Peds/PICU - Love the kids, the parents not so much!

[rnfostermom, BSN, RN]

I've been working in our Level 1 Trauma Center PICU for the past year. I've been at my hospital for several years and had floated to this unit many times before joining the unit. Since I have been on this unit, I've grown professionally and most of the time really enjoy the work. However, I have been verbally and emotionally abused (by parents and family of my patients) more in the past year than in all the preceding years combined. I really feel like I'm getting PTSD or something -- going back to work after the last episode was SO difficult. I didn't eat for almost 2 days and my sleep was badly interrupted. I'm now in the process of deciding whether to join a new unit where I've been offered a position.

I know that critical care/trauma nursing is tough, and we get really, really bad ones here. I know that parents are horrified and terrified and in tremendous pain and uncertainty. I get that. I am a good nurse and I'm a very kind person. I try to project that every day. I try to support the families as much as the kids. But I'm so sick of being treated like crap. For example, being blamed -- loudly and with great hostility -- because their kid spiked a temp on my watch (so it's MY fault their kid developed a 103 fever since last VS check and stat labs showed a doubled WBC? And the related tachycardia was because I "took too long" suctioning their trach and changing them/turning them? Really????) Or having people accuse me of not knowing what I'm doing because I was overheard asking the MD a question about one element of their child's care. Or because the parent has underlying psych issues that come roaring to the forefront during the stress of their child's hospitalization. What is it about parents that think that berating and belitting their child's nurse is the way to ensure the very best care for their child?? Not a great motivator!

I have learned a tough lesson about myself this past year: I'm just too squishy inside. It genuinely hurts me to be treated like this by some of these parents. After talking about this exhaustively with my husband this weekend and a really great informational interview on another unit (one where the nurse manager knows my work and really wants me to join them), I think I'm going to go. I feel like I failed, even though my coworkers are all supportive and I know I did a good job in my time here. I put my best out there every day, but I guess Peds nursing just isn't for me.

[NotReady4PrimeTime, RN]

Please tell me how exactly you've failed? No nurse is perfectly suited to work in every single specialty there is in nursing. As much as I love kids and working in PICU, I would probably have a meltdown if I had to work in NICU. Does that mean I'm a failure? No. It means that I can't fit my square peg into the round NICU hole. I have a friend who is a fabulous ICU nurse with awesome skills and a huge heart who tried PICU to broaden her horizons and let me tell you, she'd sooner chop off a foot than ever work there again. It doesn't make her a failure either. Peds isn't where her personality is happiest.

I don't mean to belittle your reaction to the inappropriate behaviour you've been exposed to at the hands of your patients' families. Sadly that happens on most peds units to a certain extent. The degree of it you've described is perhaps a little high and that's more of a reflection on the management of your unit than it is an indictment of you. If these incidents are reported to the administration and are allowed to continue unabated, there's a problem. We should all expect to be supported when we're clearly being treated poorly - by ANYone, not just our patients' families. When you transfer to your new job, I'd recommend that you sit down with your current manager and go over the reasons why you're leaving. Without being accusatory, you should be able to describe the way you've been treated, how it makes you feel and why you can't continue to put up with it. Ultimately you have to take care of yourself in order to take good care of others. Best wishes to you.

[picurn10]

I agree that it sounds like a management problem. I've had one pt family freak out because I wouldn't start a med (nothing critical) until I could properly scan it, and the scanner was broken. My charge nurse came in there and set the family straight on proper nursing protocol and why I was in the right. I have experienced families who treat me like I'm incompetent, but its less frequent as I gain experience and confidence, and some of that is just their attempt to control a bad situation. If you don't have management that is going to back you up, or doesn't project a feeling of competency in the nursing staff, I think you'll keep running into that. Can you try another facility?