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 Psych, Addictions, SOL (Student of Life).
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. "
It's been my experience that when someone uses the term, With all due respect, to me they are not showing me any respect at all. In fact the phrase is rude and dismissive in most cases. What you essentially said to this woman was that her mother's comfort was not important to you. Providing comfort is one of the primary jobs a nurse performs. I could understand if the patient was unstable but this was not mentioned in the OP. The patient was a hot mess in soiled and bloody sheets and very thirsty. Some contrast agents and leave a patient with a cotton mouth. It would have taken you all but a minute to get the lady some ice chips which the daughter could have fed to the patient.
I have been a patient more times that I care to mention with serious painful conditions. I always remember those nurse who smiled, saw to my comfort (Thrist, pain, warmth) prior to lengthy assessments. I also have a mother with dementia who requires frequent hospitalization. I sometimes have to explain that her behaviors are directly associated with physical discomfort which he can't express verbally and since she is allergic to benzo's her comfort needs to be attended to frequently. We usually have a family member at bedside but I have been called in the middle of the night to get consent for restraints. "When I ask if she's wet, thirsty, hungry etc..... "I usually get I am not sure!"
Sure enough a change of her brief settled her right down. The hospital she usually goes to does not allow family to provide bedside care for liability reasons. So nurses and aides must perform the care. We can do water and ice chips but since these are in a locked pantry the nurse or aid has to get it for us.
To be clear I am not a perfect nurse - but I do deal with an extremely demanding population and have almost never encountered the disrespect you describe. I do attempt to kill everyone with kindness as well as let people know what's realistically possible for me to do and in what timeframe.
Specializes in Flight, ER, Transport, ICU/Critical Care.
Hey there Cardiacdork,
Customer Service is tough. I get it. I hated it. I recall one ER family saying "when your waitress comes back around" - not even kidding.
Not bringing Bourbon or Scotch, just Dilaudid.
I am the best damn WAITRESS in the history of service - and here's turkey sandwichs with chips & cookies/soda for everyone!!
I didn't even get a tip. What rubes!
:angel:
Here's the facts. I never minded taking care of sick folks. It's a privilege. Caring for their families is a part of that. Check out AACN Synergy Model of Care. It's what I do. Why I've put in the time I have. Why I've studied, have the years experience, have taken the classes, read the journals, do it right. Keep trying to improve.
Treating folks respectfully, more often that not, gets me treated with respect in return.
However, emotions do run high in CRITICAL CARE.
I would look at my role sometimes a lot like a hostage negotiator. Focus on active communication that serves to de-escalate difficult or even hostile situations. Families come in or to a scene and their life as they knew it may be over. Emotions are running high- despair, desperation, guilt and anger can often become part of the family paradigm. Like it or not, it doesn't change what you have to deal with.
To me the most exhausting thing to deal with patients and families in the ICU is an entitlement sense.
I think all issues have the same basic paradigm.
Communicate respectfully. Tone matters. Safety and dignity of the patient is paramount.
While open visitation is a policy, it's not a mandate and should not interfere with care. Care is private. Period.
I am hyper-aware if issues develop with a overtly hostile family and am never unaccompanied.
What you put forth, you often get back. But, remember this is their emergency/illness/crisis.
Act accordingly.
:angel:
On a personal note - I think burnout occurs in 4-5 year intervals. If you aren't happy, go. I know your view depends on where you stand (deep thought)!
I feel your pain. We had a pt that somehow obtained the site manager's number and called to complain vociferously that the nurses were purposefully neglecting her by refusing to get her water and ice while they ran a code in the next bed.
Okay. Thanks for your astute analysis. Yes, it's clear I am not happy with the ICU. I know this. I recognize this. Nursing is vast and the opportunities are many. Right now I have about 4 years of experience and my ADN. By the time I finish my BSN I'll have 5-6 years of experience and enrolled in NP school (I'm in a dual degree program).
But this post wasn't really about my personal unhappiness with the ICU and where I need to take my career path.
It's about the lack of respect and rudeness that is for some reason especially present when dealing with these chronic illnesses at their worst. Work a few years in the ICU as a full fledged RN and you'll see what I mean. The frequent flyer and their families have a way of chipping away at your morale.
This isn't the nightingale nursing you learn about in school :)
I'm not sure if the ICU "rules" have changed everywhere, or if it is just my facility, but we are no longer allowed to stop family members from coming in to the room at their whim. We must cater to their every wish, as this is "patient and family centered care". Our newest administrator has decided that children of any age or behavior should be encouraged to visit in the ICU.
You got that right. Few nights ago I asked the family to wait in the visitors area and the tech to show the 7 visitors my patient came with to the visitors lounge.
This isn't a circus, your extended cousins don't have to see us wiping you down and poking you. And honestly I need some space to settle you in, because quite frankly you are a hot mess at the moment. This is the ICU, not the Hilton. I'm here to treat your open gap, elevated ammonia, DTs, COPD, CHF, GERD, and potassium or 10.0 not your family to complimentary drinks.
Well said!!!! Butt sometimes it kinda DOES feel like a circus😖.
Specializes in orthopedic/trauma, Informatics, diabetes.
There is a way to educate family about priorities post-operatively without sounding condescending. It's mostly not knowing what is appropriate to eat/drink after a procedure. I tell family about the safety portion and put it back on them-offering to explain further or answer questions, but gently and firmly getting the point across that there is a protocol for drinking/eating/visitors/etc and that their loved ones' care is your priority.
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.
I'd rather have you, Cardiacdork, with your priorities of patient safety, carrying for me our my family than all the "customer service" practitioners out there. Keep me stable and safe and I'll forgo the Hospital Hilton treatment every time!
Specializes in Mental Health, Gerontology, Palliative.
My sister is an ED consultant, she told me one day how she was trying to examine a young teenage female who wouldnt stop the texting.
In the end my sister said 'how about you put the phone down for the five minutes it will take me to examine you. If I'm happy I will discharge you and then you can text all you like."
I wonder if part of the issue in the US is that its so jolly litigious, people fear being sued because they looked at the patient in the wrong way. I'm lucky living where I do, our ACC system has removed peoples ability to sue over healthcare issues. We have other systems in place to deal with health issues which seem to work well for the most part
because if I have to politely insists that a patients family remove themselves from the room while I attend to their loved ones health needs I may get at worst a complaint to my charge nurse, which provides an opportunity for learning (in terms of dealing with challenging families). While I believe in involving a patients family in their healthcare, its not appropriate to have them in the room while we are attending to their loved ones hygiene needs or having to put an IDC in, or dealing with chronic gooby wounds.
Specializes in Mental Health, Gerontology, Palliative.
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!
Personally coming out of major surgery in the last week, I didn't give a toss about water or ice, I just wanted someone to do something to stop me vomiting and the god awful pain that I was in. Apparently they were concerned because my blood pressure was high, seriously nurses your patient has huge amounts of unresolved 8/10 pain, do you think perhaps that may be affecting your patients pulse, respirations and blood pressure.
You all obviously have a different definition of ICU than we do here. IF someones in ICU its because their airway is shot and they require intubation, and certainly not the type of patient any half way sensible nurse would be giving oral fluids to.
Step down patients are ones who may be still fairly sick and high risk for cardiac arrest, have a patent airway that can be maintained without intubation. However personally their families would be supremely peeved if we let their loved one die because we missed something critical due to being focused on customer service and getting them some ice
hppygr8ful, ASN, RN, EMT-I
4 Articles; 5,212 Posts
It's been my experience that when someone uses the term, With all due respect, to me they are not showing me any respect at all. In fact the phrase is rude and dismissive in most cases. What you essentially said to this woman was that her mother's comfort was not important to you. Providing comfort is one of the primary jobs a nurse performs. I could understand if the patient was unstable but this was not mentioned in the OP. The patient was a hot mess in soiled and bloody sheets and very thirsty. Some contrast agents and leave a patient with a cotton mouth. It would have taken you all but a minute to get the lady some ice chips which the daughter could have fed to the patient.
I have been a patient more times that I care to mention with serious painful conditions. I always remember those nurse who smiled, saw to my comfort (Thrist, pain, warmth) prior to lengthy assessments. I also have a mother with dementia who requires frequent hospitalization. I sometimes have to explain that her behaviors are directly associated with physical discomfort which he can't express verbally and since she is allergic to benzo's her comfort needs to be attended to frequently. We usually have a family member at bedside but I have been called in the middle of the night to get consent for restraints. "When I ask if she's wet, thirsty, hungry etc..... "I usually get I am not sure!"
Sure enough a change of her brief settled her right down. The hospital she usually goes to does not allow family to provide bedside care for liability reasons. So nurses and aides must perform the care. We can do water and ice chips but since these are in a locked pantry the nurse or aid has to get it for us.
To be clear I am not a perfect nurse - but I do deal with an extremely demanding population and have almost never encountered the disrespect you describe. I do attempt to kill everyone with kindness as well as let people know what's realistically possible for me to do and in what timeframe.
Just my 2 cents on the matter.
Hppy