Patient's family that lies and blames everything on staff....

[TigerGalLE]

I've been taking care of a patient on our floor for quiet awhile. They have been in the hospital for over 2 months and are still very sick. Making only slow progress. This patient's spouse is crazy. They are demanding, rude, and quick to assume/blame. Everyone has tried extremely hard to keep them happy. For example, the patient has c-diff with crazy diarrhea. Their bottom is red from the diarrhea. The pt is getting butt cream but with all the diarrhea their butt got red. The spouse is fixated on this. Saying this is a perfect example of how we have been neglecting the patient ever since they got here. We've tried to keep the pt clean and dry and turned. The patient can turn themself and get out of bed with minimal assistance. However they choose to just lay their and whine. You can't expect someone to get better that continues to refuse PT/OT every day and all they wanna do is take dilaudid ever 4 hours around the clock. Yesterday the spouse blew up. She had an absolute breakdown. Screaming at staff.

Background:

I just received a direct admission from a doctor's office that had an O2 sat of 58. Patient was on room air and her son (a doctor) brought her in. She was dehydrated as all heck and we were trying to get her O2 up and get a line in her. There were 2 nurses, a resp therapist, a phlebotomist and a her family in her room trying to get her straightened out. I kept running in and out of the room to get things. The crazy spouse of the patient next door kept glaring at me. Everytime I'd run out they'd say I need to speak with you. And I would say, "okay I'm in the middle of something but I'd be happy to talk to you as soon as I can." They stood against the wall and glared into the other patients room the whole time. I'd run out to get something, "Excuse me, how much longer are you going to be, this is ridiculus." I would respond nicely each time but they were really ******* me off.

I finally got my patient stable and went to speak with them. They yelled and screamed at me and told me I was neglecting the patient. That the patient hadn't been turned this hour and that they were passing blood in their urine and no one had done anything. Urology had been consulted and just hadn't been up to see the patient yet. I explained this but that just made the angrier. Wanting to know what the hold up was blah blah blah. Then they tried to tell me that the patient had been passing blood in the urine for 3 days and they were sick of me ignoring it. When actually we have documented and I had seen the patient's urine for the past three days and it was yellow. Didn't start passing clots until early that morning. The spouse tried to say they showed me blood three days ago and I didn't do anything. I told them it wasn't me that they showed blood to. (because it wasn't.) She called me a liar and demanded to speak to my director.

I just don't understand people. My director offered to move them to a different floor. The spouse said they wanted a different hospital because we were a sorry excuse for healthcare. I think its interesting how my other 4 patient's family's rave about our care and one actually cried on my shoulder thanking me for what I had done for his mother that day. AND I had the BEST nursing assistant that day that you could ask for. It infuriates me when people say I'm neglecting someone when I've worked MY butt off to care for them. :banghead::banghead:

Thanks for letting me vent...

[ShayRN]

I sincerely hope your director said "where would you like to go, I would be very happy to make the transportation arrangements for you." Either they would change their minds or go, either way is golden.

[NurseShelly]

Yes, this "the customer is always right" bs is the problem. First of all, the customer is NOT always right, second, that patient is NOT the only one you have to care for. I know that to a particular family, their loved one IS the only patient that counts, but most are reasonable enough to realize that this isn't how it is for you.

With a family like this, it is up to admin to clear this up. They need to be taken aside and told that their family member is getting the proper care, and that if they have an issue, there are ways to address their concerns.

And, to be blunt, some people need to be told that they can and should go elsewhere if they are so desperately unhappy with how things are being done, instead of being "coddled" in the interest of "good customer service".

Amen! I once worked at a facility where families like this were rewarded with meal tickets and flowers sent to their home after discharge. I can appreciate that patients and their families are anxious, and that outside of being sick, they continue to worry about their lives outside the hospital, paying bills, family etc. However, behaving in a manner such as the OP has described is far too common as well as the administrative response to them. Somehow, more often than not, its something that the nurse or nursing assistant could've or should've done differently. Never mind that you're prioritizing for six to seven patients, admissions, discharges, transfers, and emergencies. Not to mention, the amount of charting it takes to cover yourself and coworkers when dealing with difficult families and patients like Tigergaile's dealing with. I was berated for coffee not being available once, even though a new pot was already brewing, and most recently soap not being in a bathroom off the unit near an elevator. Seriously? In my short time as a nurse, I'm sure I'm not saying anything new to the rest of you. We need our directors, md's, and administrators to back us up. If a patient is NPO for a procedure, and their upset and the doc changes it, its "the nurse wouldn't let me eat", not "the nurse advised me that I was scheduled to have a procedure, and per md orders, I was not to have anything by mouth". I also think its very rude for patients or their family members to continue to wait outside another patients room and glare when you've already acknowledged them and told them you see them in a few moments. With a difficult situation like that, just chart, chart, chart, and keep your resources involved.

[squeakykitty]

I'm glad your director is supportive. People like that family can cause me to develop an attitude real fast. (I. will. NOT. be. yelled. at.)

[miss81, BSN, RN]

It's families like this that ruin nurses careers. They make up BS and bring it to "your boss"! Before you know it, nurses are getting canned because the boss does not have the balls to stick up for the nurses in fear of getting sued. I almost feel like it us inevitable. Someday i will get a family that will ruin my hard earned career.

[Isitpossible, LPN, LVN]

hi to all you nurses!! i am beginning a BSN program this year! (yah)....i read allnurses faithfully for several reasons.... this problem of catering to difficult families, i honestly think i will have a serious problem with...i want to be a nurse (obviously) and do the best i absolutely can for patients...i expect there will be long, tiresome days, but i also expect there will be days when i know im making a difference....my problem is dealing with harassing families...??? what is protocol within the hospital? why do nurses have to take abuse from families? how do you deal with that on a consistent basis? ...i am sooo NOT the person to deal with that....i know myself, and ill will absolutely let people know in no uncertain terms, that a hospital is NOT a hotel...i will not run around b/c a family is demanding the simplest of things, that in all likelihood do themselves.....example, my daughter was hosptialized for a month...i cleaned my daughter, changed her linens, got her linens, brought her toiletries, walked her up and down the hallway (abdominal surgery), took her vitals every 1/2 hour!! basically i did everything i could b/c she is MY daughter...the nurses were great, but i did not expect that they should do every little thing for my child, especially things that are were soo simple, and within my control....

i really think difficult families (not patients) will be problem for me....

[Medic/Nurse, BSN, RN]

Wow - some things NEVER change. There will always be patients/families like this one. They will be a PITA and they will be coddled in the name of "customer service". At least you have the BLESSING of an understanding administration. I'd even bet that administration has seen the light - with restricted stays and DRG related payments - I'd bet that there abusive, demanding "customers" have outstayed their money.

I say let 'em hit the road. I'd think fondly about the patient/family that was now stinking up someone else and their unit. Not only will another facility/nurse have to deal with all their BS that they bring - they will get the BONUS over the sure-to-never-end stories of what "terrible nurses that we had at the other hospital" - good times, no doubt.

I am sorry for what you have had to go through. Even a little bad behavior that gets allowed and gets results - allows patients/families to dial up their antics for even worse behavior and the nurse gets caught in the never-ending cycle of abuse. BLESS YOU.

I wish I had the magic formula for dealing with folks like these - a principal friend of mine gave me good advice in the "You can never reason with anyone who is yelling. Let them yell it out - wait a bit and then ask what it will take to solve the problem." I think this is good advice and I have used it successfully in the past. It keeps you from getting sucked it to the vortex of an altercation and usually when they stop yelling and you "hit pause" it makes them look like the bullies they are.

Good Luck.

[Medic/Nurse, BSN, RN]

I read in several posts that families like these will ruin careers - yep, they will.

I was "fired" off of a travel contract because of one of these "families" actions. Actually, it was a paid caregiver and I'll not bore you with too many details - except to say the patient was brought in for a syncopal episode (caregiver drove her car) via EMS - caregiver read the tabloids while I tried to get a history, ask questions and such. Every question was answered by the "caregiver" with get her records and look it up - "that is what you are paid to do" - well, the patient was sick and most records on microfilm, so we had to treat as unknown by history, allergy - not a big problem until she started acting act (caregiver). I stayed nice and patient as much as possible. The final straw came when the patient asked for a sip of water - I took a cup, filled a bit from the cold running tap and offered her a sip (caregiver was busy with tabloid reading and declined to be bothered -except for the commentary on everything I was doing) - the caregiver grabbed it from my hands and thew in on the floor and then started screaming at me calling me a racist and treating the patient like a piece of garbage only worthy of tap water - and betted that I gave bottled water only to my white patients (she saw me!) and she then got another of my patients (and his mom) in another room stirred up and asked how long they were waiting (told 'em if they were white, I'd have done my job and took care of them faster). I was so humiliated - ever patient, family and staff we out and watching this - nothing could have been further from the truth - I was beyond mortified.

My charge nurse was a dream and while I was near a melt down (she knew it was not true) this "caregiver" stirred in this for about a week, called the patients family to get them "on board with making sure I never work with any other patient again" and after many lies and administrator meetings - I was "let go".

So - you see - it happens. I eventually overcame to some degree - but, I was different. And I have a certain amount of hatred for antics - - this one came from the clear blue sky and turned into something even I could not imagine as possible. So beware of these folks - danger - will robinson - DANGER.

[TigerGalLE, BSN, RN]

Vent away, it's very frustrating to have a family like this.

Let's hope they get their wish and transfer someplace else, where they'll find the exact same "problems with care" I also think this is the sort of family that even when the facility bends over backwards and bends the rules for, they still want more.

Yea the hospital let them bring the family dog in everyday even though I work on a Respiratory floor and this has been forbidden in the past due to other patient's allergies and asthma issues. But they wanted it and they got it. (I'm all for pet therapy don't get me wrong, but not on a respiratory floor).

I'm very happy to have supportive administration and my director supports me and the rest of the staff 100% when it comes to situations like this. She knows we work hard and she tells us to just let it roll off our back.

What families like this don't understand is that if they are nicer and more appreciative they will probably get better care in the long run. When you get yelled at everytime you go in the patient's room NO ONE wants to go in there. No one wants to be verbally abused when they are trying to care for the patient.

Some people you can never please no matter what. Thank y'all for letting me vent. I just get so sick of people acting like this.

[Natkat, BSN, MSN, RN]

I like to tell them that if they want one-on-one care they can hire a private duty nurse to turn their family member more often. We can't be expected to take care of one patient when we have others who need us.

[nerdtonurse?, BSN, RN]

Document, document, document. Document that you've seen the pt turn, sit up, whatever, what level of assistance, etc. It's hard for a patient to claim neglect when all the nurses are charting that the pt can do for themselves and chooses not to (esp. those refused PT / OTs!).

You also might want to discuss with your charge nurse / pt's PCP about getting a psych consult -- 2 months and they don't want to do anything for themselves? That's either depression or some kind of mental disorder. I've had good luck with pt's calming down when psych showed up -- although one went so completely off that they got a nice TDO and eval (which believe me, they really did need). And if it's not a mental disorder, sometimes a shrink showing up lets them realize they really have been acting nuts.

You're lucky admin stuck by you -- I've seen nurses thrown under the bus if it's a way to keep a family happy.

[StNeotser, ASN, RN]

My charge nurse was a dream and while I was near a melt down (she knew it was not true) this "caregiver" stirred in this for about a week, called the patients family to get them "on board with making sure I never work with any other patient again" and after many lies and administrator meetings - I was "let go".

Sorry that happened to you. I've also worked with patients with some "caregivers" that were complete jerks. One that kept writing in a diary things like 8am meds given at 0807 by nurse X. Notified nurse X that patient having some anxiety. Took nurse 14 minutes to come back with anti-anxiety and busy phoning nasty family with exaggerations and trumped up charges. Immediately the family come in they are full of accusations.

When giving the patient some meds noticing his water pitcher was empty (guess who did have a water bottle full of ice?) I said "oh, looks like you need more water" and getting the reply from caregiver "That's your job! And it's been four hours or more since anyone came in here with any ice water" When given directions to ice machine got told "That's your job and you ain't doing it!"

There are good and bad private caregivers but I suppose that's a different thread.

[GLORIAmunchkin72]

"...I have suggested Vanilla-scented Ativan Air Freshener One sweep across the room and they go from Grrrrrrrr to AAaaahhh.

For some crazy reason, it still hasn't been manufactured. Some crazy babble about ativan needing a prescription..."

Too funny!