Nurses Are The Worst Family Members!

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Specializes in Ambulatory Clinic, Triage, Med-Surg.

Sorry that my first post had to be a rant...but I'm so frustrated and angry and really need to vent. I work on a geri med-surg unit at a local hospital...and I don't know if it's the community surrounding the hospital, but lately I have found my head on the chopping block on numerous occasions with families of patients, more often than not, ones whose family members are nurses. A brilliant example? Last night, I had an elderly patient with moderate Alzheimer's with a high fall risk, who remained agitated and combative despite many non pharmaceutical interventions which included :

(1) numerous unsuccessful attempts at re-orientation

(2) being given diversional activities - such as folding towels and magazines to read

(3) being ambulated around the unit and off the floor with a contact guard

(4) being seated at the nurse's station in a geri-chair

(5) getting an order for a tray to be placed on the geri-chair (played limbo and slipped under the darn thing)

(6) expressing to her how important it is not to get up by herself, please call if you need anything.

...still insisted on running off the floor with poor 8 and a 1/2 month pregnant S.O.B. me in hot pursuit. She may be elderly, but she sure is fast! After escorting her back to her geri chair for the 13th time, while missing being punched and scratched only by a hair, I am at my wit's end. It's almost 5:00, I haven't seen any of my other patients (one who wants a pain medication, another whose family member wants to speak to me regarding plan of care, a respiratory therapist who wants to clarify a medication on another,) and of course there are no sitters available because the hospital has cut the safety sitter budget. Great. Glorious. I call a family member and ask if there was anyone available to come sit with the patient, and hopefully help calm her down. "Absolutely!" they say. "It'll be another hour though."

Another hour. Another hour for her to run circles around my CNAs and to avoid a black eye.

Driven to desperation, I go to the resource nurse and plead my case. Call the doctor she says. Maybe a dose of Ativan or Haldol is just what she needs. I call the doctor - give her Ativan 1 mg p.o. he says. "No can do doctor, the lady is so combative she won't take p.o. meds. Any chance to give it IV?" I get a flat out no. He gives me Haldol 0.5 mg IM q4h prn instead. I give her the Haldol, which might as well have been a lollipop for all the effect it had, the lady's still going.

Her daughter finally shows up, and not only does she rub me the wrong way she feels it her God given duty to inform me and throw in my face on a repeated basis that she is a 37 year old clinician nurse in the field, that the hopsital is a dump, and that her brother is a captain in the navy who doesn't take **** from anyone. (Her words, not mine.) I take each insult with a nod and a smile. On the inside I feel like crying. She wants to know why her mother is on this medication, am I watching for side effects of another, why does her mother have a saline lock if she's not getting any IV meds? On her way out she instructs 'not suggests' that her mother get some Ativan to help calm her down. I inform her that she got a dose of Haldol.

Oops. Wrong word. Her eyes enlarge, her face reddens. "YOU GAVE THAT %$# to my mother? YOU HAVE NO SENSE OF NURSING PRACTICE!! DON'T YOU KNOW ANYTHING ABOUT GERIATRICS? DON'T YOU KNOW HALDOL IS CONTRAINDICATED IN THE ELDERLY?"

I've reached the limits of my patience. I let her know that I tried almost every non pharmaceutical intervention available (except for tying the woman down, which I'm definitely sure neither of them would have appreciated! :banghead:) I AM ONLY ONE PERSON! My God, how much do they expect me to do?

That's not sufficient. She wants to speak to the nursing supervisor. STAT. It turns out that the supervisor takes too long for her liking so she leaves with a huff and a puff before she blows the house down. I proceed to let the resource nurse know my side of the story and write the longest documentation note ever to cover my back and my license.

I love nursing, both the ups and downs of it, but I'm really starting to feel like geriatrics is maybe not the field for me...not day in and day out, feeling pinned in the corner when it comes to my practice, especially with the high number of dementia patients and fall risk patients that we have. I've only been at this job for five months but I'm already itching for a transfer....

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Specializes in ICU/Critical Care.

Haldol is NOT contraindicated in the elderly. Haldol and Ativan use in the elderly should be monitored closely because the elderly are more sensitive to its affects. I think more so with Ativan. She didn't have any right to yell at you. She just made a big buffoon out of herself. And usually when I have a family member like that who likes to brag about what they do and who their family member is, I either nod and say that's nice or I ignore it.

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Specializes in Ambulatory Clinic, Triage, Med-Surg.

I've found that alot of the things I learned in school in regards to med administration and contraindications are virtually ignored on this floor. Ativan, Xanax, Haldol, Remeron and Seroquel are given out like candy. I guess I need to work harder on the 'ignore' part, instead of trying to be understanding and compassionate...because that was just not working last night! :clown:

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Specializes in Med-Surg, , Home health, Education.

Most of the really good nurses don't advertise it when they are in the hospital. They just sit back and watch. She's probably a lousy nurse and she's just trying to scare you. Shake it off and hang in there.

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Specializes in thoracic, cardiology, ICU.

I agree, haldol isn't contraindicated in geriatrics. Sounds like she needs more than just that. some zyprexa would help mellow her out.. I'd be interested to know what area of nursing she works in since she didn't understand why we like to have IV access on our patients.

Sounds like she was totally out of line, but i think we've all been there. I just smile and nod, but if they're really getting out of line, I put them in their place. I think having confidence in your practice and knowing you're doing what you need to do is important. I swear people like that can smell fear, but they back down when they realize you're not going to run and hide from their big bad attitude. If you're professional, but stand your ground, they might not be happy, but they'll leave you alone.

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Specializes in Neuro ICU and Med Surg.

She probably hasn't practiced in eons. We had a pt who used to be a nurse in another country one night demand a new nurse. I asked her why and this was how the conversation went:

me: Please tell me why you feel that you need a different nurse.

her: I lost confidence in this nurse because she had a hard time getting my IV. I expect it to be done in one stick.

me: I understand it isn't comfortable when someone missed a IV on you. It has happened to me, but that dosen't mean anything is wrong with the nurse. The nurse you have is leaving at 11pm so you will have a different nurse anyway, but you need to understand that I cannot just change the nurse anytime they miss a IV start or blood draw.

pt husband: She is now anxious can't you please stop talking about this.

me: I was trying to resolve the issue and I did have to remind you both that not everyone is talented with IV's and blood draws on a hard stick and her being a nurse she should be more understanding of that.

The resident on call came in and offered to put in an art line and they refused that too. He tried to explain that would alleviate the sticking for blood work. Also anesthesia tried to place a art line prior to OR and stuck her 5 times and couldn't get the line. So really she was a hard stick.

I don't understand why we are so nasty to each other when we are not at our own facility. The only time I ever lost it on a family members nurse is when they lost my mom's chart in the ER and she had waited over 3 hours to be seen and was in a lot of pain. I had to beg for ice packs for her neck which was a little swollen after being cut by a seatbelt.

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Specializes in medicine and psychiatry.

My experience in Geriatric Psychiatry has made me very leery of Ativan. In fact, I am finding it used very sparingly. Haldol is an option but am seeing that Zyprexia delivers a better result. Sounds like that nurse has some family issues that have never been adressed and are not likely to be. You were wise to document well.

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Im in a geropsych unit and like Lady said the meds are passed out freely. You did nothing wrong in the situation. Personally, I may have dissolved the ativan in a teeny bit of juice or pudding and had them eat it.

((((hug)))) dont let cranky old nurses get to you. Nod and smile then cry in the bathroom if you have to

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