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

Nurses General Nursing

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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?

I didn't say that the nurse was a royal beast. I'm simply telling specific events. I think she's more than likely very lovely. I was there the whole time at no time was myself, my father or my sister hovering around my mother. We stayed seated against the wall or in a corner and out of the way except when my mother needed something. Nursing wise it would be silly for her to be up there by herself. If she needed a drink, she'd have to call the nurse. If she needed to reposition she'd have to call out to the nurse. At no time was anyone in the RN's way. At no time did she have to maneuver around anyone but her pt. Honestly, it was up to the CNA to check her vitals....she missed the O2 when it went down to 88% and I informed the nurse which she thanked me for, started O2 and told me to let her know if it dropped again. As well as making sure to make her do incentive spirometry. I'm not saying that this RN was incompetent. I was simply posting this question to bring up a point. It's not unreasonable for a husband and 2 daughters to be with a pt. immediately post op. There weren't cousins, aunts, uncles, friends or anyone else....simply her husband (who doesn't feel comfortable around medical issues anyways) and 2 competent daughters who have both been in the medical field and worked one on one with patients and their families. I agree, some families are difficult and rude and obnoxious. However, this is not my family and I'm sure if I asked the nurse herself she would agree.

Expecting someone to just up and change careers isn't realistic. But you know what, nothing is for certain. You could lose your job as easily as anyone else in these times and then what?

You still have an ethical duty to provide the best care to your pt's and sometimes that means putting your own feelings, heartaches and bad moods aside. Just because I'm not a RN doesn't mean I don't know what I'm talking about. If an Md was rude I'd say the same thing, and then all the RN's on here would say well, you're right the MD had no right to act that way. But you don't know his life, his circumstances, his workload, what's going on at home, his bills....none of that...and MD's feel the same way as nurses...their job is highly demanding and nurses don't know what they're talking about when they complain about their job. I know, I dated a few dr's and they all say the same thing.

I know that nursing is a difficult career. I was going to school to become a pharmacist when I was younger. I quit because of talking to pharmacist's that hated their job and said how horrible it was. They thought nurses and dr's had it easy and had no idea what their job was like. Well, it's the same thing...don't you guys see that? Don't you see that nurses, doctors, resp therapist's, occ. therapists, so on and so on and so on all feel the same way about their job and taking care of the public meaning pt's as well as families. It is what it is...it's a career and yes it's gonna suck a lot. There's always things good and bad about all career's.

Does anyone know of any career they can think of that would be easier than nursing???? I guarantee you the people working in that field would beg to differ. It's just like working moms think they have it harder than stay home moms and vice versa. It's all relative.

Advocating for families to do more pt care came about not only because of understaffing but also because pt's are dc'd so soon these days. Sent home to families that have to take care of them before the pt can take care of themselves. Is it really so bad to have a family that wants to do this under the supervision of a nurse so that he/she can give families constructive criticism and feel confident in their caretaking abilities. Not everyone feels comfortable doing this like it's second nature..it takes time and it's scary for some.

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.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
it's hard to say, since we have only one side of the situation. are the quotes by the nurse verbatim or paraphrased?

i agree -- we've only heard one side of the story. the quotes may be paraphrased and no one else witnessed the tone of voice. i will say, from the standpoint of the experienced nurse however, that the multiple requests for a third chair may have been extremely irritating, especially when many units have only two chairs per room because only two visitors are allowed. having multiple visitors in a room actually interferes with care -- especially when we have to stop and explain everything to each visitor separately.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
am i the only one that sees a problem with this? basically you dismissed her nurse and said that you, the about-to-graduate nursing student would take care of your mom. i don't care if you're graduating or even if you have a msn, *i'm* responsible for my patients and *i* monitor their sats and give their care. and face it: daughters don't want to see their moms in any pain and unfortunately i've never seen a post-op patient (esp post-hysterectomy) with zero pain even with the best of meds. surgery hurts. if that nurse didn't have to wade thru several family members to attend to her patient maybe she could have tried repositioning her or relaxation techniques to help ease her pain.

i can't begin to speak to the third chair issue.

goodness, i'm grouchy this morning, but this rubbed me the wrong way :(

no, you're not the only one who sees a problem with this. between the multiple visitors each with a different agenda, the multiple requests for a third chair and the implication that the nursing student would be taking care of her mother, i can see why the nurse would be extremely irritated with the whole situation. also, we don't know exactly what the nurse actually said or how it was said, we only know what the family member thinks she heard. and as we all know, family members, especially family members under stress often don't hear what we think we said to them.

the nursing student in this scenerio is asking for input from experienced nurses. as an experienced nurse, i can see a number of reasons why an experienced nurse would be irritated with this scenerio.

Specializes in cardiothoracic surgery.

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.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.

:twocents:

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.

Specializes in Cardiac Telemetry, ED.
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.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

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.)

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".

Specializes in ICU/Critical Care.

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.

Specializes in Med/surg. ED. Palliative. Geront.

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.

Specializes in cardiothoracic surgery.
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?

Specializes in Med Surg, Ortho.
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!

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