Unappreciated by the patient's family

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Hi! I don't know if this is the right forum for my topic so please feel free to move it as the mods deemed fit.

I'm an RN-BSN with around less than 2 years experience as a med-surg nurse. I currently work in a critical care unit with a slightly different set-up than most CCU units. I get 5-6 patients in a shift. When I say that out loud, a lot of nurses (from other hospitals) wonder how does that work? Well, I get 2 critical care patients, 2-3 med surg/tele patients and couple of rehab patients so if one practicies prioritization and time management, you can actually get things done within your shift. Like, give meds to the rehab patients and not worry since PT/OT will be working with the patients all shift long.

Anyway, I said all that to give you guys an idea of what my work environment was like yesterday (my friday). I've been taking care of this rehab patient 3 days in a row this week. This patient (Z) has been in the facility since the start of the year. A lot of nurses have been taking care of him but I've only taken care of him this week for the first time. Even though it's my first time with Z, I see how other nurses take care of him. I don't say anything about it but it's always bothered me that they leave this post-CVA patient lying in a fetal position. He's 60+ years old, alert, oriented but non-verbal, contracted in all extremities and all the other nurses leave him in a fetal position.

So when I had him this week, I stretched out his legs a bit because in the back of my mind, this guy will go home someday and I don't want him to go home looking like this. PT/OT doesn't work that much with him except that OT puts a hand splint on his right arm. Anyway, the thing is the son yelled at me so loud that every one in the nursing station heard him yelling at me even the other patients' and their families heard his yelling at me. He yelled that I'm not gentle with his dad and that I feed him too much (of the pureed diet). I politely replied that his dad his contracted and I wanted to stretch out his legs but he wouldn't hear anything of it. He started threatening me about a lawsuit and my license. When it boiled down to that, I just remained quiet. This son was bigger than me and angry so I didn't want to aggravate things further. As for the feeding, a part of me wanted to tell the son that I'm actually one of the very few nurses who take time out to feed and encourage his dad to eat something. Most nurses in the unit would brush that off to the CNAs and since the CNAs are busy, they just only offer 2 spoons and report that the patient doesn't want to eat. I take time out from my other patients to stand their and feed his dad and coax him to finish at least half of the tray. I coax his dad to at least drink all the thickened juice.

Then the wife complained that for the 2nd day in a row, I supposedly left the tube feeding bump beeping and that I did nothing about it. Well, for the last 2 days of my work week, I had harrowing time since considering my experience compared to the other nurses in that unit, I bore the brunt of the critical care patients. That means, I got the severely ill ones.

Anyway, what I'm saying is that --- I was just hurt that the family didn't appreciate my good intentions and efforts about their dad. I do one good thing compared to the other nurses and I get yelled at. I know I'm supposed to grow thicker skin but sometimes, being unappreciated hurts especially when I, for one, believe in my profession. I was just wondering if other nurses have experienced being unappreciated and if so, how do you deal with it?

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Nurses are basicaly unappreciated ACROSS THE BOARD of patient care. Appreciation is the least of our worries.

This family is angry.. angry that their loved one is in this situation.. and angry because they know he most likely will not improve. They are also highly aware of the marginal care he is receiving.

You are a handy-dandy scapegoat.

Do not allow family to yell and intimidate you.. call security or supervision .. whichever is appropriate in your facility.

P.S. If the patient is contracted .. "stretching out the legs" is not gonna happen.

Leave that to OT/PT to decide the range of motion.

Best of luck.. my sensitive, kind-hearted colleague.

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Specializes in Trauma Surgical ICU.

Thank you's are rare in a lot of settings. Families tend to be possessive over their family member's and can lash out when things are done too differently than what they are used to. Education is key. If the pt is already contracted, little can be done to correct this and stretching his legs out might be painful for him. I have had a few nursing home pts that were like that and every move was very painful for them. Also, a little off topic, but how much tube feed his he getting? He may not be hungry because he is getting the calories he needs from the TF.

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Specializes in Hospice.

Most families don't appreciate what we do - but in reality that is because they don't know what we do. They don't understand what nursing entails or why juggling several patients can be challenging at best and an absolute nightmare at worst.

In your case, they may be concerned about pain when trying to straighten his legs and discomfort if he eats too much (just guessing). It may also be stress or believing that he is dying and should simply be allowed to be comfortable and otherwise left alone. Yelling at you was inappropriate and should not have to be tolerated. You may want to talk with your supervisor/charge nurse about how to handle that kind of situation (my inclination would be to simply walk out of the room, but make sure you won't get in trouble before trying that).

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Specializes in Trauma Surgical ICU.

Oh and those numbers for a CCU is outrageous..I couldn't imagine doing that many plus 2 critical pts.

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He gets 75cc/hr of diabeti-ource. I just thought I'd feed him since he hasn't gained weight since he got to our unit. The reason why I wanted to "stretched it out" because I had another patient who was also contracted, post-CVA but because his legs were stretched out earlier in his post-CVA episode, it wasn't in a fetal position. My grandmother who is also bedridden is exhibiting slight muscle contractures in her legs and my dad and her caregivers exercise it daily to prevent it progressing further. I don't know if that makes sense.

But yeah, this got me thinking. I do noticed one thing --- the nurses who do the work rarely get credit while the others who talk more and work less, get all the recognition. Sigh.

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(my inclination would be to simply walk out of the room, but make sure you won't get in trouble before trying that).

Yup, that's what I did. After he yelled at me, my charge nurse came to pacify him and I said that if they want to switch his dad to another nurse's care in the middle of the day, I'm fine with it. And then the wife complained that I, along with the CNAs, used dirty wet wipes on the patient so I just took the wipes and threw it in the trash and left the room. I always try to be understanding of the family's predicament but I can not stand there and wait for them to yell at me some more. So anyway, I left hoping they would leave but I had a medication that was due to give so I came in and explained that I'm giving medication but since the pt's son loudly claims that he can do my job, I politely encouraged him to give the meds and left the room. After that, I never bothered to talk to the family again. I only came in after the left to clear out the flexiseal and mind you, I'm the one of the few nurses in our unit who takes time out to completely flush a flexiseal. Ugh. I know I shouldn't dwell on it too much.

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Oh and those numbers for a CCU is outrageous..I couldn't imagine doing that many plus 2 critical pts.

That's the common response but hey, it's a for-profit facility so money matters most. I get used to it though and luckily, things get done.

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Specializes in Emergency/Cath Lab.

I gave up a long time ago about trying to make all the families happy.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I do noticed one thing --- the nurses who do the work rarely get credit while the others who talk more and work less, get all the recognition. Sigh.

A significant number of family members fall in love with personalities, not competence. You could be the most proficient and competent nurse in the world. However, some family members will gravitate toward the overly chatty nurse who might practice in a sloppy manner, take breaks every 30 minutes, and be clueless in a code situation, because his/her charismatic personality makes the family feel good about themselves.

It's not fair, but it is what it is. Some people will actually select a phony person over the real deal because the truth hurts.

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Sounds like you are doing a great job and that you are a caring nurse, I'm sorry that the patients family can't see that.

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Specializes in Med-Surg.
Anyway, what I'm saying is that --- I was just hurt that the family didn't appreciate my good intentions and efforts about their dad. I do one good thing compared to the other nurses and I get yelled at...
I'm just a 2nd semester ADN nursing student, but for what it's worth I appreciate your good intentions and efforts. :up:
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