what do you say when they are right?

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This past weekend I have had several family members come and complain about basically ( they didnt use these words) substandard care. We are so understaffed and they are absolutely right. I can not bad mouth my employer so all I can do is lie to them and say I will counsel the CNA but what am I going to say? I know you have 12 patients but you have to be two places at once." The family are near tears and I want to say " you are right, your mother does deserve better." But I cant do any better. I don't take my lunch, I dont pee, I really do care but I can not give my 34 skilled residents the care they deserve. What do you say when they are right?

Specializes in Geriatrics, Ambulatory Care.

There is always a complaint/ concern form that can be filled out, We keep complain/ concern forms in a box outside the social workers office so the nurse, the resident or the family can fill them out. Then it gets passed to the social worker for follow up. All complaints that are in writing must have a follow up by someone. All you can do is apologize and let them see you put it in writing. No one in administration can feign ignorance if it in writing.

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....
This past weekend I have had several family members come and complain about basically ( they didnt use these words) substandard care. We are so understaffed and they are absolutely right. I can not bad mouth my employer so all I can do is lie to them and say I will counsel the CNA but what am I going to say? I know you have 12 patients but you have to be two places at once." The family are near tears and I want to say " you are right, your mother does deserve better." But I cant do any better. I don't take my lunch, I dont pee, I really do care but I can not give my 34 skilled residents the care they deserve. What do you say when they are right?

Just get out your pen and paper and start writiing it down. Get specifics. Not just that they are not happy with the care. Get them to tell you exactly what it is. Deal with the immediate issues. Example- mom has been wet for over an hour and no one has come to change her. It will certainly set you back in terms of time, but do apologize and tell them it will be taken care of right away and do it. Make sure you send a copy of the concern to the Admnistrator/DON and let the family know that you are going to do this. There is nothing you can personally do about understaffing, but you can help to relieve the stress of complaints if you know what families have concerns, and who comes in and when. I mean if you know that John Doe's daughter comes in every day at a certain time, then make sure that John Doe is ready for the visit. Have the assignment made up so that those residents who have frequent family visits get care as soon as possible. I am not saying that you should neglect others who have more immediate needs, just that if you try to take the bull by the horns and take care of the "complainers' (I hate to use that word in this situation but can't think of a better description) then it could help make your life easier. Do you have a supervisor? If so, then call them and let that person handle the complaint, unless you have a supervisor that does not know how to effectively handle situations like this and will just blame you or your staff. Maybe if the supervisor gets tired of having to answer to so many complaints then they may be able to either help you out on the floor, or ensure you have enough help to adequately take care of your residents. Can you talk to your DON about it? Can you approach her and explain your frustrations that you don't have enough help and the care needs are causing complaints from families? Several complaints from families to the ombudsman or APS can cause the state to come in and then you will have that added stress...but if I am hearing you right, it may be something that is needed to stir the administration into taking a more serious look at the acuity of your residents and the staffing needs. You don't have to say that their family member deserves better than this, but that you are sorry and understand their frustration and that you will do what you can for them. BUT be careful about making promises that you know you can't keep. If you know you can't solve the problem, tell them. Refer them to the supervisor or the Administrator. AND make sure you are documenting everything you do and say with dates and times so that you can not be accused of saying something you did not, or not providing the care you should. (sometimes a witness is helpful) I have told families that were screaming at me that they were absolutely right and that they had a right to be upset, which many times will diffuse them into calming down. If you get defensive or try to make excuses, it only makes matters worse because they do not want to hear that. You may want to also look into another job situation if you feel that you are unable to provide good care because of staffing. Unfortunately if you are in charge it is often the charge nurse who is blamed if the administration is not supportive and needs a scapegoat in certain situations. Now, that is not always the case, but we all know it does happen. Does your facility have a grievance procedure, or a concern log or something? If so, get the families the forms and let them write it down and get it to the "powers that be". If it is a problem with a staff member, then that should be delt with. It is never good to tell a family that "CNA or Nurse Dolly did not do this or that or the other" because then they and administration will question you as to why you were not supervising your staff and making sure that CNA or Nurse Dolly did what they were supposed to do. Do you have staff meetings? Ask for one. Bring up your concerns. I am sure others feel the same way as you do. Nothing is more frustrating or causes more burn out than to feel you cannot give good care when you are doing your darndest and working your butt off, not eating, taking a break or even going to the bathroom because you are over worked and over stressed and not matter what or how much you do you feel as though you can't seem to keep your head above the water. That is not good for you. And then there are the no-win-situations when no matter what you do or how good you are it is never enough. That is the nature of the beast sometimes. I hope things get better for you and your residents and other staff and that you can find some support from your supervisor and administration. Maybe they have no clue about what is going on and need to be told.

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Just get out your pen and paper and start writiing it down. Get specifics. Not just that they are not happy with the care. Get them to tell you exactly what it is. Deal with the immediate issues. Example- mom has been wet for over an hour and no one has come to change her. It will certainly set you back in terms of time, but do apologize and tell them it will be taken care of right away and do it. Make sure you send a copy of the concern to the Admnistrator/DON and let the family know that you are going to do this. There is nothing you can personally do about understaffing, but you can help to relieve the stress of complaints if you know what families have concerns, and who comes in and when. I mean if you know that John Doe's daughter comes in every day at a certain time, then make sure that John Doe is ready for the visit. Have the assignment made up so that those residents who have frequent family visits get care as soon as possible. I am not saying that you should neglect others who have more immediate needs, just that if you try to take the bull by the horns and take care of the "complainers' (I hate to use that word in this situation but can't think of a better description) then it could help make your life easier. Do you have a supervisor? If so, then call them and let that person handle the complaint, unless you have a supervisor that does not know how to effectively handle situations like this and will just blame you or your staff. Maybe if the supervisor gets tired of having to answer to so many complaints then they may be able to either help you out on the floor, or ensure you have enough help to adequately take care of your residents. Can you talk to your DON about it? Can you approach her and explain your frustrations that you don't have enough help and the care needs are causing complaints from families? Several complaints from families to the ombudsman or APS can cause the state to come in and then you will have that added stress...but if I am hearing you right, it may be something that is needed to stir the administration into taking a more serious look at the acuity of your residents and the staffing needs. You don't have to say that their family member deserves better than this, but that you are sorry and understand their frustration and that you will do what you can for them. BUT be careful about making promises that you know you can't keep. If you know you can't solve the problem, tell them. Refer them to the supervisor or the Administrator. AND make sure you are documenting everything you do and say with dates and times so that you can not be accused of saying something you did not, or not providing the care you should. (sometimes a witness is helpful) I have told families that were screaming at me that they were absolutely right and that they had a right to be upset, which many times will diffuse them into calming down. If you get defensive or try to make excuses, it only makes matters worse because they do not want to hear that. You may want to also look into another job situation if you feel that you are unable to provide good care because of staffing. Unfortunately if you are in charge it is often the charge nurse who is blamed if the administration is not supportive and needs a scapegoat in certain situations. Now, that is not always the case, but we all know it does happen. Does your facility have a grievance procedure, or a concern log or something? If so, get the families the forms and let them write it down and get it to the "powers that be". If it is a problem with a staff member, then that should be delt with. It is never good to tell a family that "CNA or Nurse Dolly did not do this or that or the other" because then they and administration will question you as to why you were not supervising your staff and making sure that CNA or Nurse Dolly did what they were supposed to do. Do you have staff meetings? Ask for one. Bring up your concerns. I am sure others feel the same way as you do. Nothing is more frustrating or causes more burn out than to feel you cannot give good care when you are doing your darndest and working your butt off, not eating, taking a break or even going to the bathroom because you are over worked and over stressed and not matter what or how much you do you feel as though you can't seem to keep your head above the water. That is not good for you. And then there are the no-win-situations when no matter what you do or how good you are it is never enough. That is the nature of the beast sometimes. I hope things get better for you and your residents and other staff and that you can find some support from your supervisor and administration. Maybe they have no clue about what is going on and need to be told.

This is great advice, and pretty much what I was going to say, but said so much better than I ever could.

OP, you never know, you might just be the one that starts to get some things changed and some improvements made - I can tell from your post that this is really distressing you, I hope things get better.

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Specializes in ICU.

Thanks guys. I have asked that they speak to the nurse supervisor ( she is on another shift, I am the supervisor on my shift) and I do let the family know that the cna is busy with another resident. The CNA are constantly working, no one takes a break. I think I will start encouraging them to let the DON/admin know. I know that some family has already complained. I think change is on the way but its tough waiting for it.

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Family members would rather have me blame the CNA, however I am honest with them and that seems to be a bad thing according to some people

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Specializes in Geriatrics.

Since I cannot say anything to the families while on the floor (could have cost me my job), I try to find an excuse to ride the elevater down with them and tell them everything NurseLoveJoy said or just happen to walk by the Ombudsmans signs posted around and give them a very obvious look and head tilt to the signs. Haven't gotten caught (yet).

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In an earlier post mel I had the same concerns. Good news bad news unless the fed gov or state gov step up and take the lead on how many pts 1 nurse can can handle then I'm afraid it won't get any better for u or I all management care about is $$$$$ and did I mention $$$$ and point #3 $$$$ why add extra staff when they weigh their cost to have extra staff and pay for benefits vacations etc versus court cost unfortunately the rather spend it on court cost and lawyer fees and the board profit driven as well all u can do is pray and ask Jesus to help you refuse some of the assignments and see how it goes write a letter to don and administrator that if adequate staffing is not met I will not be able to work that particular day do this on the day that the scheduling is done maybe u can affect change in this manner if no resolve u cmae their looking and u can leave their looking main point cya and keep your license intact

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