"What to Expect When You're a Patient"

Susie2310 · May 7, 2015

I am so tired of posts from licensed nurses (your post history says you have been a nurse since 2014) berating patients and their family members/visitors on a public web site. I find it very unprofessional.

You are new, and you have a lot to learn.

With your attitude, I would not want you taking care of my family. Yes, some patients/family members can be difficult, for which there are many reasons. I suggest doing a search on AN for tips from nurses who have found constructive ways to deal with these kinds of situations; very often they include patience, kindness, genuinely listening and trying to understand the patient/family member's concerns, and trying to put oneself in the place of the patient/family member. You are seeing a snapshot of your patient and their family's lives and you have no idea of the difficulties they are experiencing.

Also, I suggest checking the quality of care you are providing. When a family member of mine is hospitalized I pay close attention to the care the nurse is providing. It is possible that the patient/their family member are not confident in the care you are providing, and thus are behaving in a way that indicates lack of confidence in you.

Graduatenurse14 · May 7, 2015

Susie2310,

Thank you for your response. I welcome them all.

You are seeing a snapshot of your patient and their family's lives and you have no idea of the difficulties they are experiencing.

I do. I went from teaching kids and adults to going to nursing school after being with my mom every step of the way while she battled cancer for 3 years. She lost the battle but I saw amazing care given to her so I was inspired. She did chemo, radiation, had 3 major surgeries, multiple complications and obviously, numerous long hospital stays. I've been the family member of a very sick and dying patient and wouldn't wish it on my worst enemy.

I give excellent care as an RN and did as a CNA as I see every patient as my mom laying in that bed. I've had numerous patients and families specifically name me for giving them better care than they had anticipated and/or that was being given by my colleagues in a survey card, follow up phone call by my boss or in a written letter to the hospital/unit.

I'm not tooting my own horn just explaining that I've been on both sides and the customer service-driven aspect of healthcare/medicine is not a change for the better.

Susie2310 · May 7, 2015

Susie2310,
Thank you for your response. I welcome them all.
I do. I went from teaching kids and adults to going to nursing school after being with my mom every step of the way while she battled cancer for 3 years. She lost the battle but I saw amazing care given to her so I was inspired. She did chemo, radiation, had 3 major surgeries, multiple complications and obviously, numerous long hospital stays. I've been the family member of a very sick and dying patient and wouldn't wish it on my worst enemy.
I give excellent care as an RN and did as a CNA as I see every patient as my mom laying in that bed. I've had numerous patients and families specifically name me for giving them better care than they had anticipated and/or that was being given my by colleagues in a survey card, follow up phone call by my boss or in a written letter to the hospital/unit.
I'm not tooting my own horn just explaining that I've been on both sides and the customer service-driven aspect of healthcare/medicine is not a change for the better.

You provided details of your own experience of being a family member, and I am very sorry for your experience, but as nurses we have to remember that patients and their families are unique individuals and have their own ways of dealing with illness and hospitalization.

I have been a nurse for nearly 20 years, and the customer service-driven aspect of healthcare/medicine that you refer to is definitely a change for the better for the patient/family member, from what I have experienced. Health care professionals listen to patients and their families with more respect now and treat them with more respect; patients have the opportunity to express their thoughts about the quality of the medical/nursing care they have received, including the quality of the providers; there is more 24 hour visiting. If you are referring to short-staffing and patient ratios; those problems existed 20 years ago.

RachRN11 · May 7, 2015

Well some of these aren't the nicest of comments. We all have bad days and we all rant. I would certainly rather you rant on here than take out your frustration on a patient and/or family member. Pretty sure I've written down things about what I wish I could say to patients but can't...I KNOW everyone has thought of it so to say that you should re-evaluate your quality of care is just plain rude and unneccessary.

Health care is very frustrating. Patient's and family members can be difficult to deal with but that doesn't mean you aren't doing a good job. Some people are just plain difficult, end of story and no matter what you do they will stay that way. Nursing is an often thankless job, we hear that over and over again.

I'm all for ranting and writing out your feelings so you can get them out and not internalize them. Keep doing you and ignore those who say you aren't doing a good job because they obviously have no idea if you are or are not based on one single post.

TheGooch · May 7, 2015

I believe the OP was just ranting-they probably had a bad day. No one is perfect and if they can't rant here where else is there. People need to chill out.

icuRNmaggie, BSN, RN · May 7, 2015

I understand the need to vent and I agree that aggressive people make me not want to go in that room at all. However, it is time to accept that building a positive professional relationship with the family spokesperson is part of the job. Ignoring someone is very disrespectful. It's really

pretty simple in the ICU setting. Provide exceptional care, educate and do at least one nice thing for that visitor per shift whenever time permits. This is what they will remember and it will go a long way

in most cases to maintaining a calm harmonious environment throughout your shift.

Long Term Care Columnist / Guide · May 8, 2015

When I was a nurse, I used to invest 10-15 minutes at the beginning of the shift in my most challenging patient/family, discussing what the goals were for that shift, dealing with pain and answering questions. No matter how demanding they were, it always seemed that doing this reduced the amount of time I had to spend in that room, and often I was left in peace to take care of ALL of my patients. It also helped the patient/family to have confidence in me, because they felt they had been heard and their concerns addressed. So simple.....and yet so complicated at times when I had more than one "problem child". :yes:

MedChica · May 8, 2015

When I was a nurse, I used to invest 10-15 minutes at the beginning of the shift in my most challenging patient/family, discussing what the goals were for that shift, dealing with pain and answering questions. No matter how demanding they were, it always seemed that doing this reduced the amount of time I had to spend in that room, and often I was left in peace to take care of ALL of my patients. It also helped the patient/family to have confidence in me, because they felt they had been heard and their concerns addressed. So simple.....and yet so complicated at times when I had more than one "problem child".

I agree.

Now, I don't work in an ICU but if other coworkers give me a heads up about a 'problem visitor', it always works in my favor when I approach them, opening the door to answer/rectify their many, many...many...questions and concerns.

It's not really a customer service type thing. It's more, like..this: You can have an easy shift or you can have a hard one. You can have a hard day or you can make your day that much harder.

Your choice.

But, you don't hide from "problem family members". They'll just find you and raise hell because they had to, in the first place. Try to get through the shift, then. You won't be able to do your work in peace ... for them hovering on your shoulder being bothersome. I've learned as much via observation that's why my tactic is proactive.

"Problem family members" love a proactive nurse/MD/aide, etc....

So, go to them. Introduce yourself.

Open ... that ... door. (LOL)

It'll save a lot of headaches, energy and time down the road.

I do agree with the OP in a sense. I don't like it when people come to the facilities treating the staff like we're the enemy. It gets under my skin. We, my nurse and CNA coworkers, run hard for these pt's. Really ticks me off when people who don't get what we do waltz in looking for things to complain about.

KatieMI, BSN, MSN, RN · May 8, 2015

I really do not know why nobody bothered with just such an idea yet.

Nurses wear royal blue here, so do not ask someone wearing bubble pink if you can get your pain med now.

Nurses only can give meds doctors ordered. They physically cannot give you anything else, there are multiple, such and such barriers preventing them from doing this. It is done for your own safety.

"Calling doctor" usually involves system called "paging". It is not a cell phone, there cannot be immediate responce. In addition, doctors drive cars, take showers, do procedures and even sometimes have to visit restroom, so do not expect anything done right next second if a nurse calls a doctor.

Your REAL pain "experience" will probably look like this (insert the cold truth here as needed. Labor is not "just cramps", etc.).

If your doctor ordered you being on a particular diet, you will get that and only that stuff.

You can refuse anything and everything at any moment. You will be explained possible sequela and live with them should anything happens.

Nurse has more than one patient to care for in 999 cases out of 1000.

It is your business to arrange meetings with doctor, social worker, etc. Unit secretary can give you phone number to call.

Nurses have no control neither knowledge of who is coming in the unit at any particular moment, and when. I cannot call Dr. X and order him to get there now because you want to speak with him.

If something happens with your mom at 3 am, we will call only once and to only one person. Make someone family spokeperson, and do not expect us to call cousine Whinney in Atlanta.

Etc., etc.

BrandonLPN, LPN · May 8, 2015

Your family being demanding, aggressive, passive-aggressive, haughty and demeaning to those taking care of you and you thinking they are protecting you so that you'll get better care in the form of more attention is usually dead wrong. We stay away from patients like that unless it's absolutely necessary to go in. If three call lights are going off, yours will be answered last since it is absolute torture to deal with you and/or your family.

While I totally understand where you're coming from, prioritizing which patients you see first based on how annoying their family is is not very good nursing.

(But a pamphlet informing families that their complaining will not result in quicker service.... that I could get behind)

Karou · May 8, 2015

I just finished three shifts in a row with more than one very difficult patient, so I am not going to shake my head and tsk tsk at you OP for what is obviously a frustrated vent thread.

Here is what I wish all of my patients knew...

1. I have at least four other patients. The PCT has at least eleven. I cannot physically be in more than one location at a time.

2. At night I cannot call your attending physician. I am going to call an on call physician who has no idea who you are. This means longer communication time so please be patient.

3. Our fridge at night is usually pretty bare, so no, you can't have fourteen packets of gram crackers tonight. I am sorry but we have over thirty patients on this floor and what we have has to be enough for everyone.

4. I can't just order you Tylenol, Benadryl, ibuprofen, cough syrup, or any other OTC medication. I need to call the physician even for "basic" medications.

5. We can not medically treat or feed your family members. I can't take your mothers blood pressure or give your brother a boxed lunch. Food is for patients and if you think your BP is high then you need to go to the ED.

6. Hospitals are loud. Your neighbor might be a confused and agitated patient screaming all night long. I can't control that, but trust me, I wish that i could.

7. This is a hospital and you are here because you are sick. That means that you may need frequent monitoring of vital signs or lab work, IV medication, eat. I don't WANT to wake you up, but I need to. I will try to cluster care and allow you as much uninterrupted sleep as possible. That benefits both me and you. But some things are just necessary.

8. IV insertion is a skill learned with practice. Even with a skilled nurse it can be difficult. Just because a nurse may not be able to get your IV does not mean they are an unskilled nurse.

9. Write down all your questions for the doctor because they will provably spend less than ten minutes in your r room and leave. Trust me, write it now before you forget.

10. I am on your side. I am doing the best that I can. Please know that we are all trying to make this easier for you, because that means it will be easier on us also.

8. I