How do you deal with irate family members?

[asun21ta]

The last incident I had was a resident's daughter being so upset her mother's breif was wet, she waved it in the Supervisors face and mine. She accused me of giving poor care, when I had just changed her mom 45 minutes prior! I was in another residents room cleaning up a toilet overflow. When I opened the door, she was dangling the dirty diaper in front of the supervisor. When she saw me come out the room with a ton of wet linens, she began to yell at me. Not even giving me a chance! She then wrote a letter saying that because I am per diem, I don't care about her mother-which is totally untrue! Her mom is a doll. The daughter is the difficult one! I treat everyone with dignity and respect and I know I go above and beyond when it comes to patient care. My DON says it's the guilt talking and not to worry because she knows I am a hard worker.

I have worked as a CNA for several years. This LTC that I work for has to be #1 when it comes to complaints from the families. So my question is, how do you deal with irate families or families who have issues everytime they visit? Many of us (Nurses included) want to run for cover when we see certain family members!

[yousoldtheworld]

Most of us deal with difficult family members at one time or another, so I know how you feel. If I know I didn't do anything wrong, I just try to brush it off my shoulders.

If someone complains to me, I apologize, rectify the situation as soon as possible, then get my nurse or supervisor to talk to them.

Your DON is right - people feel guilty about putting their family ones into facilities, and if they see something that isn't perfect (and even sometime when they don't) they lash out. Not only that, but most of them have never worked in healthcare and they have NO IDEA how difficult it is to be everywhere, doing everything at the same time.

Being experienced, you probably know this but jut in case someone doesn't: Any time you have a complaint made by a family member, MAKE SURE you direct them to your nurse or at least report it to the nurse. This is just to cover your behind in case the person were to go further up and complain that their problem wasn't addressed.

[asun21ta]

I should add, later that night, she was on her cell phone in her moms room yelling so everyone could hear. She called all the CNA's are "stupid" and she doesn't know why half of them have a job. She then proceded to say she was going to get all of our licenses revolked because we CNA's were "stupid jack @@". When I alerted the supervisor to inform her the family member was making other residents uncomfortable as well as myself. I advised the supervisor that she was creating a hostile working environment. The supervisor then reassured her that it would not happen again. We even had a family member who was a so called "nurse" dart at our nurse while disputing a signature. At what point do you draw the line against a family member? Above instances being short of assult and extreme hostility, how far is too far?

[RochesterRN-BSN, BSN, RN]

I worked for a short time as an ADON in long term care and well to say the least it ended bad-- One of the other ADON's didn't like me...for no good reason....and was in tight with the DON so she got her to fire me--again with no actual reasons---

But thats another story! LOL So yes I undrstand the difficult families.......have you had one of the social workers try talking to the family? Sometimes that can help.... a meeting with the DON and the SW and family and Administrator or owner if possible. They need to find out what the patients actual complaints are and try to come up with a plan that will satisfy the family--if they are still just nasty and out of control to the point of harrassment I have seen an administrator and DON tell a family that they would need to find another LTC facility for their loved one as their behavior--despite all their efforts to please the family-- has made it an intolerable environment for the employees and the other residents as well......offered to have the SW fax out a current PRI to a few places of their choosing, but that they had 30 days to find other accomodations.......

Seriously they did this--it was awesome!!!

[yousoldtheworld]

Ugh. One of those times when you'd just like to be able to say "Look, if you're so unhappy with everyone and everything here, you are beyond welcome to GTFO!"

[fuzzywuzzy, CNA]

^Yeah, or "It's called HOME CARE."

I remember this one family we had who treated us like their own personal servants. We were constantly fetching them sodas or whatever. One daughter would come at supper time specifically so she could eat everything off her mother's tray rather than go home and cook. It really ****** me off when I'd get her a soda and she'd make comments about how it wasn't cold enough, and whatever else. One time she asked me to take her mother to the bathroom, please, and then said, "Why did I say please?" I was like, "because it's polite" and started stuttering, trying to explain herself. She was not rude to me again. That family also had loud, profane screaming matches in the hallway a few times and had to be asked to leave.

[systoly]

There are many reasons why family members become irate. Guilt, as mentioned above, is one of them, but there are many others. I believe Expectations is a big one. When our expectations are not met, we tend to board an emotional rollercoaster. Many family members have expectations based on lack of knowledge not only of operation of long term care, but also of the aging process. For instance: you just turned a patient after giving peri care, only to have the patient expell residual urine just from being turned. The next lay person that comes along might think you didn't do your job. Often times expectations are formed or wrongfully reinforced by promises made on admission. Do I fault the admissions director for painting a scene where the milk and honey floweth over? Not on payday. As always, prevention is the best cure, but that's another topic. When confronted with an angry family member it is appropriate to validate their anger, "I know you're very upset, so let me get the charge nurse please". I discourage my CNAs to immediately appologize for the following reasons: fault has not been established, appologizing in the absence of wrongdoing might encourage the behavior of using the CNA as outlet for poorly managed emotions. So make sure the patient is safe and get the nurse. As far as dangling the soiled brief is concerned: absolutely inappropriate, big infection control issue, much bigger issue than the patient wearing the soiled brief. Remember, you don't know who's brief this is. It could be from the patient with UTI or C-dif or even worse. When faced with a dangerous situation like that, it's ok to state that this is unsafe and ask the family member to place the brief in an appropriate receptacle immediately while you get the nurse. Remember, be nice, be polite, be professional, don't apologize for doing your job, accept criticism and sarcasm, but don't allow anybody to use you as a punching bag.

[ctmed]

Ah yes, the terrorist family members.

Hopefully you work with a facility that supports thier workers. I one

time got fired at a hospital for being "rude" and not bringing

cranberry juice for 45 minutes during a busy night. (of course

politics were involved as well with a new boss looking for an excuse

to be rid of me.. but that's another tale. I was working the next week

at another place making more money)

If you do not, consider another facility.

That said, there are some ways I have found to make things easier.

- Sorry, Thank You for bringing that to my attention, I'll get on it.

There is an old Hotel-Restaurant axim to deal with irate guests

called STARS that can kill most MOST of this before it gets big.

Basically, it means:

Sorry- "I apologize that your family member was wet."

Thank You- "Thanks for bringing that to my attention. With

my other duties it is hard for me to know precisley when your

family mmer wets evn though I strive to check frequently,"

Action- Actually change the diaper.

Recover- Re-organize yourself.

Share- Tell other CNAs and the charge nurse so they can have

heads up about icomng terrorists.

If you know the approximate time they visit, you can make an effort

to make sure this is taken care of before they arrive.

I try not to make small talk with the extremely agitated terrorist variety

other than sorry and thank you as few things can change thier

enraged state and sometimes they can twist words to make

you sound bad. I do my job and get out of thier view.

Needless to say, never argue with a terrorist because you will

not enlighten them. Instead you will give them "proof" of your

bad attitude and you could very likely end up looking for other

jobs sooner than you would like.

It's a tough spot. Sometimes, once terrorists understand the workload

and the system of LTC I have seen former terrorists converted into

merely concerned family members. But this is usually after a long period

of talking with the DON, staff nurses, and others. The ones that do not

have deep issues that is best handled by the facility management.

Main thing is do your job and be without blame. If they continue

to make ''''''''' of themselves, I have seen DONs send them to other

faciities in the same manner an above poster mentioned.

Good Luck