What's the reason for a RN to be snippy to a new post op pt. ? - page 4

OK. I don't want to fluff any feathers. I'm simply trying to get an opinion to experienced nurses and try to see this from the nurses point of view. I'm a nursing student so my POV is still very... Read More

  1. by   cardiacmadeline
    OK, so I know we don't have all the sides of the story. But based on the OP and other posts, I honestly don't see what the OP did wrong. Other than the O2 sats, which I stated before, if it was continuous monitoring, how can you expect the family not to look at it? Wouldn't you if it was your mom? However, families can watch it, but it is ultimately the nurses responsibility to monitor vital signs. I agree, no nurse should actually ask a family member to monitor vital signs. Based on what is being said, the family sat back and didn't interfere. If this truly is the case, please explain to me what they did wrong. What is wrong with families helping with the little things? If a patient wants their leg elevated (if their medical condition warrants this), what's wrong with the families doing this? Even if the nurse was having a horrible day, it would still be no excuse for how she responded to the pain and chair issue. No matter how bad of a day I am having, I never ever talk to patients and families like that.
  2. by   Ruby Vee
    Quote from momofqc
    thank you everyone for reading and replying. let me sort of answer/clarify a few things.

    1. the chair thing....we were belligerent in asking, quite the contrary. i'm sure if she would have just said "no and this is why" it wouldn't have been an issue, it was more of her unnecessary tone that was an issue and made everyone feel uncomfortable.

    2. i didn't just chime in and say "i'm going to do all of her care because i'm a nursing student. my mom had told her i was before i got up there. the nurse asked me to keep and eye on her o2 sat. i also helped my mom turn and get positioned. the cna was fine with that...it helped her with her workload. they both acted like they were more than happy to have someone experienced there to help.

    3. we weren't in the way. it's a huuuuge room, my sister sat in one corner and my dad in the other. my dad and sister both had a laptop to occupy them and keep noise down. when the nurse came in we made sure we weren't in the way, everything was picked up and tidy and we kept our mouths shut.

    4. i know that in nursing between the pt. demands, dealing with families, workload..yadda yadda yadda it's stressful and tiring at best. but i also know, and this situation just reitereated, that to each pt. you're their nurse. how could they possibly know what it's like to be a nurse, or a cna, or a pharm tech...whatever it is. they can't and you can't expect them to. if you went to a restaurant you want the server to be nice and hospitable...you don't care if they had a bad day, if they have a crapload of tables and side work, if they worked a double and have class the next morning. if they are rude and don't live up to our expectations we don't tip well or complain to the manager. it's no different. it's a service minded job. people expect a certain level of communication from all professions.

    5. if so many nurses are so unhappy taking care of pts and families, workload, not enough pay, schedules, dealing with other nurses. why not find another job in another profession. every job/profession sucks period. every job has crappy schedule, crappy customers, crappy bosses, get in the way of our own personal lives. that's just how it is be it a nurse, pharmacist, doctor, waitress, mailman, whatever. working to live sucks. i feel i have to look deeper at it than just a job...it's an extremely important job and it demands my respect if i'm going to want others to respect me.


    you asked for advice and input from experienced nurses and you got it. but it sounds as if what you wanted was merely to vent about some "inferior service' you felt you received. guess what, student. nursing is patient care, not a service profession. the "suits" seem to have lost sight of that concept but hopefully they'll catch on sooner rather than later. we nurses have not lost track of the concept even though you apparently weren't taught that (yet) in your nursing program.

    the "yadda yadda yadda was unnecessary as was your assertion that anyone who doesn't radiate perkiness to your standard ought to just find another profession. get back to us once you've walked a mile in our shoes and let us know how you feel then.
  3. by   Virgo_RN
    Quote from momofqc
    OK. I don't want to fluff any feathers. I'm simply trying to get an opinion to experienced nurses and try to see this from the nurses point of view. I'm a nursing student so my POV is still very different from that of a seasoned Nurse and I understand this fact.

    My mother had surgery today. She was scheduled to have a Hysterectomy and a Tummy Tuck. Her Hematocrit was too low (25) to do the tummy tuck so she just had the hysterectomy and will do a tummy tuck in roughly 6 weeks when she has healed and hopefully brought her iron back up. She has lost tons of weight and kept it off through diet and exercise alone. She quit smoking after 20+ years as well. Needless to say, this was a big day full of ups and downs for her and the whole family. (myself, dad, sister and brother)

    Once she got to her room 2 hours post op she was doing as well as can be expected. She was of course in and out of it but pretty much knew what was going on. My dad, sister and I were there in the room. My sister had planned on spending the night with her and helping her with anything she needed. I was helping her with positioning, drinking fluids, answering any questions she or my dad had. My family has always believed that family involvement is very helpful to the nurses and we have always wanted to do as much as we could knowing that nurses are extremely busy and their time is precious. That all being said. My mother's nurse was less than enthusiastic that my mom would get talkative with her, my mom simply does this out of nervousness (esp with people she just met). I told the nurse I was a student and just about to graduate. I could make sure she did her incentive spirometer, kept and eye on her O2 sat, and let her know if we needed anything. Well, there were only 2 chairs in the room. We were all fine with one of us standing and being busy or just simply standing looking out the window during quiet times. My mother however was a typical mother and insisted that there was a third chair in the room. I asked the CNA, my sister also asked the CNA. We were told no problem and she would bring one back when she found one. Two hours pass and my sister and dad go to eat. When they come back my mom, once again in and out of a morphine nap, insisted there be a third chair. When the nurse came to the room my mom asked for a third chair very sweetly with a raspy dry voice. The nurse, in a not so nice tone said she'd try to find one. Moments later, she came back and said "Well here you go but just so you know now the room next to you has to be without a chair because of you. I hope you're happy".

    Of course her tone didn't sit well with my mom, dad, or sister. I brushed it off and said she probably has a big workload and is tired. Then a couple hours later my mom was starting to have more pain that she thought she should. I know that the nurse needs to hear from the pt. herself the description of the pain so we called the nurse. Well, she was less than happy to have to discuss this with my mom and simply just said "well I gave you Toradol so any pain you have you just have to deal with"


    To me, this is very uncompassionate care. I understand that nurses see a ton of different people, pt's as well as their families. But for my family, this wasn't a daily thing. This was a stressful and difficult day physically and emotionally. My mom and dad don't do this everyday, they paid a lot of money via insurance as well as out of pocket. Of course my mom was upset and didnt' feel comfortable with her nurse. I really wanted to go speak to the charge Nurse about it but I didn't, I left it alone.


    Is my family wrong in feeling that this was very unprofessional as well as uncompassionate or as a nurse is everyone supposed to just bow down and be glad you even came to their room and answered the call?
    1) Experienced nurses are giving you their point of view, which you say you asked for. It's really bad form to argue back about why they are wrong.

    2) That question at the end wasn't a real question, was it? You already know how you feel.

    Overall, I find your post disingenuous. I don't think you really wanted feedback so much as validation. If things happened exactly as you described, then yes, that nurse does sound rude. However, I agree with a previous post that most likely there is your side, the nurse's side, and what actually happened. There is no way anyone can tell from an internet forum posting what really happened in that room.

    As far as the pain med, I would have taken the time to educate your Mom on how to use the PCA, explained to her that she should push the button frequently to get the level of pain med in her blood stream up, and to not wait for the pain to get bad before pressing the button again, but instead, to press it every time she feels the pain creeping back up. I would have explained that waiting too long results in increased pain levels that are harder to overcome, and that frequent button pressing to keep the level of drug in the blood stream is far more effective. I would have explained that she cannot overdose; that the machine is set to only deliver a specific amount of drug, and that we are monitoring her status closely.

    As far as the chair, that would have been WAYYYYYY down on my priority list. I would have simply told her that chairs are in high demand, as every patient has family members at the bedside and each room only gets two. I would make no promises and make it clear that a chair may not happen, but I would certainly snag one for her if I just happened to see an unclaimed one.
  4. by   Ruby Vee
    Quote from momofqc
    maybe as nurses you could put yourselves in your pt.s shoes and realize that they and their familes are scared, stressed and not at their best. to expect them to be is unrealistic during a time of family crisis and i believe i learned in my first nursing class that pretty much any hospital stay is a time of crisis for the pt and family. it's completely out of their norm in an environment that most are uncomfortable in. maybe that's where the compassion can come in and realizing this can make your job as a nurse better.
    what you've obviously failed to grasp is that seasoned nurses are people too, and we've all either been in the hospital or had a family member hospitalized. telling us to put ourselves in your shoes is ridiculous -- we've all been there. i'm a cardiac icu nurse; have no experience with gyn surgery and was terrified last week when i went it for some. my father died in january after a prolonged hospital stay. and those are just the most recent events.

    instructing us about the role of compassion in caring for patients and their families makes it clear that you weren't seeking information; you have an agenda. i'm sorry your mother had a negative experience, and i'm sorry you and your family created a negative experience for the staff involved. i'm sorry you don't get it after having it pointed out several times. once again, good luck in your nursing career and be sure to visit this thread after you've been walking in our shoes for a couple of years. i'd love to know how you feel then!

    (i'd be cringing with embarrassment.)
  5. by   Fiona59
    One last thing, we don't permit visitors/family to assist staff to transfer or reposition a patient. The Workers Comp. Board will refuse to pay an injury claim if you are injured doing routine bedside care in an "unsafe manner". The family/visitor has sued the health region when they have injured themselves. If the family/visitor wants to reposition while we are not in the room fine, but we do turn down your offer of "help".
  6. by   RN1982
    Regarding the chair, thanks Virgo. The chair is way low on my priority list. If I had to choose whether or not to give a patient their pain meds or another family member a chair, the chair would be the last thing to do. I'm so sick of the whining about "But I didn't get my chair until an hour after I asked.."....Patient care trumps a chair.
  7. by   Higgs
    There is never any reason why a nurse should be snippy to *any* pt.

    That's what professionalism is all about. Makes no difference whether you're tired, hungry, on a long day, going to answer a pt's buzzer for the millionth time that day - it should never happen.

    If she's snippy when visitors are present - then I'd hate to imagine how she is with pts alone in the room.

    Write her up and be glad you did.
    Last edit by Higgs on Jun 19, '09 : Reason: typo
  8. by   cardiacmadeline
    Quote from Fiona59
    One last thing, we don't permit visitors/family to assist staff to transfer or reposition a patient. The Workers Comp. Board will refuse to pay an injury claim if you are injured doing routine bedside care in an "unsafe manner". The family/visitor has sued the health region when they have injured themselves. If the family/visitor wants to reposition while we are not in the room fine, but we do turn down your offer of "help".
    I should take back my comment on families helping to reposition. You are right, they probably shouldn't be helping with repositioning. And when I say helping, I mean assisting nursing staff. But if family wants to elevate mom's leg/arm or make minor adjustments, is this OK?
  9. by   RedhairedNurse
    Quote from leslie :-D
    as a student, i would like to inform you that while nurses who are compassionate, are ideal, it is not a requirement.
    nurses at all times, should be professional, efficient and competent.

    as for the chairs...
    no, it was not priority and depending on how often you/family asked, perhaps it came across as a bit persistent?
    i don't know...
    but do know that sometimes, finding various items can be challenging at best.
    however, the nurse saying "i hope you're happy" was inappropriate.

    re the pain...i'm not understanding.
    it sounds like mom was on a mso4 gtt and had prn toradol?
    is that right?
    how recently had she gotten the toradol before complaining about the pain?
    the way you describe it, it sounds like she only complained of pain once...is that right?
    is that the only time she had seen this nurse in regards to her pain?
    it would also be interesting to hear what the nurse had to say.
    but, it is perfectly reasonable to ask and relay your concerns to the doc re pain mgmt...

    bottom line is regardless of the situation, we are always expected to respond professionally.

    hope mom feels better.

    leslie
    Compassion is not a requirment, but we are in customer service and we should provide people with the same respect we would expect in the same situation. Whether or not she had just received pain meds or not, the nurse was disrespectful and rude!

    To the OP:

    You need to file a complaint against this nurse ASAP! Without
    question, I would report it if it were my mother. Probably burn out,
    I see it with nurses I work with, sad but true.
    If this nurse is ever in the hospital, maybe
    she'll get a lesson one day on how to be nice and respectful.
    This is one reason I went into nursing myself, to try and make a difference.
    There were many times that I was treated badly by a nurse
    when I took care of my dear loved one for many years.


    Just let this be a reminder to you when you go into nursing.
    When we've been on the patient/family side, esp as many years
    as I was, I think it gives us more understanding to the way patients and family should be treated.

    PS. Sorry for every thing, sounds like your post didn't go over so
    well with other's. Sorry about that. Don't take it too personally.
    Seems that typing makes it easy for people to tell how they really
    feel regardless of your feelings. There are good nurses out there!
    God Bless!

    Take care!
    Last edit by RedhairedNurse on Jun 19, '09
  10. by   RedhairedNurse
    Quote from Purple_Scrubs
    I beg you to come back and revisit this post after you have been a nurse for a year. I can pretty much guarantee your perspective will be different.
    I've been a nurse for over a year now and still agree with the OP.
    I don't understand how you think she was wrong and her nurse
    was not in the wrong.
    Sounds like another burn out to me.

    It's hard to understand some of the posts I'm reading here.
    Sad for my profession at times.
    Last edit by RedhairedNurse on Jun 19, '09
  11. by   LEN-RN
    Quote from momofqc
    Thank you everyone for reading and replying. Let me sort of answer/clarify a few things.

    1. The chair thing....we were belligerent in asking, quite the contrary. I'm sure if she would have just said "no and this is why" it wouldn't have been an issue, it was more of her unnecessary tone that was an issue and made everyone feel uncomfortable.


    4. I know that in nursing between the pt. demands, dealing with families, workload..yadda yadda yadda it's stressful and tiring at best. But I also know, and this situation just reitereated, that to each pt. you're their nurse. How could they possibly know what it's like to be a nurse, or a cna, or a pharm tech...whatever it is. They can't and you can't expect them to. If you went to a restaurant you want the server to be nice and hospitable...you don't care if they had a bad day, if they have a crapload of tables and side work, if they worked a double and have class the next morning. If they are rude and don't live up to our expectations we don't tip well or complain to the manager. It's no different. It's a service minded job. People expect a certain level of communication from all professions.

    5. If so many nurses are so unhappy taking care of pts and families, workload, not enough pay, schedules, dealing with other nurses. Why not find another job in another profession. Every job/profession sucks period. Every job has crappy schedule, crappy customers, crappy bosses, get in the way of our own personal lives. That's just how it is be it a Nurse, Pharmacist, Doctor, Waitress, Mailman, whatever. Working to live sucks. I feel I have to look deeper at it than just a job...it's an extremely important job and it demands my respect if I'm going to want others to respect me.


    1. In rereading your post, it says that the 3rd chair was "insisted."

    2. I am an RN, and purposely leave that out when my family is receiving care. Unless I am unhappy about something and want them to know what I am talking about. And believe it or not, it does not improve service. Quite the contrary. (thats why I dont like to tell)

    3. Family members can drain staff very quickly. You will find that they come out like ants. You give alittle, and they demand it all. Before you know it, you are giving snacks to sons in law, brothers in law, ex spouses, ex sisters in laws, next door neighbors, ex next door neighbors, ladies from a church that the patient doesnt even go to anymore. I am not kidding. "This drawer sticks when I open it." and what were you doing opening the drawer?? Your not the patient. "can you find the fishing channel?" the patient is asleep, I doubt 90 year old Aunt Lucy watches the fishing show ANYWAY. "what is the phone number to the pizza shop across the street?" or "we need to let Uncle Lester know shes in here. do you have a phone book." or "little bobby knocked his mouth on the bed frame. can we get some ice?" So why did you let little bobby treat the bed like a junglejim??

    You are right, nursing is a service industry. But when a nurse is being investigated for neglecting a patients in room 101... I doubt the nursing board, or attorneys are going to care that the family members in 104 were wined and dined and taken care of.

    The patient is the reason the nurse is there. Not the family.

    *I do think the nurse sounded rude, and her reponse to your mother about the pain med was unacceptable. I do think you should have reported it, and asked for a different nurse.(the hospital should be made aware) Or contacted the doctor about the pain. He would have been right on it.(hopefully)
    Last edit by LEN-RN on Jun 19, '09 : Reason: ADD
  12. by   Moogie
    Quote from momofqc
    Of course her tone didn't sit well with my mom, dad, or sister. I brushed it off and said she probably has a big workload and is tired. Then a couple hours later my mom was starting to have more pain that she thought she should. I know that the nurse needs to hear from the pt. herself the description of the pain so we called the nurse. Well, she was less than happy to have to discuss this with my mom and simply just said "well I gave you Toradol so any pain you have you just have to deal with"
    I agree with other posters that there is no reason for a nurse to be snippy with a post-op patient who is having problems with pain control. Regardless of the reason---whether her life is falling apart, she had a bad day or that's just her nature---there are more professional ways to deal with patients and families than to tell someone in pain to "deal with it".

    Quote from momofqc
    OK. I don't want to fluff any feathers. I'm simply trying to get an opinion to experienced nurses and try to see this from the nurses point of view. I'm a nursing student so my POV is still very different from that of a seasoned Nurse and I understand this fact.
    I think the OP is aware that she's not an experienced nurse and, from what she said, she is interested in hearing how experienced nurses would approach the situation, both as nurses and as family members or patients. After a year of experience, sure, she might view this situation quite differently. But she's dealing with her feelings NOW and trying to get a handle on the situation as it occurs. Most of us have 20/20 hindsight and, with professional and LIFE experience, we see things from a different perspective after they occurred. I get the impression the OP is trying to gain some insight from experienced nurses to help her deal with her feelings now, not to determine how she will feel in the future.

    Quote from momofqc
    Once she got to her room 2 hours post op she was doing as well as can be expected. She was of course in and out of it but pretty much knew what was going on. My dad, sister and I were there in the room. My sister had planned on spending the night with her and helping her with anything she needed. I was helping her with positioning, drinking fluids, answering any questions she or my dad had. My family has always believed that family involvement is very helpful to the nurses and we have always wanted to do as much as we could knowing that nurses are extremely busy and their time is precious. That all being said. My mother's nurse was less than enthusiastic that my mom would get talkative with her, my mom simply does this out of nervousness (esp with people she just met). I told the nurse I was a student and just about to graduate. I could make sure she did her incentive spirometer, kept and eye on her O2 sat, and let her know if we needed anything. Well, there were only 2 chairs in the room. We were all fine with one of us standing and being busy or just simply standing looking out the window during quiet times. My mother however was a typical mother and insisted that there was a third chair in the room. I asked the CNA, my sister also asked the CNA. We were told no problem and she would bring one back when she found one. Two hours pass and my sister and dad go to eat. When they come back my mom, once again in and out of a morphine nap, insisted there be a third chair. When the nurse came to the room my mom asked for a third chair very sweetly with a raspy dry voice. The nurse, in a not so nice tone said she'd try to find one. Moments later, she came back and said "Well here you go but just so you know now the room next to you has to be without a chair because of you. I hope you're happy".
    Maybe the extent of family involvement may seem like too much to many of us, but has it occurred to anyone that possibly the OP is of a different culture than the nurse she thought was "snippy"? Culture of origin often sets the individual and family standards for what is appropriate or not in terms of reacting to pain, dealing with grief and family involvement. The high amount of family involvement may have seemed unusual to the nurse, but had she assessed the situation completely, it might have made sense to her. Moreover, I am sure the chair was not a big deal to the nurse, and maybe it was against facility policy, but it obviously was a big deal to the patient. Would it have been so difficult to either calmly and kindly explain the policy or just get the chair without complaining? And if she was so busy and inconvenienced by trying to get a chair, couldn't she have asked a CNA or tech to get it for her?

    I think another factor in the nurse's behavior (as well as something that's influencing some of the posts here) is that, intentionally or UNINTENTIONALLY, the OP may have come across as threatening. Sometimes, when a family member (or patient) says, "Oh, I'm a student nurse...or RN...or LPN...or nursing instructor or whatever" it comes across as "Listen here, nurse. I'm going to watch every move you make, check for every mistake, look at the slightest screw-up. Because I'm a nurse (or a student) and I know it all." Again, that may not have been the intention AT ALL for the OP's remarks but that's likely how it was interpreted. I've had patients/residents/family members, etc. tell me that they were nurses in attempts to just start conversation. I've had nurses tell me they were nurses in an effort to intimidate me. I also had a situation in which a family member who was a DON wanted to be very involved with her relative's care in an effort to handle her loss and deal with the lack of control she had over the situation. Unfortunately, sometimes my first reaction in such situations was defensive, wondering if the nurse-family member was doubting my competence---even after years of experience. I think that's a very human way to respond and might be what's behind the defensiveness in some of the responses on this thread.
  13. by   RedhairedNurse
    Quote from Fiona59
    I hate to tell you this but the third chair just wouldn't happen in my hospital. Two visitors to a room and no overnighters unless the patient is dying.

    Post op we have the patient leave the room for 30 minutes because we have work to do without having to constantly ask the relatives to step aside so we can work. Even then many patients are too groggy, in pain or just plain out of it post op to deal with visitors. We've had them thank us for asking their families to leave. They are there to recover not visit.

    Frankly, we're fed up of this "I'm my relative's advocate" line that is being promoted by worthy publications such as the Readers Digest and media pundits like Glen Beck. We don't ignore our patients, we don't let anyone die. If the average nurse has enough room to do his/her job, they are usually good at it.

    The pain meds, maybe she just opened her mouth and what she was thinking came out. Brain fart for lack of a better time. I've seen q3h morphine followed by q6h Toradol, warm blankets, you name it be inefctive for something as simple as a lap appi, only to discover later that the patient is on 80mg Oxycontin q6 for back pain that they forgot to mention.

    Walk a few miles in the nurses shoes and then see how you'd deal with it.
    NOT! Take a look at the Board of Nursing website to see how many nurses
    are losing their license Each Month because they are ignoring their
    patients and/or letting them die. Texas BON is a good one to look over.
    I advocate having family to advocate for the patient. My mom would
    be dead right now if I weren't in the room, very seriously. Nurse could
    not and did not recognize her s/s of fluid overload. Her BP was 175/100,
    pulse 140, resp 40. Myself, being ONLY a nursing student, got the
    doctor on the line, my mom was better in a matter of hours. Go figure that one!! They told me she was in heart failure and was dying, I knew better being ONLY a student. FAMILIES KNOW THE PATIENTS ALOT BETTER THAN NURSES DO!

    I agree there are crappy family members, but still no cause for
    disrespect. Get another assignment if need be.
    Last edit by RedhairedNurse on Jun 19, '09

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