No Respect.

Nurses General Nursing

Published

Where did the respect go for nurses and doctors? My nurse friend whom is in her silver years was a nurse many many decades ago and recently has retired.

I was telling her a story of a patient whom I received from the cath lab. The patient arrived as usual from most operational/procedural suites, a hot mess. Lines and tubing everywhere. Bloody sheets and so forth.

Well soemhow the family snuck in with her and it was such a busy night with no tech or secretary so instead of the family being told to wait in the waiting area (while I settled her in) they chose to barge in with the patient and began ordering me on what needed to be done!

I nicely and kindly explained to the daughter what the priorities at the moment were and why, despite my explanations she said

"well the priority right now is getting her (the pt) water and ice".

EYEROLL

Excuse me but that's not the priority and I told her so. I told her that with all due respect I've been doing this for a while and although I understood her mom was thirsty, I had to assess her mom and wait for the fellow to give further instructions.

She finally settled down and stopped talking.

I find this behavior annoying, and families are equally entitled acting and rude to physicians. They do not care that you are an expert and there to care for them. We are not the enemies. We went to school and have experience, and before we can accommodate to your every wish we must ensure your safety.

Anyway, my nurse friend commented how in her early years as a nurse DECADES ago... people respected nurses and doctors more than they do now.

Guess this is just a rant vent. One more reason I want to leave ICU.

Also, I'm so done with the elimination of visitor restricted hours and this new fad in "open visitation".

Specializes in ICU, LTACH, Internal Medicine.
Are you kidding me cardiacdork? Get the woman some ice and water, ftlog! What's your deal??? Why don't you assess the woman is dry and wants water? You wonder why we don't get respect?! Really? Listen to the patient! Get the water! Family is good for patients!

(sarcasmometer is ringing up)

Oh, yeah. Forget about the fact that the patient just came off the table. Forget that she has a plastic contraption holding an artery which would totally exsanginate her in roughly 30 to 60 seconds. Forget that the lady is still on ICU level monitoring, which means that there are reasonable expectations of a possibility of cardiac arrest at any moment. Forget that she is already freaking cold after lying down in wet sheets for hours. And, BTW, that she must be still NPO can be forgotten as well because she is a customer, and customer is always right.

Ma' baby wanna some ice! Just some water and some ice! What kind of hospital it is that he cannot get some water with ice? You give me an attitude! Go get your manager, I want to complain!

The nursing assessment, may I dare to remind you, first and foremost is about patient being ALIVE and SAFE, not about wishing and wanting. It is especially so in ICU. If family still didn't get it when the patient hits the door, then, well, it should be gently, politely and politically correct brought to them in the most unequivocal form.

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Respectfully, no. Cath patient coming to ICU? I work cardiac and when I get a cath patient back, I'm assessing and getting those q15 vitals first thing. I have told family that the water has to wait before and I would never change that.

Respectfully if it was you laying there you might feel differently. I've taken care of cath patients before too. Check the pressure and get the ice. It's not the end of the world to have an ice chip!

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(sarcasmometer is ringing up)

Oh, yeah. Forget about the fact that the patient just came off the table. Forget that she has a plastic contraption holding an artery which would totally exsanginate her in roughly 30 to 60 seconds. Forget that the lady is still on ICU level monitoring, which means that there are reasonable expectations of a possibility of cardiac arrest at any moment. Forget that she is already freaking cold after lying down in wet sheets for hours. And, BTW, that she must be still NPO can be forgotten as well because she is a customer, and customer is always right.

Ma' baby wanna some ice! Just some water and some ice! What kind of hospital it is that he cannot get some water with ice? You give me an attitude! Go get your manager, I want to complain!

The nursing assessment, may I dare to remind you, first and foremost is about patient being ALIVE and SAFE, not about wishing and wanting. It is especially so in ICU. If family still didn't get it when the patient hits the door, then, well, it should be gently, politely and politically correct brought to them in the most unequivocal form.

Wow a little dramatic! I reread he didn't say she was NPO. Even so she could be offered mouth care or maybe even an ice chip or 2. At least reassure the family. It's such a terrible thing to take care of patient wants??? Since when? I also don't get the big EYEROLL from OP?! The woman has been through some stuff. She's only asking for a little water. :wtf:

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Respectfully if it was you laying there you might feel differently. I've taken care of cath patients before too. Check the pressure and get the ice. It's not the end of the world to have an ice chip!

I disagree with you completely. I've spent plenty of time in ICUs in my lifetime as a patient, not just a nurse, so I can speak to being the n both sides. You don't just cycle a pressure and grab ice. If you had read the OPs scenario, this patient came back a mess.

Everybody who comes to my icu unit gets a bath immediately and new sheets. They are fresh from surgery, infection risk is high. I often get unstable people back from OR or Cath Lab. People are not allowed to die down there. So, there vitals are of the utmost importance to me.

Once I get them clean, stable, and settled, I will swan out their mouths if they are dry. I'm not giving ice chips until given the order to do so. People aspirate on ice chips.

My job is to keep them stable and safe, not to give them what the family feels they need at the moment. All family are escorted to the waiting room until my patient is settled. They can visit afterwards, but when you come to me, the physician has deemed you critical. That makes my assessment critical as well.

If you don't see that, maybe icu is not where you should be.

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That's fine. We can totally agree to disagree. :cheeky:

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Specializes in Critical Care.

Wondern

Nothing wrong with ice chips, once it's been cleared by the fellow. People can and have aspirated on ice chips. In the world we live in now where everyone is so quick to sue, I rather not take my chances. I'm sorry but this is MY livelihood and your mothers thirst is going to have to wait about 15-20 minutes or maybe even less while I settle her in, make sure she's not bleeding, ensure her vitals are stable, and I've spoken with the fellow on the following plans for the patients medical care.

The ice chips can wait, especially when I'm the only person in the room. She expected me to walk out of the room sedonds after her mom arrived and leave this S/P cath patient without any cardiac or sat monitoring on the bed where she could possibly BEND her leg because I didn't even have a chance to explain to her that she can't bend her leg. It's not as simple as, "get the poor woman some ice". It's not like I'm a dragon that's depriving the lady of ice.

I guess I'm the mean ole ICU nurse just trying for keep the patient safe and settle her down with absolutely no help whilst the daughter condescendingly tells me to reroute my priorities.

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Specializes in ICU, LTACH, Internal Medicine.
That's fine. We can totally agree to disagree. :cheeky:

Absolutely. Just please do not remove the Life Vest because family "wanted" the patient to have bed bath right away.

(yes, I saw it done by someone who passed NCLEX)

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That's fine. We can totally agree to disagree. :cheeky:

You say you've taken care of cath patients before. Fresh Cath Lab patients? Because saying it's no big deal for the patient to have water tells me you haven't.

My icu is a little different from CardiacDork but I get patients from the Cath Lab. They often have angios but for different reasons. Many of my patients are still npo when they come back as they may have to go to surgery later.

I'm very protective of my patients' safety and well being. Often I'm given orders that if the patient passes a nursing dysphasia screen, then we can start with ice chips are advance diet as tolerated. After, I'm done getting them settled in and stabilized, I can do that for them. I don't think any of us are there to deprive patients of water and nutrition, but I think you are vastly missing the point. The patient was not asking for water. The family was demanding the nurse immediately give their loved one water and ice when it's not the priority.

ICU is all about prioritizing. It scares me a little that you would just cycle a pressure and walk away for ice. What about the rest of the vitals? What about checking your orders? What about ensuring your patient is safe, clean, and comfortable in bed?

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I guess I've been extremely blessed to not have patients and families be disrespectful or condescending too much. Very rarely. I do look at patients as customers in a way because of how much I want them to feel satisfied with the care they are getting after making sure they're safe of course. Some people pay a lot of money for their health care. I would love to make them feel like they were in the 'Hilton with tubes' as much as possible. Ha!

Healthy debate is a good thing. So are varying perspectives. You said the floor was short staffed. The family is usually there to help. Maybe you could have asked her to go to the nurses station and ask for a cup of ice while you checked vitals and untangled spaghetti.

You said yourself you were happy to be leaving ICU and were just ranting so I would think a differing opinion might be expected maybe. Family is usually there to help not hinder.

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Specializes in Critical Care.
I guess I've been extremely blessed to not have patients and families be disrespectful or condescending too much. Very rarely. I do look at patients as customers in a way because of how much I want them to feel satisfied with the care they are getting after making sure they're safe of course. Some people pay a lot of money for their health care. I would love to make them feel like they were in the 'Hilton with tubes' as much as possible. Ha!

Healthy debate is a good thing. So are varying perspectives. You said the floor was short staffed. The family is usually there to help. Maybe you could have asked her to go to the nurses station and ask for a cup of ice while you checked vitals and untangled spaghetti.

You said yourself you were happy to be leaving ICU and were just ranting so I would think a differing opinion might be expected maybe. Family is usually there to help not hinder.

There wasn't a floor nurse involved. Just me, the ICU nurse running with no help at the moment. At any cost, I also see your point of involving the family and I find that to be something I can employ tactfully. Make them needed and involved by getting the cup of ice she can potentially have (on hold right now) but make them feel like yes the ice chips are a possibility and yes you are pet of the team too. I suppose that is something that can be used.

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You say you've taken care of cath patients before. Fresh Cath Lab patients? Because saying it's no big deal for the patient to have water tells me you haven't.

My icu is a little different from CardiacDork but I get patients from the Cath Lab. They often have angios but for different reasons. Many of my patients are still npo when they come back as they may have to go to surgery later.

I'm very protective of my patients' safety and well being. Often I'm given orders that if the patient passes a nursing dysphasia screen, then we can start with ice chips are advance diet as tolerated. After, I'm done getting them settled in and stabilized, I can do that for them. I don't think any of us are there to deprive patients of water and nutrition, but I think you are vastly missing the point. The patient was not asking for water. The family was demanding the nurse immediately give their loved one water and ice when it's not the priority.

ICU is all about prioritizing. It scares me a little that you would just cycle a pressure and walk away for ice. What about the rest of the vitals? What about checking your orders? What about ensuring your patient is safe, clean, and comfortable in bed?

I'm so glad you asked. Yes, lots and lots of fresh cath patients! Cath patients that even went home the same day. They are not all ICU patients. One of the top priorities was to keep the pressure dressing and sandbag intact and the patient basically immobile for 4 hours. I never bathed one on arrival. My clean bed/stretcher was waiting on their arrival. I've given plenty of ice chips the minute they got back as they'd been NPO all night long and were relatively healthy and thirsty as all get out. That would usually be their only complaint. Cath patients don't always go to ICU. Some walk in and walk out later that day. Actually, I'd have the ice chips waiting with a spoon for that sister to feed her with, then I wouldn't have to walk away but I will eventually so... and its a given to me that I would ensure their safety first!:woot::up:

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You say you've taken care of cath patients before. Fresh Cath Lab patients? Because saying it's no big deal for the patient to have water tells me you haven't.....

ICU is all about prioritizing. It scares me a little that you would just cycle a pressure and walk away for ice. What about the rest of the vitals? What about checking your orders? What about ensuring your patient is safe, clean, and comfortable in bed?

Nursing is all about prioritizing, not just ICU!

Heck, life in general is too, come to think of it. :geek:

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