Pt/Family RAGE

CseMgr1, ASN, RN · Dec 16, 2005

Oh, YES...Many, MANY times. I once had a rather nasty encounter with the son of of a home care patient who had been inappropriately admitted (and under political pressure, I might add), to our HHA under Medicare. Discharge planning had been carefully documented by our Social Worker and every nurse who had an encounter with this man and his son thoughout the four months we were involved with his care. Well, lo and behold, the day of discharge finally comes (and not a day too soon, I might add), I get an irate phone call from the son. I cannot get a word in edgewise, as I patiently attempt to remind him that Medicare does NOT pay for custodial care, for he is screaming at me that he "has to have chux and diapers for his Dad". After he has been politely asked to lower his voice and declines to do so, I inform him very coldly: "Sir, I am NOT sending a nurse back out there in order to provide diapers and chux for your father". This immedately provoked a tirade of expletives from the other end of the phone, and I hung up on him. Not fifteen minutes later, I get pulled aside by my boss, who has received a call from our Corporate Office, as Foul-Mouthed Son has now called them and lodged a complaint against me. She starts into me, and I get right back into her face and angrily inform her that I was not ONLY not going to take any more verbal abuse from this family member, who together with his father had manipulated their scheming little ways through EVERY HHA in our area in order to get free diapers and chux, but I was also NOT going to tolerate it from anybody...EVER again. Her eyes got wide as saucers, as I went on, pointing my finger at her for emphasis: "You were WELL aware that these two had been through the system even before the admission happened, and I am NOT going to take the blame for that, either". I had never talked to a supervisor like that before, but I didn't care. These people know EXACTLY what they are doing, and all I have to say is that I am pleased as punch that I don't have to deal with them anymore...and don't have to risk being fired because I STOPPED kissing their rear-ends! :angryfire

Mountain Nurse · Dec 16, 2005

Good for you CseMgr1!! Stand up for what yourself. You definately deserved more respect than you got.

Blackcat99 · Dec 16, 2005

When I worked at the state psychiatric hospital I got plenty of physical and verbal abuse from patients. The worst visitor abuse was when I worked at a LTC facility. We had this male visitor who would yell at the top of his lungs every evening at all the nurses and CNA's. He would constantly complain about the horrible care his wife was getting and how horrible we all were. One night, I had had it with him. I yelled back and said "Well, if we're all so horrible here and your wife is receiving such horrible care why don't you take her home and you take care of her yourself" He was stunned speechless when I said that to him and he never yelled at me again.:)

DusktilDawn · Dec 16, 2005

The big problem I see in regards to abuse from patient's and their families, is that it is considered part of the job to tolerate this abuse. It's not just the patient's and their families/visitors that believe this, nurses, their managers, and administrators also believe this. In fact in alot of instances, abusive behavior towards nurses is often rewarded by placating the family/patient. Most of the time, nurses are made to feel that somehow they were the cause. We often have no recourse or support when dealing with abuse.

The toleration of abuse takes it toll on nurses. It contributes to burn out. Many suffer symptoms of PTSD and do not know that they are suffering from this.

The fact of the matter is, THAT ABUSE SHOULD NOT BE TOLERATED. There needs to be some recourse for nurses who are abused. There are patient advocates, why not nurse advocates. As long as abuse is tolerated, it will continue and escalate.

This is a problem that needs to be brought out into the open, instead of brushed aside by our profession and administrators.

StNeotser, ASN, RN · Dec 17, 2005

I almost posted on this same subject a couple of days ago.

It's a little easier in a hospital environment than in a SNF environment I think. Though maybe I have that view because hospital patients only stay a few days whereas in a SNF you have them for a couple of years.

I work prn at a very good SNF where I used to work full time. One 89 year old post stroke with CHF patient was admitted when I was there two years ago.

For the whole two years he was there he would scream for most of the night if he was awake. If he wanted to get up in the wheelchair at 1am then staff would do that. We then got told by the family not to do that because his legs were dependent for so long edema in his feet made it too difficult to get shoes on him - something pointed out by the facility. I would then get an abusive phone call from his daughter asking why we were no longer "meeting his needs" meaning getting him up at 1am if requested. She would not let him take any sort of anti psychotic or sleeper even though ordered through the MD because she had read on the internet about their side effects. She would not hire a private aide but insisted that we take care of him, even though it meant at least four nursing hours of an eight hour shift. Management support was non-existent to the point of the DON saying "Well, they're a rich family and used to having this and that done for them" and "I don't want to hear any more complaints from Mr X's family"

Well, Mr X died a few days ago and one nurse is now suspended because of it, possibly being terminated. Mr X collapsed after going for a walk in the evening with his "lovely" daughter. He spent two days with labored breathing, MD was aware, meds ordered, hospice consult rejected by the family. Daughter now claims that the reason that brought on his death is because the night shift nurse on the night prior to this collapse ignored and neglected this man all night while he was yelling and screaming and that is why it happened. She is actually saying this night shift nurse is responsible for his death even though the next day his vitals checked out OK and had no new issues. I can't believe that management are actually swallowing this and the night shift nurse has actually been suspended over it. He was, I repeat, 89 years old.

Two days ago I was working a shift where one nurse was screamed and yelled at for giving a 7pm Ambien at 7:50pm by a family member. This same family member who had spent time chewing out a CNA for her mothers room being a mess then spent a further five minutes chewing out the CNA for having the audacity to clean and tidy the room while the family member and patient were out of the room. This screaming at the top of her lungs also included profanity.

I just don't see this in other service industries. Try yelling and swearing at a waiter for not getting your order right (even though it is right). Try going into a place of business where you are a customer and the first little thing that doesn't meet with your approval threaten the employees there with "you'll be fired for this" It just doesn't happen.

I do not feel as if I have any rights at all. I work in Colorado which is one of those "at will" states and don't believe I'll be getting any back up soon. Yet I'm sure we have some right to a safe working environment. I suppose it doesn't cover being constantly abused by spoilt people who can do so because "they pay for it". I'd like to see where the fee is on an itemized nursing home/hospital bill that says Employee Abuse Fee.

Mulan · Dec 17, 2005

I just don't see this in other service industries. Try yelling and swearing at a waiter for not getting your order right (even though it is right). Try going into a place of business where you are a customer and the first little thing that doesn't meet with your approval threaten the employees there with "you'll be fired for this" It just doesn't happen.

Exactly, and then they wonder where all the nurses went.

tencat · Dec 17, 2005

A job where I'm expected to be abused and take it is really not a job worth having. It does happen in other professions....it's one of the reasons why I left public education. I once had a parent physically come after me during a meeting when I said something he didn't like. He was intercepted by another teacher,and I walked out of the meeting telling the man I would never meet with him again directly. I got in trouble for it and told "well, of course he was mad at you for saying that," implying that I deserved the abuse and brought it on myself. I didn't put up with it then, and I don't intend to put up with it in nursing, either. Like I said, if I would get fired for standing up for myself, then it's not a job worth having.

DusktilDawn · Dec 17, 2005

A job where I'm expected to be abused and take it is really not a job worth having. It does happen in other professions....it's one of the reasons why I left public education. I once had a parent physically come after me during a meeting when I said something he didn't like. He was intercepted by another teacher,and I walked out of the meeting telling the man I would never meet with him again directly. I got in trouble for it and told "well, of course he was mad at you for saying that," implying that I deserved the abuse and brought it on myself. I didn't put up with it then, and I don't intend to put up with it in nursing, either. Like I said, if I would get fired for standing up for myself, then it's not a job worth having.

Perfect example Tencat why abuse continues. Lack of support from our management and administrators. Excuse me, but why would it be considered acceptable for this person to become physically aggressive and how is that your fault?

We are accountable if we are the perpetrators of abuse towards our patients or their families. We will suffer consequences for abusive actions. Yet when we are the victims of abusive behavior, we are often made to feel that somehow it was our fault and that we brought it on ourselves.

Health care is failing when it comes to protecting nurses.

snowfreeze, BSN, RN · Dec 17, 2005

It would be nice if people knew how to be civil. I blame their parents for not teaching them proper behavior. The parent is now the patient and the children are just rude and selfish.

Town & Country · Dec 17, 2005

It's sort of "the squeaky wheel gets the grease."

EVERY hospital should implement a Visitors' Code of Conduct that includes patients' families and is part of the Admission Packet.

They should have to sign it to even get admitted.

Then administration should STAND BEHIND NURSES when they are harassed by hostile, ignorant families.

Just my opinion....but I predict it won't be happening soon b/c of the "Customer Service" attitude so prevalent these days.

-gag-

:rolleyes:

FroggysMom · Dec 17, 2005

Exactly, and then they wonder where all the nurses went.

Exactly. :angryfire