The patient's family members

[Foxfour]

My brother was a nurse a few years before I had started nursing school. He told me numerous times that he wanted to leave the floors because of the family members. I didn't fully understand the gravity of his words until I started working the floors. A few days ago, one of many incidents, a daughter walked out of her elderly father's room ranting and raving about why her father had been laying in bed with a soiled diaper. I explained to the daughter that I was in that room approx 15 mins ago, and he did not have a soiled diaper at that time. I had just finished a bladder scan. Which resulted in the need to do a in/out cath. I changed his diaper at that point. He was aphasic due to a CVA, so he couldn't add to the conversation. If he could have, I'm sure he would have told his daughter what good care he was receiving from me. I'm not trying to say I'm wonderful, but I know that I'm not lazy. "Oh well, let him lay in his own feces. I don't care." That's ridiculious. I would never williingly allow that. I'm sick of those family members who assume the worst. The statistics for me are approx one "ranting and raving" incident/shift. Calgon, take me away!!!

[TazziRN, RN]

I once had a sz pt brought in by ambulance.....young adult woman who had had her first sz just a couple of months earlier, cause not found yet. Because of the short ETA the medic didn't have a chance to start an IV, so the first thing I was set up to do was start a line. Hubby got furious with me and started yelling that because his wife had been on state assistance with the first sz (before they were married), we had not done what we should have, there was no CT, we didn't care, etc. I kept trying to diffuse the situation and told him that I would call for her old chart and look up what was done. I finally told him, "Sir, I understand you feel you had a bad experience last time, but I wasn't here that day. Please give me a chance."

Turns out she did get the workup she needed on that first visit, it was done before he had actually arrived in the ER. A couple of hours later I sent the pt home. A few hours after that while I was in another part of the hospital, I was paged to return to the ER. The husband was standing there with a bouquet of flowers for me and a heartfelt apology. As much as I disliked how he was acting, I understood his fear and it was just a matter of getting him to listen to me. No, of course we do not need to put up with abuse, but most of the time we are not dealing with abusive relatives. We are dealing with scared and frustrated ones.

[fbmom]

My personal favorites are the family member who arrives on Saturday morning and DEMANDS to speak to the attending because NOW they want to know what is going on with mom/dad/sister/brother. Usually they are not the health care rep and are not happy to learn that their attending is not in house!!! They also refuse to comprehend that EVERY department in the hospital is NOT working full steam on weekends, why does the pt have to wait until Monday for the CT scan, cardiac cath, echo etc???

I realize people work and can't get in when the attending is there.But I DO NOT keep track of every attending's schedule so I sweetly offer the attendings office number and the hours they can call there.

[cardsRN]

while i agree that people in times of stress deserve a little slack- we all snap sometimes or have a bad day, i must differentiate that from pt family members who are habitually abusive/obstructive to staff and have boundary issues.

once i took care of a pt whose family members were so terrible to deal with that they literally ran through all of our staff in a week. they made a new RN cry every day. there was no getting through to these ppl. at one point the wife threw herself across the pt's body hysterically screaming how i was trying to kill him- as i moved in to suction oral secretions. and this was just business as usual with them. there were daily screaming matches, insults to staff, physical contact- slapping our hands away... the only thing that ended it was that the poor man (who had been very pleasant) passed away. management does nothing to defend floor staff in these situations.

repeated exposure to this kind of behavior makes our jobs unbearable, it is not reasonable to expect us to just grin and bear it

imho.

[maddynrs]

I have had family members who were the kindest people and only wanted to do what was best for the pt. They were great with the staff, obeyed all ICU policies concerning the visitations and helped with the pt care when I was out of the room with the other pt. ... Those were the good days.

My worst day with a patient family member was a drug seeking pt who's family member only wanted her to quit whining. At every turn he was asking for her pain medication and once even questioned that I gave the medication when I gave it right in front of his face and still had the empty syringe in one hand and the iv line in the other. He ARGUED that I didn't give the medication. We were the only two people in the room besides the patient and I had no witnesses but him. I politely told him that I just gave the medication and any further administration would be a detriment to the pt's health. He proceeded to become angry with me as I told him I needed him to leave the room if he would continue to interfere with his family member's care. I was of course, subsequently reported to my supervisor for not bowing to the almighty righteousness of the family member. Fortunately, my supervisor is a fair and good boss so he backed me up.

The point is, we have no real control over what is said and done by the family member where the pt is concerned. Yes, we hold the care of the pt literally in our hands, and yes we have the right to ask the family to give us some privacy, but when it all boils down to it, they have more rights because they are family. I will concede that family should be allowed to be with the pt for benefit of care and healing. I think it progresses the pt's recovery to have a familiar loving face involved in the care. But not when the family member will try to interfere with good care and try to supercede the duties and authority of the primary nurse. We have set visiting hours for a reason. Sometimes we need a break too.

m.

[General E. Speaking, RN, RN]

*sigh* Unfortunately, some days I would totally support a "No Family Day".

[hjwdancer]

My personal favorites:

1. The patient is awful to his wife who stays at his bedside. He literally wants her hunted down if she leaves the room for over 5 minutes (even if she is getting lunch, etc). He wants her awakened from a deep sleep if he is awake, simply to cover his feet with a blanket. He will use his call light nonstop all day long, even to have us come wake his wife. We have explained that the nurses have other patients, that if nothing is wrong besides some errent request to move another object to his sense of feng shui then we will be unable to determine when he needs something or has a true emergency.

2. The family tell us what we should be doing and the doctors orders are nothing like that. Doctor says wound dressings with silver sulf and the family insists on bringing bottles of honey or something else to use to dress the wound instead. Or family brings confused patients meds from home and leaves them in the room with out telling anyone to be helpful...

3. Family telling the patient... You're in pain aren't you... See, she's telling me she's in pain by moving her toes (when the patient is perfectly able to communicate their wants and needs).

4. Wife constantly telling anyone who will listen about how we're not doing our jobs... She has to change his sheets, clean the room, get his coffee, bathe him and take him for walks for PT but if any of us tries to beat her to it then we don't know how to do it right and we should just let her do it. Also, she constantly told the patient just how sick he was and how he needed her to get better...

Just venting... These situations were all handled with education and understanding. It's just nice to know I can vent.

[Rnover805]

Family members are one of the reasons I,m leaving hospital nursing. I work very hard and I'm very understanding to the fact that they are worried and afraid, but it can be so overwhelming, and can make it difficult to take care of that patient and the others.

[LeahJet, ASN, RN]

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

Amen.

[chadash]

When my mom was in last, I did most of her care. They would always check in and run for linen for me and such. I was really pleased with their help and attitude. I was careful to mention them by name to there supervisor as great NAs.

One night, though, I went home for the night, she seemed to be doing well (I spoke to the night nurse to make her aware mom was still dizzy from the meds an needed some help walking to the commode). Poor girl got a case of the runs, and apparently there was different staff that night. Figures. In the morning, what a mess! Mom had called for help, but they just didn't come, left her on the commode for two hours, didnt clean her up when she was done. It is amazing to me how different one shift can be from the other! Her linen was soiled, the floor had stool on it. We just cleaned up, and I stayed the next night.

[LPN1974, LPN]

One solution I have is to start writing the time and date on the diaper when it was changed. We do it on dressings of wounds...why not the diaper?

Then when a family member wants to come in and start some yelling, they won't be able to.....because there it would be....the time and date of 15 minutes ago where he had been changed and cleaned.

[banditrn]

Ah, ya just gotta love the families!:rotfl:

One time, a visitor called me in and asked me if we kept 'butter' on the unit. I told him, no, we had margarine, and why did he want to know? He tells me "Well, if you'd have had butter, I'd have had you bring me some toast!"

I told him, nicely, that if we would've had butter, I'd have shown him the toaster - and he could make his OWN toast.

I always generally got good ratings from patients and family, and I've always done what I could to help - but I wasn't there to be a servant.

[babiesX2]

One solution I have is to start writing the time and date on the diaper when it was changed. We do it on dressings of wounds...why not the diaper?

Then when a family member wants to come in and start some yelling, they won't be able to.....because there it would be....the time and date of 15 minutes ago where he had been changed and cleaned.

That is such a good idea. It makes perfect sense. Thanks for the tip!