Published Feb 15, 2011
You are reading page 4 of So... how do you deflect family members when you're busy?
Oh, I can relate OCN. We were in the middle of an emergency (not quite a code but headed that way). I dashed out to make a quick call to the MD and the mother of another patient demanded that I call the gift shop to ask if they had any curlers because her spoiled princess of a 24 year old daughter wanted to do her hair. NOW. Tried to follow me back in the room. I said, "You'll have to call them yourself, I have an emergency." Had to literally shut the door in her face!! And this is SICU!
I usually tell them that I have x number of requests ahead of them and I will get to them as soon as I can.
Often times as I go about my night and different people need blankets, juice, ice etc. I make a note of it because I will forget.
And I work night shift...families are still very much present and demanding.
When I am able to get around to their request I always thank them for their patience (if they have been). As far as I know, it works.
Horseshoe, BSN, RN
Oh so sad and true tale from the ED. Her precious child couldn't wait a few minutes for a drink. I was told I could have somehow found a few minutes to take care of the situation rather than letting it escalate to the point that the mother was angry. The "mother" could have gotten the water for herself since as en employee, she knew where the water dispenser was.
Wow. Truth is stranger than fiction sometimes. That whole situation is unacceptable and I would have had a hard time letting that one go.
Esme12, ASN, BSN, RN
But I would be willing to bet you were a very well-behaved family member. Being scared and vulnerable doesn't give you the right to mouth off to the nurse because she didn't bring you a turkey sandwich, chips and a soda. Being scared and vulnerable doesn't give you the right to follow the nurse into another patient's room because you want another blanket for Mom and you want it now.There are limits to what being scared and vulnerable should allow you to get away with.
There are limits to what being scared and vulnerable should allow you to get away with.
I really get it guys......I too have had times when a patients family have gone WAY past the limits of advocate for their loved one to being an intrusive, pushy, foul, rude PITA! and YES...they need to be put into their places. But sometimes we need to be reminded that families are as frustrated as we are.........they get pushed aside with sighs and rolled eyes and a let me get your nurse for you or.....I'll be right there as soon as I can.......and no one comes........for hours.
Although there are problematic families who need to be dealt with........it has been my experience that there is a pretty large portion of family complaints and rudeness based in being blown off at some point. Everyone is overworked, underpaid and understaffed. We ARE being asked to do more with less.....and no it is not fair but it is a reality. To be honest.....families don't give a cat's patootie about how busy you are.... they are far too narcississtic to care which I believe is a new problem in gereral in this electronic depersonalized age, but that's another discussion all together......there are very few people that have posession of real manners and respect of another personal space and utilize please, thank you, or excuse me and feel they have the right to do what you please.
I also believe that when a nurse is drowning with her/his assignment and a critical patient transfer; I believe the manager or supervisor needs to step in to navigate the chaos and allow the nurse who is drowning to catch up but to also evaluate if she needs to modify or hone her time management skills in the future. I also believe that the nurses co-workers should jump in and help out and oversee and care for the other patients when one nurse get bogged down with an unstable patient unitl the dust clears so the patients don't feel abandoned. It has also been my experience that when there is an emergency....... call bells start going off, families become more demanding. Kind of like the change of shift phenomenon........they are afraid of being forgotten or ignored and sometimes I think petty jealousness that someone is getting attention before them. I too, have had a family member in and ED walk into the room while we were coding a child. I think they were nosey and wanted to see what was going on, they felt they were entitled and deserved that cup of tea they had been waiting for, and they were P.O.ed they were going to have to wait AGAIN (whatever). I was not polite and ordered them out of the room.
That being said......Most people just want to be heard they want to know someone listened and HEARD what they had to say. So the next time you are ready to bite the head of a family member stop and place yourself in their position before speaking. If you can kind of see where they are comming from take a deep breath and smile and try to rectify the problem. If you still want to knock their block off call a family meeting and set limitations and guidelines for the family to follow or let your manager/supervisor know maybe they can help. I like to engage the family in assisiting with care or getting their own ice and blankets it makes them feel like they are doing something. I also like to set up a specific time everyday for family members to get together for the Q&A for the day's activities, tests or results and call it a day. I say all this from a place of love and caring...... not reprimand. Just a little food for thought to maybe give a different prespective to better deal with the next PITA.
Of course I was a well behaved family member and would NEVER walk into another patients room for any reason.......but I became a real B**** when I came in to see my Dad face down in his breakfast, hypoglycemic with last nights dinner in bed with him and waiting a full 10 min after putting the call bell on the emergency bathroom light on attending to my father watching people rush by my father's room to shout in "I'll get his nurse" when I finally called my own rapid response (just dial 0 it's very effective). There is bad staff and crummy care everywhere and chances are every family member has run into one or two which can make someone pretty reactive to all situations. What people have also learned it IS the squeeky wheel who gets the oil.......and the louder the squeek.....the quicker the oil comes. Sad but true.
I also believe that this new electronic age has ushered in a new breed of rudeness and ill mannered breed of people. Polite society rules and manners are no longer preserved. People view every open space their own personal space. When you air you dirty laundry on the phone in line at the grocery store at thre top of your lungs for all to hear, how could one have a sense of personal space and respect for others? or a respect for other's privacy. So everything has become fair game. Years ago I would have never had to deal with a patients family entering another patients room because they wanted something. It just didn't happen. Today is different. To deal with families is a moment by moment day to day endeavour. BUt set limits.....stay true to your word go back whenyou say you will go back. Be honest and when you a really in an emergency tel them the must immediately return to their room and remain there until you are free that you are involved in an emergency and cannot be interupted. Turn your back and continue on.......I hope this helped somewhat. As caregivers we must see both sides of every story and do the best we can for all involved.
Have any of you ever had a family member in the hospital? Especially before you were a healthcare professional. These people are scared and their only priority is their family member. To you, getting grandma's water is pretty far down on your list, but to the granddaughter all they see is grandma being uncomfortable and they want to fix it. They don't know the way the hospital works. I know when you are in the middle of something HUGE the last thing you need is a family member asking you questions, but please remember how vulnerable these people feel. You are the only one they feel they can go to, look at that as an honor rather than a burden.
Umm, we already know that. This thread is about trying to deal with you and the 7 other pt's families JUST LIKE YOU who also have the same feelings, wants and needs. How we VERY human nurses cope.
This forum is about being able to express stuff from the OTHER side of the equation.
It's about how feeling, thinking, highly educated and empathetic people called NURSES deal with "you on the other side". It's about how WE deal with emotional bombardment day after day after day.
So, please. STOP with the lecturing, comments on our personal lack; and INSENSITIVITY. We ALREADY know how you feel.
This is about how WE feel, and how we deal.
Sometimes family members just suck.
Have been a family member of hospitalized pt and hope the nurses did not think of me that way. Actually, don't think any nurse should think of family members that way.
Ruby Vee, BSN
have been a family member of hospitalized pt and hope the nurses did not think of me that way. actually, don't think any nurse should think of family members that way.
as stated so much better above, this thread isn't about you. it's about nurses and how we deal with insensitive, rude, intrusive, demanding and entitled family members. if you don't think any nurse should think of family members that way, you're either laboring under the delusion that nurses really are "angels in comfortable shoes" or are one of the aforementioned family members that we need to vent about.
nurses are human. we've all been patients and family members of patients, so we know how that feels. but right now, we're venting about how we feel as nurses.
Haven't read through all pages of replies yet. But this is always a big issue.
At first greeting with patients in the morning, I always try to speak of the general POC, any pending concerns with it, what my plan is for adressing these issues within my 12 hours, (what docs I'm going to call, what labs may or may not be an appropriate request, what pain management needs to be reassessed, etc). Then I make sure that the patient tells me their concerns...even if it is only that they hate milk and will vomit if they see it on their tray today...and I let them see me write my little list on my paper. I make sure I tell the patient what I am going to do to adress those things. It usually doesn't take more than 5 minutes in the med-surg world. Every time I do a walking round I update the patient on what is happening.
Now, when the family comes in...I definitely make sure we set up ONE representative and explain it well and logically about how information can be corrupted the more we repeat it. Then there's always the HIPPA crutch. I provide paper and pencil for the family member if necessary for them to list specific questions. Unless there is something acute with another patient, needed right now, I will at least tell the member the above. Then if I am truly busy RIGHT NOW, I will tell them please wait for within the hour I would be happy to speak with them about the POC and what their loved one AND I have planned for their care. I will even provide numbers of docs IF the doc has been negligently unresponsive to the family member (and staff) and their questions re: things which are illegal for me to adress until the physician adresses them first. This usually quells the family member until we can speak. Now, of course, there are the patients who can not be discoursed with because they are not in shape to do so.....so when the family member speaks to me, I briefly outline what exactly I am working on for the patient within my 12 hours....then the schpeel about one representative....and only if I am truly busy RIGHT NOW...do I put them off until later. This always seems to instill a lot of trust and helps the family see I am on the ball for their loved one. If all else fails....have the charge nurse , CNL, or manager (worst case) connect with the family asap. That's just how I do it. Despite all it's hassles, I love bedside nursing.
addendum to above:
Yes, sometimes when they are just b&*%$ing about water or manicures....I always have this in my hat..." I want you to know that your mom, sister, etc..is the most stable and healthy patient I have the privilidge of caring for today! If I could, I would spend all day chatting with him/her because they are so funny, delightful, have a dark sense of humor like me....whatever...but unfortunately some of my other charges are experiencing much worse at this time. So if we don't get back with the water, manicure, hairdresser right away; please know that I am just trying to prioritize MEDICAL needs...and I will never forget your grandma, uncle, dad.....etc. I will be in to discuss all of your concerns as soon as possible......
"Be patient, you're going to have to wait." Sometimes, you have to be firm and take control of the situation.
canesdukegirl, BSN, RN
Family attitudes and understanding have rapidly fallen since patients became "customers". The lack of respect to those in the medical field has declined and will continue to do so as long as this continues. Family as well as patient behaviors have hit an all time low over the past decade and there will be those that you just cannot appease; reward good behavior and apologize when you can't meet their unreasonable standards for water, ice or some other nonurgent but "life threatening" need
Sometimes I think families expect drive thru medicine. "Welcome to McHospital, may I take your order?"
You know, another thing that I did when I was working on the floor a few years ago was to tell the families that they can do x,y and z for their loved one. I set absolute boundaries on what they could and could not do, and provided a few minutes of teaching. This way, the family member feels that they are participating in the care of their loved one (many of them had to learn anyway because the pt was being discharged into the care of the family member). It drives some family members crazy to just sit and do nothing. So I showed them where the ice/water machine was, showed them where the linens were and asked them to please keep track of how much water they were giving my pt. You would not believe how much this helped. I only did this with stable pts who were due to be d/c'd soon.
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