Inappropriate family members

Nurses General Nursing

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Family-centered care is the model that my hospital follows. We don't have visiting hours; families can stay all night if they'd like. For the most part, I like the model and appreciate the information and relationship with patient's families, but some times, it can a nightmare.

Is it ever ok to tell patient's family member that they are being inappropriate and unrealistic? I admitted a pt at 1930 and left her room only 3 times. Once was to get meds for her and the other 2 times were to check on my other patients. Each time, the daughter would call the nurese's station or come looking for me. Once she called my wireless directly and said I had to come back because her mom needed the bathroom. It took me about 90 seconds to get there and then the daughter starts yelling about how I took too long and never should leave in the first place. The mother was so anxious that I called for ativan for her, and the daughter refused to let me give it to her so the patient refused it based on the daughter. The mother was so anxious an hour later that the covering MD had to come up to the unit and tell her that the mom needed ativan right away. It worked too. Imagine that! The pt was also in RAF so I need to push IV lopressor twice and although I told the pt and dtr that bedrest was required with such a fast HR, they demanded that she be able to walk to the bathroom. The pt ended up throwing a fit like 5 year old (which is why she needed ativan), and even refused a bedside commode. The situation was out of hand and they were incredibly uncooperative.

I'll stop ranting, but how are difficult famililes best handled. Am I really supposed to endure 4 hours of this with a smile on my face? What are the best ways to respond to demanding families who clearly don't understand how hospitals work even after you try to explain it?

I would spend as much time tending to my other patients as possible. When the family complains, remind them that you are not their private employee and refer them to your supervisor.

Specializes in Emergency & Trauma/Adult ICU.

I'm sorry this happened to you ... and I couldn't work at your hospital. That's all I can say.

Please understand that this is not so much about "how to do this with a smile on your face" as it is about what you will do and what the consequences will be when the rapid a-fibber crashes while in the bathroom because your hospital and the clinicians in it chose to ignore accepted standards of medical care.

Specializes in stepdown RN.

I hate overbearing, needy family members. Have you ever noticed a patient can be perfectly fine then when a family member arrives they are doing soooo terrible, are tearful, in pain, noone has been the room etc...It's so annoying. I had a family member call me onetime I had just got out of report and had checked on only one patient at this time. It just happened to be his mother. He wanted to know what was wrong with her states he just left the hospital and she would not wake up, didn't eat all day and wanted to know why. Never understood why he didn't come to the desk and ask instead of leaving and then calling. But, anyway I told him I wasn't given any such information in report about her not waking up and in fact I had just talked to her and she was fine. He called me a liar and said he would be in "if she's doing so good" He then hung up on me. I saw him running down the hallway with his wife so I went into the patients room and was carrying on a conversation with her when they walked into the room. I wanted him to witness it. I thought if they walked in themselves the patient would play "possumm" again. He apologized to me, now I usually wouldn't say anything but I was ****** I was called a liar and they were trying to catch me in a lie. I just told him we nurses have no reason to lie and I would never try to hide the facts from him we are here to help these patients and I told him the next time his mother's nurse tells him something he shouldn't be so quick to judge because this happens all the time. Patients act a different way when they are around. It's hard to deal with them sometimes and my manager has tried to get a nurse to apologize to families for something they didn't even do and these nurses have refused. Don't know if there is a solution but we can only take so much, I don't think a nurse should have to take care of this paitent for more than one day in a row because if you have to deal with it too much you might lose your patience and not good for anyone. Sometimes it can't be avoided though.

Specializes in Hospital Education Coordinator.

Remain calm. Tell your supervisor. Involve other people, like house sup if needed. Even the patient advocate person. Document very objectively and carefully. I have even tried getting the family to discuss their expectations then patiently explain the ones that are unrealistic. Then let them complain. They will anyway

Remain calm. Tell your supervisor. Involve other people, like house sup if needed. Even the patient advocate person. Document very objectively and carefully. I have even tried getting the family to discuss their expectations then patiently explain the ones that are unrealistic. Then let them complain. They will anyway

I love this idea. Thanks!

Specializes in Critical Care, Nsg QA.

I respectfully disagree with Caliotter3, as this behavior will only add "fuel to the fire" (and is passive/aggressive in nature). I have to admit, I would want to do as Caliotter3 suggests, but realistically you are setting yourself up for more problems. I would use the chain of command, and report it to the charge nurse/ANM/NM to let them deal with it. Another thought might be to contact Risk Management.

Another tactic would be to educate the patient/family as to the reasons why things are done. They are anxious for their loved one and don't understand why we nurses do things the way we do.

Admittedly, I'm probably talking about an ideal situation/solution, but I think it's worth thinking about. Good luck!

Another tactic would be to educate the patient/family as to the reasons why things are done. They are anxious for their loved one and don't understand why we nurses do things the way we do.

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I educated, and I educated but the stress was so high that no one was getting it, or they didn't care. They wanted things there way and that was it. The pt's daughter kept saying that her 86 year old mom hadn't ever been in the hospital. I wanted to say, "obviously". They had no clue about anything even after my 4 hours of trying to educate. Either that or they didn't care.

Specializes in Hospice.

I work in a family centered facility with no visiting hours and i have seen up to 8 or 9 family members spend the night (the other night another nurse had more than 30 members show up in the middle of the night :eek:) I actually like having family there for the most part, like you they are usually pretty helpful.

I have never had family be that unreasonable but i always let them know that I have 5 or 8 pts ect..... and that I am going to go take care of some other meds and then come check on them. when someone refuses loraz especially with a fast HR i would talk to them about my concern about their heart working so hard right now and that Loraz could help by relaxing their mind which will calm their heart down as well. if they refuse I accept that but i also use their famiy as a one on one ..... I have a cna that partners with me and we like to 'team' so that if i have someone that is feeling im their 'one on one' i send her first so it kind of teaches them the multi team approach. for the bathroom issue I push the BSC the first night if vitals are off. never had a family refuse that. we have a BSC placed in each room so i don't offer any choice just pull it out and tell them "at least for tonight we are going to conserve your mom's energy and the work her heart is doing and use a toliet at the bedside" good luck. it can be a challenge, last night i had a pt that was incontinent having an active gi bleed and the family wouldn't let me put a brief on them or our gowns they had us put more personal clothes. I didn't take my own advice and tried to get 'his permission' to temporarily do the brief which he refused...... If i have them tonight i will change how i present it "tonight we are going to do a brief blah blah blah..........' its all how you present it. For anxious family members they really aren't at a place to make reasonable choices so i word it so its not a a choice and they usually go along with it.

Specializes in ER, Trauma.

The family feels helpless. Since they can't think of anything to do, they're demanding way too much of you. You can try telling the family that you and they are on the same side, but you must do what's best for the patient medically. If they insist on asking for inappropriate care, tell them so, and document, document, document. I'm glad it's you and not me having to deal with them. Good luck.

Sometimes those family members are not only wearing on your nerves as a nurse, but on the patient's nerves as well. There were times my husband would come to the hospital and fuss at me and leave me in tears with the nursing staff bewildered. There were times I wish I could have banned him from the hospital! My mother-in-law died about a year ago, and I know for a fact that some of the vistors wore on her 80-year-old nerves.

But there are other times that family can actually be a help. There were times that my husband sat with me at the hospital and kept me company, got me water, and other things that I would have had to ask the staff for. One time my husband was sitting there quietly (this was not during the time that he was fussing, that was later) and a nurse wanted to put him out. I told her that either he could stay or I could wear out the call button when I got scared and lonely. She took the point and left us alone.

Family can be a blessing and a curse at the same time, I guess.

Specializes in LTC.

I was a new nurse and 3 mos pregnant when I had my 1st family member run in. B beds dtt in law had messed with A bed and was in a fit of rage saying that my cnas had ignored A beds alarm. She got in my face literally, we were touching noses & she was trying to get at my cna til I stepped in front of her and told the cna to leave. She ranted on and she grabbed my name badge which was on a necklace type thing and broke it from my neck. That was IT! I told her she had 2 seconds to back up away from me and that me or my cnas weren't gonna listen to her degrade us and that she was only there for B bed and was never to touch any other resident. She said she was going to report me to the don and administrator so I offered to get them on the phone myself. By the time I got the phone and took to her , numbers in hand she was gone. She never did report me and I filled out a grievance on her. I personally informed my superiors of what happened and told them I'd never allow somebody to get in my face like that. I found out later that this tyrant is a hOSPICE nurse! That was 5 yrs ago and to this day I haven't had a problem out of her since. Sugar wouldn't melt in her mouth when she's talked to me.

If shed have done that to me in any other setting I probably wouldve hit her. She's crazy as a bed bug. I guess she finally got the right one when she got me because shed done this type thing to several other nurses and made them cry.

Not me. My hormones took over and it was over. She really hated it when I told her she needed to mind her business and not touch others. Plus I found out her rant was all a lie! Every accusation she made was false. Guess that's why I didn't get reported. I was surprised my superiors even backed me, it sure wouldn't happen now since those are gone.

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