Unhappy family members

[moonshadeau]

What do you say to family members when obviously they show you no respect and begin yelling at you in the middle of a hallway for 10 minutes plus. Do you walk away, do you call security what does every one else do. I am a well known doormat on my floor this is what happened to me last night.

I had a patient that was admitted with colitis that wasn't doing well with the antibiotic therapy that he had recieved a few weeks before and was now in the hospital on failure to thrive issues. This woman was extremely anxious. (I don't give meds to people freely, but this woman definately needed medication because she was throwing herself in a tizzy and becomingly increased in Dysp. r/t talking so much.) So I got an order for Ativan 0.5 and gave it to her. She was slightly confused in ramblings but was oriented to direct questions. Three hours later.... I get a note from a staff member stating that the family has questions and wants to speak to me. The staff member tells the family that I had just gotten an admission and that it would be a few minutes. I was walking out of my admissions room p 15 minutes and was on my way to see them when another staff member came up to me and said these people want to talk to you. Again it was the family I was going to see. There in the hallway they let me have it. I tried to move them into a more private area but they wouldn't budge. They bantered me with how LONG THEY HAD TO WAIT to talk to me. PLEASE. Then they wanted to know about the condition of the patient, what was wrong with her, why was she so incoherent (not anymore than she had been before). They wanted to know why a diagnosis hadn't been made. (she had been hospitalized less than 24 hours). Then they start saying to me, WHY ARE YOU THE ONLY NURSE THAT IS TAKING CARE OF HER????????????? Hello, what planet are these families from. They wanted to know what the other nurses were doing sitting at the desk and why they couldn't give them any information. Not only that but when this family was up at the desk they start yelling at a doctor who just happened to be up at the desk. I told them that they were not going to get any information out of me unless they stopped attacking me. "We aren't attacking you"they yelled. Then comes "how do we helicopter her out of here, we want her transfered to mayo. Or do we have to take her by car. ON and on this went for over 2 hours. The doc comes in and calms them down and the family says "well I guess you are doing all the right things and we can't expect anymore right now.' PUKE

Where do these families come from?

Then as a side note, 1 hour later after they left, the patient crashes with end result being sent down to icu. The family says to me "well I guess we were on the right track in thinking about sending her"

My bad- I said sure but she would have crashed on you in the back of a car or ambulance.

What would you have done. The family was comprimising the care that I was trying to give to my other patient in multiple ways. Thank god I only had 3 other patients that night.

[deespoohbear]

Families can drive you absolutely insane!! We actually had a family complain about the way their Mother's hair had been done by the CNA. The CNA took the time to set this lady's hair after washing it, and the family had the nerve to complain!! My response to them would have been: "Next time bring in your own hair dresser and PAY for the services." If I have a family that I absolutely cannot calm down, I call the super or the DON. Let them deal with it. I actually had an Amish family call the doctor once and tell him that nurses were taking over the floor!! Cherish the thought!! I had kicked about 30 people out of this guy's room because they were upseting him and one of the sons called the doc!! I had a good time over that one!! If a family member ever assaulted me or threatened me, I would call the cops real quick. We don't have security at our small facility either. I will not tolerate being physically or verbally abused by anyone!!!

[fergus51]

Do you have an ocupational health nurse or board? I would talk to them about doing inservices on the issue. Ours did a great lecture and we went through senarios. I always try to be nice at first, saying "I understand this must be very upsetting for you, but I need you to calm down in order for me to help you". If they don't calm after a period of time I leave the room and call security up as a precaution (note that I don't tell them that is what I am doing as one nurse was interecepted on her way out of a room by a violent family member). The family member does one of two things. If they follow me out and continue making a scene I calmly inform them that they will be removed from the hospital if they can't control themselves. If they stay in the room, I go back with security waiting outside the door and try again. If they don't calm down I have them removed. I never at any point yell, scream or do anything that will raise the tension level.

I work L&D and one of the reasons we get a lot of freaks is that our visiting hours are anytime. Having a strict policy about no visitors after say 9PM would be really nice.

[fergus51]

Oh Canoehead! I never let anyone block my exit!We were told standing at a 45 degree angle to the door doesn't block them from leaving, but at the same time gives me an escape route if I need it. It works well.

[grouchy]

Hi- I was a psych tech while I attended nursing school. I was trained to protect my safety by not letting anyone who could block me between me and a doorway. We are lucky enough in my hospital to have pt relations representatives on call. If families are really wacko, I say as little as I can in neutral unemotional language, so that I run less risk of being misinterpreted. I tell the families I'm going to get someone who can better address their concerns, and I turn it over to patient relations. I probably would ask them to lower their voices so the other patients are not disturbed, but, I personally would probably avoid private conversations out of earshot with anyone this wacko for fear of them twisting my words. I would have no witnesses to support my version of the story. I agree that it could be appropriate for a supervisor or pt relations representative to have a private, unwitnessed conversation, if they are able to continue the conversation as long as it takes for the family to vent, and to reach a successful outcome. I know that as the nurse I would not be able to take enough time away from my other patients to give a family like this even 1/10th of the attention they want. Thus, they will probably remain angry. One more thing I learned in psych: I had a terrific manager who taught me to point out to verbally abusive people that "I am treating you with respect. I expect that/or I would appreciate it if you would treat me the same way".

[grouchy]

P.S.-I agree with the guilt theory, but I disagree about the cause. In my experience, it is those who haven't been closely involved in the patient's care who are usually the most aggressive. It's the adult child who wasn't too close with Dad, moved far away, and has flown back in now that he is hospitalized who is questioning every move we make. The most involved family members usually seem less anxious because they have a better idea of what is going on, and , their personal experience has led them to have a better intuitive understanding of the patient's prognosis and of realistic expectations for treatment, even if they have little formal medical knowledge.

[momrn50]

Personally the family members that I like are the ones who visit about once a year and then ask What have you done to Mother??? This is usually one of the little old ladies who get progressively thinner and more and more confused. Of course telling the familyu that maybe they should visit more often they could see Mothers decline...but no its always the nurses fault and God forbid Mother recognizes the nurses and not the family member!!! Shame that people don't realize the aging process...also that they feel that they can talk down to nurses and CNA's. I think that if they don't like the care Mother is getting, then please take mother home!!! I do love LTC though..love my old people.

[thisnurse]

look, i know you are upset. id be upset too if my (pt relationship here) was as ill as your (pt relationship here) is.

and i would want the best of care for him/her, just like you, but your shouting isnt going to get him/her care. can we work together to see that your (relationship here) gets that care?

can you tell me EXACTLY what it is you want me to do RIGHT NOW?

if that doesnt work...it usually does...i tell them i am calling the supervisor and they can vent their concerns to her. she is better capable of helping them than i am.

then i leave.

there are ways of letting the families think that your ideas are really theirs. you dont have to psyche them out. they are scared. how often are we faced with the death of a loved one?

how many people really know how to act?

whatever i do tho...i try never to piss them off.

that will only hurt ME in the long run.

and i have to agree with canoehead..if i were afraid of the families id not have the nerve to do this job.

if i am ever unfortunate enough to be hurt by one of them ill probably change my mind about my whole approach.

[momrn50]

Had a little lady who had a blue foot, faint pedal pulses..sent her out to hospital who sent her back with a diagnosis of cellulitis...well. we all knew it wasn't cellulitis, but her MD insisted on treating it as such...untill he came in to do rounds and looked at it...he immediately sent her out...to make a long story short, they had to amputetate her leg....so this morning her daughter called and saidI just wanted to let you know that mother died and we have very good lawyers...now of course this family rarely ever came to see mother....so guess who they blame for all this....right, the nurses...thank God for good documentation on this one...

[debbyed]

As Senior Clinical Nurse who runs charge all the time I'm the one that gets called to deal with irrate patients and families and with waiting times getting longer and longer there are more and more of them.

First I listen

Second I try to determine what exactally the problem is

Third I try to fix the problem if possible, if not I try to explain why I can't fix the problem

Fourth I try to find a compromise

and then if all else fails and the person gets worse and worse than I call security.

Please note...I will not tolerate anyone abusing any of my staff. Security is called first and the police are called if necessary.

It's ok to be angry but it is NOT OK TO ABUSE ANY HEALTH CARE WORKER FOR ANY REASON.