Rude Families-How do you deal with them?

Trauma Columnist · Oct 5, 2004

Hot topic! Yes, I think (I'm 46) that the world is definitely becoming much ruder. People and families in hospitals and LTC lose a lot of control so their only means of controlling their environment is with little things. This can be frustrating for them and they are a lot of times not nice to the staff in order to express this. Just my observation. When I'm confronted with nastiness that I don't think is deserved, I make solid eye contact and say, "I know this is a scary, uncomfortable, or whatever emotion you think they are displaying but I'm here to help...what can I do?" I do not tolerate being sworn at though and I tell those people: "I can see that you are upset at the moment. However, I will not tolerate you swearing at me. I'll be down at the desk (or wherever) and when you calm down, please let me know." I work the ER and believe me, people are incredibly rude!

jschut, BSN, RN · Oct 5, 2004

I also work in LTC, and there are days that the families just seem to ALL be having a bad day, and there are the select few that are having bad lives... :rolleyes:

But seriously, in their defense, I had a family member go ballistic on my just a couple of days ago. The daughter was so angry that she began to cry. And she told me that it was the hardest decision that they have ever had to make to put Dad in a nursing home. I imagine alot of their anger was guilt, and that little things aren't done, like fingernails being trimmed and dirty (they were) and just minor ditties....

You know? That means alot to families when their loved ones are clean and tidy....

I had a few extra minutes after my shift and made sure this gentlemans nails were cut and cleaned the next day for him (and his family), and I also took the time to let them vent their problems to me. Yea, it did take some time I could have been using elsewhere, but I am there for families too. I can empathize with the horrid guilt they must be feeling having to put Dad there in the first place.

Hang in there, stand up for your facility, assure them that you are doing all you can for their familiy member...but the little things do mean alot I have discovered.

We need good nurses in LTC, I do realize it is probably the hardest job you will ever do, but it is also one of the most rewarding.

Good Luck to you! :)

Thunderwolf, MSN, RN · Oct 5, 2004

Rude family members come in different packages. Can you provide some of your situations? Some family members are just concerned, maybe even frightened that their loved one may not get adequate care. Some do not understand how to be helpful, so resort to demanding behaviors as a demonstration of cariing to the patient...such as "by God, I'll make something happen!". Some family members may have their own personal problems, often presenting to get their own needs fixed. Some of the worst family members can be nurses themselves, dictating/criticizing the care provided or not provided or should be provided. What has helped me in the past to understand angry family members is that anger is often the kissing cousin to fear. Listen to or for the underlying fear, the anger usually diminishes. Also, another tactic is when the family member gets louder, you purposely get softer...it forces them to listen to you. Sometimes, making it ok for the family member to be "a team member" in providing bits of care is helpful because it empowers them to be genuinely helpful. Quite often the patient appologizes for their family member's behavior once the family member leaves; this should be a clue to you that it has nothing to do with you or the care you provide. Also, you may have to consider that the family member may have their own psych issues which worsen under the stress of their loved one's illness or being in a hospital. And believe it or not, there are just very rude and controlling people in the world. They get away with it at home or at work and expect the same in the hospital. In this sense, let it roll off your back. I agree with you that our health care system has changed the perception as to what a hospital is supposed to provide nowadays. The system markets itself as a hotel environment more so now than it ever has to attract the buck. The more it became a business, the more it lost its focus or soul. Deep down, patients and family members feel this and become afraid. So, if a person walks in the door ill and expects hotel accomodations, it sets everyone up for failure and great disappointment. Family members become upset. It has no reflection on you. And yes, family members can be more exhausting taking care of all their needs than the energy it takes to take care of that one patient. You have to take care of yourself. Talk it out, vent, exercise, take a smoke (oops, did I say that), switch assignments, take a day off or plan that vacation, what ever it takes to take care of you.

BeenThereDoneThat74, MSN, RN · Oct 5, 2004

sassy,

was your night as bad as mine? i was actually supposed to initiate this thread!! i don't know if i would be calling them rude (defiinitly not nice). i prefer the term 'difficult'.

i work in peds, oncology no less. i feel like it's taking a toll on me. i can't relate, but i'd like to think i can appreciate what they are going through. i keep trying to think about how i'd feel if it were me (or my child, god forbid). but sometimes it just doesn't cut it! it still hurts when people put you down and insult your skills or expertise. last night's mom has issues- it wasn't the first time she lashed out. she wanted to know why no one helps her. she told her son 'you call the nurse when you need help, they get paid to do this. problem is, her 11 y/0 son wants his mother- not the nurses- to wipe his butt (understandable). and i'm sure he doesn't want to hear about how stressed his mother is- especially since she will most likely outlive him...and he knows it too.

Blackcat99 · Oct 5, 2004

:) I work in LTC and I only work night shift so I don't have to deal with family members. I use to work eve shift and I got sick and tired of the constant hassles with family members. It's not worth it.

sassynurse78 · Oct 6, 2004

:) I work in LTC and I only work night shift so I don't have to deal with family members.

That is something I had not considered, but I could go to nights! I have worked nights before and there are a lot less families to deal with. Seconds is prob worse, because everyone stops in after work. Thanks for all your comments, it is always nice to know that it not just you! :)

My biggest frustration is that while I am dealing with families, another pt. is waiting even longer for me. The experience that made me post was this: A confused woman told her daughter that she was left up all night in her w/c. The daughter came to me furious, which I couldn't blame her. But after I told her that I had personally helped her mother into bed when I took in her 9pm meds so I know she was there at one time, but it was always possible she got back up, that I would find out and take care of it if this was the case, she began to yell at me that she didn't beleive me, I was lieing to cover up how lazy everyone here is. This went on a few minuted before I stopped her and told her that if she had prob with the staff that she needed to be specific so that the prob could be addressed, she walked off in a huff. I then overheard her telling another family member that her mother was left up all night, the staff here is lazy..I lied to her etc.

I know I shouldn't take it personal, that I work very hard as well as everyone else. That the pt. was taken care of. I do not beleive that she wanted anything fixed, she just wanted to complain! I need to get over taking it personal I guess :chuckle (A day off can bring things into proseptive for you!)

angel337, MSN, RN · Oct 6, 2004

working with the public has always been and always will be tough, but it is especially challenging in healthcare where people are usually going through major life changes. this does not excuse rude behavior, but it does make you more empathetic to what others may be experiencing. i can only recall a couple incidences when a family member was very upset and usually it was about other things like how long they have been in the waiting room to see the doc or how another staff member was rude to them. in the ER people have very high anxiety levels because the are usually acutely ill. i always try to keep my patients informed of what is going on with them (pending lab results, possible admission status, etc..) because most people get upset when they feel they are not being acknowledged. but on the flip side of that, you can only do so much. some days you just CAN'T do it all so i say just as long as you are nice and approachable, most family members won't give you a hard time. hang in there and don't feel bad about it. and also the next time a family member screams or yells to the point of abusing you.....call security. you deserve to be treated like a human being with feelings also.

Nursenan0 · Oct 7, 2004

Rude doesnt even describe my yesterday! This whole situation has gotten out of hand...the short version.......... One of our LPN's young daughter lives in our facility. The mother has filed a lawsuit against the facility...ongoing for a year now, and legitimate in my opinion. This woman is the terror of all terrors when it comes to family. The facility turns their head and she does what ever she wants. On the clock or off. Yesterday topped them all. She came in, transferred her "hoyer lift only" daughter into bed herself....then came screaming out into the hall wanting me to "come look" well she screamed, yelled, cursed in my face for about 5 minutes...at the top of her lungs, until I put my hands up told her I didnt have the authority she was looking for. I went to get the unit manager of that hall. As I was in the hall discussing the complaint with the UM and the medical director she comes rushing down the hall f-ing this and that while she was screaming she was calling the state. The unit manager tried to get her to calm down and discuss what was wrong and she called her f-ing this and that....then she rushed out of the facility. She returned a few minutes later and reported many lies about the scene to the administrator. We are all devastated by what has happened...not to mention the many alert and oriented residents on that hall who were witness to the scene. Then we are told...coporate will have to handle this and decide what to do! AAAAAAAAAAAGGGGGGGGHHHHHHHHHHH what is there to decide????? I dont get it. Can you spell M-O-R-A-L-S ???? The unit manager found another job today.... My conscience says I should go to, but I love my job...just not the way things are being run.

chemoqueen, BSN, RN · Oct 7, 2004

bless you for being a peds onc nurse!

sassy,
was your night as bad as mine? i was actually supposed to initiate this thread!! i don't know if i would be calling them rude (defiinitly not nice). i prefer the term 'difficult'.

i work in peds, oncology no less. i feel like it's taking a toll on me. i can't relate, but i'd like to think i can appreciate what they are going through. i keep trying to think about how i'd feel if it were me (or my child, god forbid). but sometimes it just doesn't cut it! it still hurts when people put you down and insult your skills or expertise. last night's mom has issues- it wasn't the first time she lashed out. she wanted to know why no one helps her. she told her son 'you call the nurse when you need help, they get paid to do this. problem is, her 11 y/0 son wants his mother- not the nurses- to wipe his butt (understandable). and i'm sure he doesn't want to hear about how stressed his mother is- especially since she will most likely outlive him...and he knows it too.

debRN0417 · Oct 7, 2004

My administrator would have given the family a 30 day notice.....I would have told her to go ahead and call the state, that I was calling the police as she was threatneing and verbally abusing staff and causing fear and panic in the residents who could not understand what was going on. I am sorry, but I have no tolerance for that type of behavior and would tell her that since she is so dissatisfied with the care then she needs to look elsewhere that obviously we were not meeting her needs.

This is a response to NursenanO's horrible screaming lady story...

Nursenan0 · Oct 7, 2004

Deb, If it had been any family but her they would have hauled her out...they only let her get away with this behavior. The worst part is...We believe she is setting up the "things she complains about" herself, then blaming the staff.