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

RedhairedNurse, BSN, RN · Jun 19, 2009

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.

LEN-RN · Jun 19, 2009

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)

Moogie · Jun 19, 2009

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".

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.

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. :twocents:

RedhairedNurse, BSN, RN · Jun 19, 2009

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.

Moogie · Jun 19, 2009

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.

Sounds like you have dealt with family members from Hades. Does your administration and nursing management condone such outrageous behavior? Do they convey the attitude that your institution is not a health care facility but a hotel with nursing staff? Explicit or covert messages from management and administration that any family behavior or demand is acceptable might be setting you and your co-workers up for this sort of nonsense. Behaviors like that would drain ANY nurse and might make it less likely for him/her to be understanding for other, more reasonable family demands.

You are right that the patient is the reason the nurse is there. Throughout my nursing education, I've had it drummed into my head, though, that to holistically address a patient's needs, we must consider the family system and sometimes address family needs as well. We can't just take care of patients in isolation from their family members---though sometimes, yes, that might be better for everyone!

I'm old but idealistic enough to believe that there can be a middle ground between serving coffee to ladies from the church the patient no longer attends to meeting the legitimate needs of a family in crisis.

Virgo_RN, BSN, RN · Jun 19, 2009

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!

No. I am most certainly NOT in "customer service". I am a healthcare professional. I do not care what bill of goods the hospitals are trying to sell. My job is to keep my patients safe, to protect them from harm, and to help them to recover from the acute phase of illness and transition to the next level of care. I am not a waitress.

LEN-RN · Jun 19, 2009

Sounds like you have dealt with family members from Hades. Does your administration and nursing management condone such outrageous behavior? Do they convey the attitude that your institution is not a health care facility but a hotel with nursing staff? Explicit or covert messages from management and administration that any family behavior or demand is acceptable might be setting you and your co-workers up for this sort of nonsense. Behaviors like that would drain ANY nurse and might make it less likely for him/her to be understanding for other, more reasonable family demands.
You are right that the patient is the reason the nurse is there. Throughout my nursing education, I've had it drummed into my head, though, that to holistically address a patient's needs, we must consider the family system and sometimes address family needs as well. We can't just take care of patients in isolation from their family members---though sometimes, yes, that might be better for everyone!
I'm old but idealistic enough to believe that there can be a middle ground between serving coffee to ladies from the church the patient no longer attends to meeting the legitimate needs of a family in crisis.

Unfortunately, money and reputation are the bottom line. Also, families are catered to because unhappy families and friends can bring complaints, whether valid or not. And complaints mean investigations, paperwork. So management says to smile, do the best we can, and smile, smile, smile.

I drew the line when a mother left a sticky note on the television in a waiting area Big BOLD LETTERS "Animal channel or Cartoon channel ONLY", because she would let her children run back and forth unattended. Half the time they werent even watching tv. But she didnt want any other visitors to change the channel. The other staff wouldnt touch the note. I tore it up. I told her it was a public room.

LEN-RN · Jun 19, 2009

No. I am most certainly NOT in "customer service". I am a healthcare professional. I do not care what bill of goods the hospitals are trying to sell. My job is to keep my patients safe, to protect them from harm, and to help them to recover from the acute phase of illness and transition to the next level of care. I am not a waitress.

I agree with you, and still do. But some of those demanding family members can cause alot of trouble. Most of the time, I just grin and bear it. They may have a long wait, but I tell them someone was crashing, and I was knee deep in blood.(lol not really the explanation, but something similiar) That usually calms them down.

Virgo_RN, BSN, RN · Jun 19, 2009

Yep. The good news is if I'm not hovering over you, you're not my sickest patient. The bad news is that you might have to wait a bit for that cuppa coffee. Am I rude about it? Of course not. I follow the Golden Rule. But the simple fact is that while whether or not you got what you ordered on your dinner tray might be your top priority, my top priority is the guy next door who is trying to climb out of bed with a sheath in his groin. It's a hospital, not a hotel. I'd rather deal with a complaint that I didn't get a patient their correct dinner tray than have a sentinel event on my conscience.

Maybe that's what's behind that nurse in the OP's attitude. Maybe she's sick of people acting like a chair should be her top priority when she's doing all she can to keep her patients safe. Does it excuse her rudeness? Of course not. But perhaps we can understand it just a little. Maybe she's due for a vacation.

Heck, maybe she put in for that vacation that she's due for and was turned down because the unit is understaffed. You just never know. Again, I'm not excusing being rude to patients, just offering up some thoughts.

maxthecat · Jun 19, 2009

If the nurse reacted as you say I agree she was out of line. I would probably have said something to her charge nurse.

To address another issue that has come up in this thread--if customer service is so important to the hospital then why don't they hire customer service personnel for the nursing units. These people could fetch chairs, serve snacks, handle problems with tv, etc., thus allowing nursing staff to handle assessments, education, medication administration, etc. I have heard that this is not done because it would be a liability problem, but I wonder. Administration seems to have no problem shoving liability onto our backs because of short staffing. Oh, yeah...it's on OUR backs, not theirs!

Ruby Vee, BSN · Jun 19, 2009

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.

a year is just a tiny speck of time . . . .

RN1982 · Jun 19, 2009

I agree with you, and still do. But some of those demanding family members can cause alot of trouble. Most of the time, I just grin and bear it. They may have a long wait, but I tell them someone was crashing, and I was knee deep in blood.(lol not really the explanation, but something similiar) That usually calms them down.

You know what? We shouldn't have to "calm" down any family member because they are irate that they didn't get their chair or cuppa coffee. We shouldn't HAVE to say "Oh, I'm so sorry about the delay, my hands were in another patient's chest".