Nightmare Families and Hospital protocols

Roseyposey · Mar 7, 2008

I got a pt the other night, 30 days inpatient, new CA. Fresh from ICU, the reporting nurse tells me, family nightmare. Within 15 mins of arrival, 3 nurses, and the CNA are besides themselves. The bed wasn't right, we need soda, we are staying the night, etc, etc. The day after we get another pt, similar deal in the next room, creating a group from hell. My thought on this is if everyone involved, the doc, admin, the floor staff draw a line in the sand, this crap stops. Instead I see nurses and aides in tears some days from sheer frustration. I mean the family actually barging into the staff
break room with demands. Does anyone work for a facility that actually has a protocol for this nonsense? It has become so common, and we all know, no matter what we do, how much time etc we put into these people they are still going to complain. To the detriment of the 5 other pts and families who are reasonable. Just wondering and appreciate any imput

They come into your break room ? Holy heck, now I know why ours has a lock!

General E. Speaking, RN, RN · Mar 7, 2008

I have encountered families like this. Very, very difficult to take care of the patient. Customer service and Press Ganey is important in the hospitals these days that many times I think administration looks the other way. I don't have an answer and as far as I know, we do not have a policy on the matter.

This is going to be a hot topic...

nrsang97, BSN, RN · Mar 7, 2008

First get a lock for the break room. The kind where you have to punch in a code. (No seriously) That way they can't barge in.

Get your management involved. Set limits. When they come to the desk for something do as they need but politely say on the way out that "If you need anything else please use the call light, and someone will attend to your need as soon as we can." (sometimes this works and sometimes this dosen't).

Rotate the staff. Split the two rooms with demanding famlies. NO ONE should have to have both. This just isn't fair to continue to give them to the same person over and over.

Everyone needs to be on the same page with limits. They will get the same attention as everyone else.

We have one of those famlies now. They wanted a different bed in the middle of the night. I told the nurse (who was at her wits end trying to make the pt comfortable) that she didn't qualify for a special bed and would not get one. So the family went and got a mattress cover from home I assume (middle of the night) and we put it on the bed over our mattress. That did help.

Some people have this incredible sense of entitlement that I just don't get. I hate when the term VIP is used. Every patient is important. That makes me crazy. I have actually told other nurses that NO ONE is a VIP over someone else. The homeless guy down the hall who was assulated and is now in a coma is just as important as the proclaimed VIP. Everyone should have to follow the same rules. I just wish management is more on board with it.

Also document document document.

lindarn · Mar 7, 2008

I am beginning to feel like this needs to be an issue when contract time comes up, or a mass meeting with administration. setting FIRM LIMITS ON VISITATION, INCLUDING THIS NONSENSE OF FAMILIES CAMPING OUT IN PATIENTS' ROOMS AND THE WAITING ROOMS. THERE NEEDS TO BE NO CHANGING OF THE RULES BY NURSES WHO DON'T HAVE THE GUTS TO STAND UP TO THESE NIT WITS. ONE SET OF RULES FOR EVERYONE! Nurses need to put their foot down and stop being doormats. To hell with Press Gainey!

Send these disgruntled visitors to administration, and let them deal with them. Or better yet, call the nurse manager at home or administration. The operator has their numbers. Just say NO!! Document like hell all of their unreasonable demands and deliver them to the law firm that defends the hospital with the message that because of these visitors you were unable to care for your other patients. This leaves the hospital opened to law suits from these patients.

Make it the hospitals' problem, not your!

Lindarn, RN, BSN, CCRN

Spokane, Washington

ERNurse752, RN · Mar 7, 2008

Ditto locking the break room with a punch pad. And if there's a window, block it. Take off any labels that state "Break Room." Change them to "Staff Only." Or no signage at all.

Social worker. Stat.

Okami_CCRN, BSN, RN · Mar 7, 2008

I do believe that strict visitations rules need to be put in place and enforced. At my facility children under 12 are not permitted, yet i see two year olds in C.Diff rooms and to not undermine the authority of the RN I cannot tell them to please wait in the lobby due to the risk of cross contamination due to the low immunity of the child.

Then we have a very loosely enforced rule of only 2 visitors at anytime but on thanksgiving eve we had to block a room because a "party" of 30 people decided to visit their mother and take over our activity room and make it into a football party... needless to say I was mad... not to mention they took everything from on our pantry.

We as a team need to stand up and tell them to leave as they are disturbing the peace of other patients... yet we fear the almighty press gainey.

Lorna Doon · Mar 7, 2008

Our facility has just announced a switch to "open visitation" for all units (including all the intensive care units). Anyone have experience with this?

Peri · Mar 7, 2008

:angryfire I've had this problem as well, but not to your extent.

My heart goes out to you.

At present my ward (and the wards around) are planning to change visiting hours back to two hours in the afternoon and one hour in the evening.

Good idea, gives the relatives an excuse not to have to be there all day, gives the patient quiet time to relax, and helps the nurses plan their day.

Good luck, but I think that it is time management did what they are named after.

angel337, MSN, RN · Mar 7, 2008

yes, i see this all the time and its so discouraging for me as a nurse because i know that i can't retire at the bedside. hospital administration will never do anything because they have an obligation to keep up "customer satisfaction" numbers. its only going to get worse because we live in an entitled society. my advice is to just do the best you can, be nice to the family..because the first time they sense you have an attitude there will definitely be problems..and remind them that you are doing what you can to take care of the PATIENT and their health status. everything else is secondary. i see an even shorter nursing shortage in our future.

Ruby Vee, BSN · Mar 7, 2008

our facility has just announced a switch to "open visitation" for all units (including all the intensive care units). anyone have experience with this?

it's an absolute nightmare -- but it needs it's own thread.

snowfreeze, BSN, RN · Mar 7, 2008

Document, document, document...everyone, nursing assistants and nurses and charge nurse. Get social services involved too and MAKE them visit the patient room when the problem family member or members are there. Case Management needs to know what is going on also as the docs may be charting the patient needs to be at a higher level of care than they actually need just to satisfy agressive family members.