The patient's family members

Crocuta, RN · May 14, 2006

Family members of hospital patients are going through their own issues along with the pt. They may be worried, scared, have feelings of helplessness, grieving, etc. Sometimes they don't know how to process these feelings and the stress results in them taking it out on the closest available person who unfortunately is us. I try not to take it personally, and try to assume that they're good people in a tough situation.

When I have a family member say something like you related, I try to thank them for pointing out their loved one's need and tell them how much we appreciate having family members around to participate in the care. Make them feel good about being there - so many patients have no one but the staff to look out for them. Also, I try and make a mental note to find some time to talk to the family member about how the hospitalization is affecting them personally. Sometimes you get an opportunity to do a little family nursing, and I find that very satisfying.

TazziRN, RN · May 14, 2006

It's hard not to get defensive when someone says things like that, but family members are going through their own stressors, including loss of control regarding their ill loved one.

Beary-nice · May 14, 2006

I am glad to see these responses and agree with the same. I also see family as part of the challenge of taking care of the patient. They are just another part of the whole and I personally like the challenge.

lindarn · May 14, 2006

It's hard not to get defensive when someone says things like that, but family members are going through their own stressors, including loss of control regarding their ill loved one.

I would be more sympathetic to that explanantion if it weren't for the fact that, regardless who is at the patient's bedside, and who is responsible for whatever they are angry about, NURSING IS THE ONLY ONE WHO IS THE RECIPIENT OF THESE out- of- control VISITOR TEMPER TANTRUMS. I have never seen a family member lost it to a physician, radiology tech, lab tech, etc.

If the patient's tray isn't just what they wanted, WE are the recipient of their foul mouthed anger, certainly not the dietician, etc, and ad nauseum. Enough is enough. There is no good reason for nursing to be the 'whipping boy" for whatever visitors and family are angry about. The visitors can be directed to the nurse managers office, or administration, and they can rant and rave till their heart's content. I am sorry if I sound so unsympathetic, but I have had more than my share of these familiy members over 30 years, and I am no longer in bedside nursing, in part due to to abuse by family members.

It has been my experience, that the most out- of- control family members are the ones who have mega-guilty consciences/feelings, about how they have treated their loved ones. And other inter-family issues. This, by the way, is not my fault, is it. Again, I don't feel that it is my job to deal with/solve these issues for them. Furthemore, they just do not pay me enough to put up with it.

Lindarn, RN, BSN, CCRN

Spokane, Washington

TazziRN, RN · May 14, 2006

You are right, many family members are out of control out of guilt, but that still comes under the heading of personal stressors. And nursing is always the one who gets the brunt of it. Doctors can do no wrong, and the other ancillary services (to the family) do what we tell them. I've seen x-ray techs come in to do a portable film and sit the pt up when it was definitely contraindicated to do so, and the nurses get blamed by the family when something happens. Do I think there's nothing wrong with that? No, of course not. But most of the time I know it's not me they're lashing out at.

Runningnurse · May 14, 2006

In my experience, family members can either be a nurse's biggest help or biggest hindrance.

I had one patient who would continually soil the bed...10-12 times per shift. The urges were simply too quick for her to have time to get on a bedpan or bedside commode. Her family cleaned her up -every single time-. They would only tell me after the fact, and sometimes not even then. I'd only know because I'd walk past and the door would be closed (it was otherwise left open). I told them numerous times that while we appreciated the help, they should not feel at all awkward about asking me or the NA for help. The lady felt bad asking and being "a bother" and I told her again and again that she was no bother at all, that I was more than happy to help her. I think they eventually got it, but...still never called me. I felt a little guilty, honestly, like I was falling down on the job. But they were so sweet and kind and honestly just wanted to do this for the lady so...of course I let them! They were doing phenomenal skin care, etc. The whole nine yards. On a day with 4 other very busy patients, they about saved my sanity!

On the other hand, there are the families who just make you want to have a no-visitors policy all the time. Yes, they are going through a really tough time. I get that. But I also think there is a line that gets crossed sometimes...just because you're under a lot of stress and grief does not give you the right to verbally abuse someone who is only there to help. One family on our floor "fired" their nurse for the day because she couldn't give out information about their family member who was down in the OR. She didn't -have- any information but they didn't believe her and asked for a different nurse. That was a bit out of line, because before they "fired" her they called her into the room and berated her. She had done -nothing- wrong...I'd been down by that room all day and she's one of our best nurses.

johnson0424 · May 14, 2006

In my experience, family members can either be a nurse's biggest help or biggest hindrance.
I had one patient who would continually soil the bed...10-12 times per shift. The urges were simply too quick for her to have time to get on a bedpan or bedside commode. Her family cleaned her up -every single time-. They would only tell me after the fact, and sometimes not even then. I'd only know because I'd walk past and the door would be closed (it was otherwise left open). I told them numerous times that while we appreciated the help, they should not feel at all awkward about asking me or the NA for help. The lady felt bad asking and being "a bother" and I told her again and again that she was no bother at all, that I was more than happy to help her. I think they eventually got it, but...still never called me. I felt a little guilty, honestly, like I was falling down on the job. But they were so sweet and kind and honestly just wanted to do this for the lady so...of course I let them! They were doing phenomenal skin care, etc. The whole nine yards. On a day with 4 other very busy patients, they about saved my sanity!
On the other hand, there are the families who just make you want to have a no-visitors policy all the time. Yes, they are going through a really tough time. I get that. But I also think there is a line that gets crossed sometimes...just because you're under a lot of stress and grief does not give you the right to verbally abuse someone who is only there to help. One family on our floor "fired" their nurse for the day because she couldn't give out information about their family member who was down in the OR. She didn't -have- any information but they didn't believe her and asked for a different nurse. That was a bit out of line, because before they "fired" her they called her into the room and berated her. She had done -nothing- wrong...I'd been down by that room all day and she's one of our best nurses.

when do you say enough is enough? when do you draw the line between them just Picking on you and the line of you dont have to take the abuse from them? anyone have a clear distinction of this because i see people that take way more than their share.

Runningnurse · May 14, 2006

I draw the line if they become abusive towards me personally.

If they're insulting me as a person ie "You stupid ^$(@#!, why don't you just shut up?" or threatening me, I'll ask for a change. If they're angry because they had to wait forever in the ER, or because they don't think the MD is paying them enough attention, I'll call our patient-visitor relations folks or call the MD and explain the situation.

It is a very fine line, but I think nurses have a good sense of when something is "off". Sure we all take more than our share of crap if we can stand it in order to give the patient good care, but I'm not there to be abused or threatened. The moment that happens, some kind of action gets taken. Whether it's changing assignments or not going into that room alone, we do what needs to be done.

mshultz · May 15, 2006

I had one patient who would continually soil the bed...10-12 times per shift. The urges were simply too quick for her to have time to get on a bedpan or bedside commode. Her family cleaned her up -every single time-. They would only tell me after the fact, and sometimes not even then. I'd only know because I'd walk past and the door would be closed (it was otherwise left open). I told them numerous times that while we appreciated the help, they should not feel at all awkward about asking me or the NA for help. The lady felt bad asking and being "a bother" and I told her again and again that she was no bother at all, that I was more than happy to help her. I think they eventually got it, but...still never called me. I felt a little guilty, honestly, like I was falling down on the job. But they were so sweet and kind and honestly just wanted to do this for the lady so...of course I let them! They were doing phenomenal skin care, etc. The whole nine yards. On a day with 4 other very busy patients, they about saved my sanity!

This should be the standard for deciding whether to allow family members to stay with the patient past visiting hours. Family members providing intimate personal care and who are actually helping the staff should be allowed to stay. The others should be sent home when visiting hours are over.

I am not a heathcare worker, but I would expect my visitors to behave themselves. My visitors and I were all well-behaved when I was in the Critical Care Unit, by the way.

OliveVinesRN · May 15, 2006

Family members of hospital patients are going through their own issues along with the pt. They may be worried, scared, have feelings of helplessness, grieving, etc. Sometimes they don't know how to process these feelings and the stress results in them taking it out on the closest available person who unfortunately is us. I try not to take it personally, and try to assume that they're good people in a tough situation.
When I have a family member say something like you related, I try to thank them for pointing out their loved one's need and tell them how much we appreciate having family members around to participate in the care. Make them feel good about being there - so many patients have no one but the staff to look out for them. Also, I try and make a mental note to find some time to talk to the family member about how the hospitalization is affecting them personally. Sometimes you get an opportunity to do a little family nursing, and I find that very satisfying.

As if we aren't altruistic enough, now we have to deal with very rude, aggressive behavior from the patient's family member just because they cannot deal with their stress like an adult?

Oh, I'm sorry if I sound harsh, but I do not agree with that. That is the one of the main reasons I have abandoned bedside nursing as well. These visitors and family members are out of control. Yeah, I know their stressed, hurt, pissed, or whatever they may be feeling. But, that does not mean they can't address others in the way they would want to be addressed. There is no excuse for people acting like idiots toward nurses simply because they have problems coping.

I've have had ill family members as well. But none of my family member, nor myself, have ever disrespected a staff member, never! It will continue to go on until nursing managers and hospital administrators stop catering to these belligerent people and fully voice what they expect of visitors when in the hospital. People need to know that that kind of behavior and mistreatment of staff will not be tolerated. It creates a hostile work envirnonment and it's wrong. It will go on as long as people sit down and accept it. We nurses must start standing up and demanding respect. And if we don't get it, then I say we can always find work in a facility that will respect us elsewhere.

ShayRN · May 15, 2006

At times, the family members are getting the wrong information from the patient. We had a son come in the other night ranting and raving at the nurse, who came and got me. (Supervisor on the evening shift.) I walked in and he was going on and on about his mother not getting her medicine and that the nurse wanted to roll his mother on her side and he wanted to see it IN THE DOCTORS WRITING that his mother was allowed to be turned. So after I said to him, first of all, I understand your frazzled and upset, so lets try to calm down and work through this together, OK? That stopped the ranting. When I asked him what medicine it was that his mother didn't have, it was the IV with K in it. I said, sir, there are 3 pharmacists for over 400 patients, surely you understand that the cardiac and pain medicines are the priority. He said, oh yes , well I do get that. Then the mother spoke up and said, I haven't gotten my pain medicine in over 6 hours, so I had the nurse bring in the MAR, she had just gotten it 30 minutes before...mom just was a little out of it from the morphine. Finally I explained to him that turning a patient is basic nursing care, not a medical issue and it was done so that mom didn't get a bed sore, surely he didn't want that! Then he started ranting about wanting to see the chart, he was the POA and he had every right. I said, sir, I am trying to work with you here and your just being ignorant. THAT stopped him cold. As it turned out his father had Alzheimers and mom was the primary care giver. He had just moved home from out of state to take care of them both and was a bit overwhelmed. By the end of his visit, he was out at the desk shaking my hand and apoligizing for his earlier behavior. Gotta admit, that makes it worth it!