How do you handle difficult family members?

TheCommuter, BSN, RN · Nov 15, 2008

Unfortunately, I haven't found the universal answer to dealing with difficult or demanding family members and visitors. To be perfectly honest, they remain one of my biggest challenges in the workplace. The only thing I know is that there's no "one size fits all" approach to handling them. In addition, management seems to back them up, regardless of how unreasonable or abusive their behavior is toward the staff.

I prefer to work night shift so I can avoid as many of these difficult families as possible.

lindarn · Nov 15, 2008

Unfortunately, I haven't found the universal answer to dealing with difficult or demanding family members and visitors. To be perfectly honest, they remain one of my biggest challenges in the workplace. The only thing I know is that there's no "one size fits all" approach to handling them. In addition, management seems to back them up, regardless of how unreasonable or abusive their behavior is toward the staff.
I prefer to work night shift so I can avoid as many of these difficult families as possible.

When is the nursing profession going to hold administration accountable for adding to the stress of bedside nursing? We do not need a clueless administration backing abusive family members and patients. No other profession puts up with "customer abuse" like nursing.

If you behaved the way families and patients do when they are patients in a hospital, in the local Walmart, or shopping mall, you would have security and the local police department called to drag your sorry @$$ out of there to the local jail cell. No doubt in my mind.

So again I ask, when are nurses going to hold administration accountable for their lack of support with these imbeciles? Put together a staff meeting, and address this with the nurse manager, and inform them in no uncertain terms, that when patients act up you are calling security and the police and having them arrested. And you will follow up by pressing charges. There is no reason for anyone to have to put up with this nonsense. You can always escort them to the office of the hospital CEO, and let the big wigs sit and listen to the complaints for a change. Especially since they are the ones with the power to change the poor staffing, etc, that seems leads to most of the complaints. JMHO and my NY $0.02.

Lindarn, Rn, BSN, CCRN

Spokane, Washington

soulofme · Nov 16, 2008

Im all for George Carlins "Idiot" dart gun method!

snuffyRN · Nov 16, 2008

Kill 'em with kindness!!!

Ruby Vee, BSN · Nov 16, 2008

i've been known to give them the name and pager number of the nurse manager to let her deal with them. when they instituted 24/7 visiting at my old facility, the manager graciously announced at a staff meeting "and if you have problems, refer them to me." i don't think she expected anyone to take her up on it, but i did several times. i'll never forget the sight of one particularly distraut wife of a patient flinging herself into my nurse manager's arms, whereupon they both toppled over onto the floor. shortly after that, visiting hours were de-liberalized a bit and we utilized security a bit more liberally when we had problems.

SoundofMusic · Nov 16, 2008

I try at least to arm myself with enough knowledge about their case, their problems, what the treatments plans are, etc, so that I can discuss with them the plans. If I go in "blind," I ask them for time to review their case, explain to them that I just came on, dont' know their case, etc. MOST people will understand and give me time to get caught up. Then I can investigate, find out what's wrong, try to help, etc. With most reasonable people, it works.

I also don't get too friendly lately, EVER. I am professional, friendly, but not a "friend" to families. I am their nurse, try to be their advocate, but I'm not their friend. I have been burned from being too friendly with those who simply turned on me in a flash when things started not to go well.

With some who get unreasonable, I will try to politely reason, try to politely provide explanations, and often I can turn them around and get them to calm down. I will try to listen to them as much as possible, see their point of view, etc.

The ones that TOTALLY get me are the ones who complain about the food. I mean -- it's SO childish to me to complain about a hot meal -- who CARES if it's not restaurant quality -- most of it is edible, at least -- and if they are well enough to complain about it, IMO, they aren't even sick enough to be in the hospital in the first place. Just my opinon -- just grinds my gears to no end.

Vito Andolini · Nov 16, 2008

i've been known to give them the name and pager number of the nurse manager to let her deal with them. when they instituted 24/7 visiting at my old facility, the manager graciously announced at a staff meeting "and if you have problems, refer them to me." i don't think she expected anyone to take her up on it, but i did several times. i'll never forget the sight of one particularly distraut wife of a patient flinging herself into my nurse manager's arms, whereupon they both toppled over onto the floor. shortly after that, visiting hours were de-liberalized a bit and we utilized security a bit more liberally when we had problems.

roflmbo

why did she fling herself?

SusanKathleen, RN · Nov 16, 2008

I was a high school teacher for 20+ years, and family/parent issues are very similar to what you are describing. The teacher takes all the grief, because s/he is on the 'front line', meaning easiest access. There were times when I would suggest that they speak to an administrator, and typically, when it was a ridiculous complaint, parents would decline. Some people just live to gripe. The nurse too is the 'front line', also with easiest access. Families are not so willing to create a fuss with a physician or hospital administrator, are they? In my mind, if a complaint was really legitimate, they wouldn't be so hesitant to discuss it with the docs or administrators. Some families have a very cockeyed idea of what health care is supposed to provide. But these people are not going to go away, and they are not dealt with by administrators because it's about the money, and it's about the lawyers. Hope I'm not offending anyone.

The way for me to deal with unreasonable people is to focus on the patient, and not give much credence to difficult family members. Easier said than done, eh?

SoundofMusic · Nov 16, 2008

I also work night shift. Works like a charm . ..unless they insist on spending the night and being a PITA throught the night as well. Most are fine, but there are some who also insist on being taken care of through the night, brought pillows, blankets, etc.

One man got on my nerves so much -- was asking for us to feed him as he also was a diabetic -- basically wanting to be treated for "his" condition also. Would ask for sodas and crackers all night long .. .yikes -- get OUTTA HERE!!!!

Had one lady this past week who chewed me out because her sister "lost" her glasses. Just b***tched me up and down. It was too funny when the glasses were found in her nutty sister's bag after all. I REALLY wanted to go in there and say, "Well, thanks for balling me out over it, lady!"

-- but I didn't. :icon_roll

Virgo_RN, BSN, RN · Nov 16, 2008

I grit my teeth, grin and bear it, and kill em with kindness, and get through the shift, hoping that their loved one will be discharged before I have to come in next time.

mama_d, BSN, RN · Nov 16, 2008

I find that at times, if they are complaining about another shift/facility/docs etc. it helps to cut them off if I say politely "I'm sorry that you feel that way, unfortunately I cannot answer to or take responsibility for the actions of another person/facility. I can however give you my manager's business card so that you may inform her of your concerns. Right now my main concern is attending to my patients' immediate needs on my shift, so I would really appreciate it if I could go and do that now."

If they're being a real PITA and want to complain about what I told them, they just end up looking stupid..."Mama_D told me that she couldn't help me and wanted to take care of the patient instead" is one of the few complaints that I won't get in trouble for.

I have also been known to get risk management involved, even if it's 2am, if it is a big enough issue. And to call security for a walk through if it's getting out of hand verbally or physically.

I did almost get nailed one time b/c I had had it with a verbally abusive, bullying, threatening family member. Another family member came out of the room to apologize, and I told her straight up that the patient was lucky that I was the one assigned to care for her b/c I really don't care how the family members are as far as not letting it affect patient care, but her father's continued threats would be found to be very intimidating by most staff and would eventually result in the patient's care being compromised b/c noone would want to care for the patient and deal with him. When the patient's husband asked me at the end of my shift if I would be caring for the patient the next night, I told him no, b/c I found his behavior to be unacceptable; just as the patient has the right to refuse care from a nurse, we have the right to refuse to take a patient back again when we have been inundated with abuse and threats from caring for them. He looked totally shocked, like noone had ever told him that kind of thing before. The only reason why I didn't get into trouble is b/c when my manager went in to talk to him about his concerns with the care his wife had gotten, he threatened her as well. And I had it documented by security that they had to be called multiple times in the shift I had her due to her husband's behavior.