to be quite honest I have always preferred working

with lower-to-middle class folks. When I was doing home health, I

enjoyed working in the poorer and rougher neighborhoods in town,

much more than I enjoyed going into the more affluent suburbs.

Having said that, it doesn't matter WHO you are taking care of,

you don't deserve abuse. Your patients deserve your best care,

your efforts to include them in the plan of care and the goals for

each shift. As long as you are providing quality care, using best

practices, and again, keeping patients and families in "the loop"

as much as possible... that's all they can expect from you.

For example... if a family member wants to know the EXACT

time that daddy is going for their colonoscopy in the morning,

and you say "I'm sorry I can't tell you the exact time", and

they begin to yell and call you an idiot and demand to speak

to your DON... You have every right to say "I don't appreciate

the way you are speaking to me, please calm down.". Then

give them the DON's name lol.

[missmollie, ADN, BSN, RN]

Families who believe they have more knowledge, oh I love them. I often make the statement of "I have never heard that, and I've been in this specialty for three years. Tell me what you know about *blank*" in the most sincere voice. I often pull up a chair. As they start to explain, when I know it affects something else, I will ask about that. You'll get a odd look, and then it dawns on them...they don't know everything. Then you educate, use the biggest words you know, and when they look confused you bring it down to their level.

The trick to this is to be really sincere and open. It is honestly the most diabolical thing I do.

[Been there,done that, ASN, RN]

Still sounds like a pretty good gig. Your demeanor will prevent "mild entitlement". Flagrant verbal abuse should be turfed to the doctor or supervision. Sometimes turfing to security is fun.

I provided nursing care for the richest of the rich.. they respected me.

[Orca, ADN, ASN, RN]

What you are talking about is one of the main reasons that I got out of hospital nursing. I became very tired of having to placate people when nothing had been done wrong, because they were "customers".

[JKL33]

I will not "tango" with people like this, unless I sense there is something I can successfully address, such as fear or grief (altered coping). I never ever try to "correct" them any more or argue with them if I sense that they simply want to sport. In that case, I tell them it sounds like they have concerns beyond my purview and that I will ask the supervisor to come and speak with them. This serves the purpose/possibility of a therapeutic outcome and also gives someone else a chance to experience the situation first hand rather than doing nothing and second-guessing me later.

If there's no support from admin then you will not escape this problem without finding another environment in which to work.

[Thanksforthedonuts, BSN, RN]

I really, truely understand where you are coming from.

I work in a unique long term care setting. Honestly, I wish I could assess the families (INSTEAD of the potential resident) before admitting them. As hard as the resident might be, if you have a family that is easy to please or is willing to go with the flow then it makes life so much easier. I would rather take care of darling grandma who bit me, slapped me, and scratched at me until I was safely able to lower her to the ground as long as the family is aware of her behavior and willing to work to get it under control.

I live in an affluent area as well where most of the families are either MDs, lawyers, or Microsoft/Boeing executives.

I can't imagine in acute care how their behavior might be (the worst are the lawyer sons IMO)

At least in LTC you get to know their quirks and work it *somewhat*

I told our director that we need to figure out a system to assess the families level of crazIness before hand... so far we haven't gotten anywhere.