I work in a pediatric ER and I am so sick of all the crazy parents out there. Just the other day I had this little 26 day old come in with a known seizure disorder on phenobarb. Baby was d/c'd from NICU the day before and had a seizure at home... so what do the parents do? Rush the kid to the ER for a "STAT phenobarb level and want to immediatly 'give her a po bolus' of phenobarb." UGH, had to explain to them that giving her a "po bolus" will make her stop breathing! So, we draw the phenobarb level, they won't let us draw anything else because they state the baby is anemic and that drawing another 10th of a teaspoon of blood will push her over the edge (even though we can't draw a CBC to see if she really IS anemic).
So we draw the Level and are waiting for results now, every 5 minutes they come out and ask if the results are back, meanwhile they have "bolused" the kid without our concent--although not as much as they would have if we hand't said something, because they know better since the dad's a pharmacist and the mom is supposedly medically inclined somehow. So we're waiting for the level and the kid has a seizure in the ER, great, just what we need. Baby's pink so we're setting up a little O2 and suction and the sat probe falls off the kids toe, mom freaks, throws her portable O2 tank on the bed dad starts yelling "she's getting dusky" And meanwhile we put the probe back on, the kid's fine. I keep saying, she's fine, she's pink... mom's yelling "I'm losing my child!" UGH, drama.
So then MD orders ativan, which I was soo happy about so that we can prevent this kid from having another seizure and having the parents freak again (asked them if they'd witnessed seizures before, they said yes "at least 6"... but only in the NICU). I go in to push the ativan and they ask, once again, if the level's back, I state that I will check the minute I'm done pushing the med. But no, they won't let me touch the baby until I check. I had had enough at this point, I kinda blow out of the room, I know I shouldn't have, sit down at the computer and nope, not back yet. Mom starts crying at this point, telling me to not be upset. I apologize, push the ativan and leave.
Another nurse does most of the care after this point, thank goodness, because I wasn't sure if I couldn't take much more of these poeple. I try to educate that the kid will have seizures, she has a seizure disorder, but parents are too freaked to listen.
(There were at least 4 other very demanding families there that night, the MD almost lost it too.)
MAN, this was probably the most unwilling, demanding, dramatic family I've ever dealt with. I barely kept it together. I'm kinda ashamed with myself for losing it like I did. But, even the Doctor went into the room and told the parents we were trying to care for their child, but they were making it difficult. How do you get over these families? I just keep my finger's crossed and hope that these people don't come back when I'm on (isn't that horrible). Anyhow, just needed to vent. thanks.
I can totally understand where you are coming from as well as the parents concern. Rest assured that as the parents 'know better' they will 'do better' when baby has set backs.
Since baby has a seizure disorder i'm betting you will see the regularly if not frequently for the next little while, think of it as a chance to build some trust with the parents.
I can't blame the parents for questioning things even though they were getting on staffs nerves. New parents are bombared by the media with horrifying and true stories of medical mistakes that result in deaths of small children.
That combined with little to no sleep and a sick baby would make any parent a little "nutty" :selfbonk:
If they come in again maybe suggest to the parents that they attend a support group for parents of ill children or contact their local epilepsy support group. They obviously need support and reassurance and more information.:icon_hug:
In my opinion, sounds to me like as that child grows up the parents are going to make it a nervous wreck. With this baby having a seizure disorder the parents are going to have get used to being strong and control themselves and letting the medical team that they came to for help in the first place care for the child. It is very hard taking care of a pt when the families are trying to control the situation and not let you do your job.
Wow...I feel for ya! Did anyone ever explain to the parents before they left the NICU that seizure meds do not stop seizures, they just control them.......to a point.
I have a child who has seizures and she takes Phenobarb, Dilantin & Klonopin for them and still has breakthrough seizures occasionally, but it doesn't freak me out..we just watch her closer...
I remember one time when my daughter had to be taken in by ambulance for something, her blood work was done for her monthly levels of her meds, but it was for something else though...low platelets I think..anyway she has alot of medical issues so I always have an ambulance drive us to the hospital if we go to the big city hospital for anything for safety reasons if I am alone with her ... and one of the ambulance people actually said to me "well her dilantin level is high so we don't need to worry about her seizing" when I was telling them the info on her recent labs..I just said " Oh really.....who told you that" because a person can have seizures from too much meds just as they can for not having enough....I would love to know who told this ambulance person that line of BS...lol
Anyway maybe the parents have no control over what their baby is going through so they try to control whatever they can.....and this just happened to be the one thing they had control over or thought they did......... I am sorry you had to bare the brunt of it though, that is awful.
When my daughter got sick as a baby at 3 weeks old (she's 17 now) I will never forget a nurse at the hospital in the icu......we were told my baby was going to die pretty much...and they next day I was looking in my daughters notes in her flow sheet..and a nurse actually wrote in the notes " mother appears to be under the influence of a substance".....can you imagine????? I was up all night the night before crying because I thought my baby was dying...so of course I looked like crap the next day, swollen eyes and all from crying...and the gall of knowing this yahoo thinks I am on something....gee let's do a cartwheel because my baby may die............ so
needless to say I was stunned..................
Maybe these parents are just really scared..... hopefully they will be ok after everything sinks in.........it is very overwhelming as minor as something is but it is major from their standpoint.........you just have to grin & bare it unless of course they are over the top with being nasty to the medical team .......and that isn't right either........well I hope this doesn't turn you off for the job you obviously do very well at..........
I just wanted to tell you I totally understand what you are feeling. I think some of the most stressed parents are first, parents of newborns, and second, parents of a child seizing, even with a known seizure disorder. I know it is super stressful to have your child in the ER but some parents are beyond reasoning with.
When I have parents who are freaking I try to just spend a little extra time with them during assessment, if this is possible, and allow them to vent and ask questions and give them some idea of what is going to happen. Also, giving them some opportunities to make decisions about their child's care sometimes helps. Little things like allowing the parents to give po meds, asking them which hand the child favors if we are inserting a line, anything within reason really. I also constantly remind them that we are here to help their baby and we are going to do all we can.
Sometimes none of this works and when that happens I walk outside for a few minutes and breathe and remember it's not personal. Sorry you had a crap shift. Next time you get that big hug from the 2 year old you just gave an IM to you'll remember why we do this!
I don't have any kids (yet) but I work with parents in the NICU all the time. The problem is that it is so frustrating to try and care for these babies when the parents are trying to run the show. I think that's what happened in that ER. The parents came there for help, but they only wanted things done THEIR way. The ER staff is trained to deal with seizing children and probably has a protocol that they usually follow, but when the parents are refusing treatments, it leaves the staff flustered. It's like, why are you coming in for treatment if you think you know how to handle things on your own?
There is a fine line between trying to have some control of the situation and actually interfering with the medical treatment of your child. I think that line was crossed by these parents. I mean, come on, they gave medication right there in the ER after being told not to. That is interference.
I think the original poster has every right to be frustrated, whether she has children or not.
On the ambulance, we get parents of ill patients who can be challenging, to say the least. I had a "aha" moment one day trying to deal with a parent who was being very demanding. This mother was a nurse. As I talked to her I got the impression that she was frustrated because she was a nurse and she couldn't "fix" her baby. Also, as a nurse she knew the long term prognosis for her baby and the worst case senarios- knowledge can be a frightening thing. I try to remember this (ok, sometimes it seems like I reminding myself of this every 20 seconds when I'm dealing with a particularly challenging parents). In the medical field, sometimes we deal with emergencies on a daily basis... but usually they are someone else's emergencies, not our own.
Also, I'd (usually) rather deal with demanding parents than with parents that either don't have a clue how serious things are or don't care about their child's illness or injury.
Perhaps because I'm not an RN yet I can't relate to your experience...but I am a parent. I was a young mom at 18, and when I was five months pregnant I was told my daughter had gastroschisis. Despite the research, I was still in complete and total SHOCK when she was born. I didn't see her face...I didn't hold her, smell her, kiss her...everything that I had been dreaming of for eight months. She was whisked away, and went into surgery before I had a chance to touch her. My second daughter was late...aspirated a bowel movement, stopped breathing and was in the NICU for almost a week. I can't even begin to describe how emotional I was...
After reading your post I thought back to when my oldest was in the NICU (which is when I decided to become a nurse) and I know that those nurses probably wanted to throw me out. I never left her side, and I asked a million questions about every beep, and every procedure. I also remember requesting to not have the iv in her head. I didn't even want them to change her diaper because I was afraid that they wouldn't be as gentle with her as I was. Although I understand dealing with annoying parents (there are some parents my children go to school with that I would like to shake and ask what they are thinking) but I can remember the pain and fear I felt for that month...and I was irrational...but not to be annoying or interfere with the staff, just out of the deep love for my baby.
If the man is a pharmacist he definitely knows meds.., maybe he was not being very rational and accessing all the knowledge he has, but when it is your child involved you kind of lose rationality. It's hard to explain, but being a mom of three I can understand their desperation.
When you become a parent you will not give a hoot what other people think. I've got three children and I can see why these parents would be worried.
See, I'm babbling and not even being very rational right now. My children are my reason for living. I would cut my own heart out of my chest and give it to them.
At the same time it doesn't make your job any easier and from that aspect and I understand your frustration.
Also, I'd (usually) rather deal with demanding parents than with parents that either don't have a clue how serious things are or don't care about their child's illness or injury.
I couldn't agree with this statement more. Just recently we were preparing to intubate a very sick 2 year old and the mom was sitting in the corner talking on her cell phone about where she wanted to go that weekend.
My oldest daughter has been very ill in the past w/ JRA. So, I understand the worried parent point of view. I also can relate to being in the medical profession and knowing too much, but not enough (I am in OB, but not a Peds person). That being said, I also can relate to the OP. Giving your child medicine right there in the ER when you were told not to is WAY over the top. I get frustrated w/ crazy parents of our labouring women and their SO's who have all sorts of "rights" they think, to boss the staff and cause all sorts of chaos. I think we as healthcare professionals need to start commanding a little respect. We do a very important service to society, yet many people feel like they can treat us as if we are subhuman and completely subserviant to their every whim. Most patients and families are not like this, but a signifigant proportion are. They seem to feel they have a "right" to be angry and control everything when we haven't done anything wrong or indeed before we do anything at all. I had a woman several years ago who told me to "go out and chart at the desk." she wanted to see the pt's contractions on the computer screen. I didn't leave the room, but I still can't believe the gall of this woman who thought she could talk to me like this. She wanted to be in the room for the delivery, but the doc told her to leave because she was the pt's friend's mom and the pt. already had 2 other support people. Of course she flung open the door when she heard the baby cry. This exposed the pt's perineum to those out in the hall as she was still having the repair done. I guess this woman got to see what she wanted so that is what counted for her!:angryfire There are some totally ignorant people out there! I think we need a mediator to be talking to some of these "radical" patients and families who "advocate" for us as healthcare providers. The hospitals all fear litigation and complaints from these "nutjobs" so we are left open to abuse when we don't or won't cater to their bad behaviour.
I think we as healthcare professionals need to start commanding a little respect. We do a very important service to society, yet many people feel like they can treat us as if we are subhuman and completely subserviant to their every whim.
I think we need a mediator to be talking to some of these "radical" patients and families who "advocate" for us as healthcare providers.
:yeahthat:
This is absolutely what we need. When pts sign their consent for treatment, I think they also need to sign a form stating that they understand their responsibility to treat the staff respectfully and refrain from interfering with treatment. Every hospital has a "Patient Bill of Rights" hanging on the wall, and the list of responsibilities needs to be right beside it. And if this agreement is violated, they can then discuss it with the mediator.
It makes me think that something is very wrong when corporations will go to all kinds of expense with satisfaction surveys and Press Ganey and all that, but probably never even considered an idea like this.
Sorry for your God-awful night, OP. I've been chewed up and spit out by a couple of over-the-top parents myself. Keeping your cool professionalism is hard, hard, hard.
Perhaps because I'm not an RN yet I can't relate to your experience...but I am a parent. I was a young mom at 18, and when I was five months pregnant I was told my daughter had gastroschisis. Despite the research, I was still in complete and total SHOCK when she was born. I didn't see her face...I didn't hold her, smell her, kiss her...everything that I had been dreaming of for eight months. She was whisked away, and went into surgery before I had a chance to touch her. My second daughter was late...aspirated a bowel movement, stopped breathing and was in the NICU for almost a week. I can't even begin to describe how emotional I was...
After reading your post I thought back to when my oldest was in the NICU (which is when I decided to become a nurse) and I know that those nurses probably wanted to throw me out. I never left her side, and I asked a million questions about every beep, and every procedure. I also remember requesting to not have the iv in her head. I didn't even want them to change her diaper because I was afraid that they wouldn't be as gentle with her as I was. Although I understand dealing with annoying parents (there are some parents my children go to school with that I would like to shake and ask what they are thinking) but I can remember the pain and fear I felt for that month...and I was irrational...but not to be annoying or interfere with the staff, just out of the deep love for my baby.
What you're describing is normal and pretty much expected behavior. I'm happy to answer questions (even the same one several times), I encourage parents to change all the diapers they can, and we only use the head as a last resort for IVs anyways. That isn't enough to make us want to throw you out. If you started fiddling with the ventilator or the IV pump, THEN I would want to throw you out. A parent shouldn't interfere with the nurse's job. I don't know how else to explain the difference except to say that as long as you aren't stopping us from giving your baby the care he/she needs, we're pretty tolerant and empathetic.
ahsitters
44 Posts
I can totally understand where you are coming from as well as the parents concern. Rest assured that as the parents 'know better' they will 'do better' when baby has set backs.
Since baby has a seizure disorder i'm betting you will see the regularly if not frequently for the next little while, think of it as a chance to build some trust with the parents.
I can't blame the parents for questioning things even though they were getting on staffs nerves. New parents are bombared by the media with horrifying and true stories of medical mistakes that result in deaths of small children.
That combined with little to no sleep and a sick baby would make any parent a little "nutty" :selfbonk:
If they come in again maybe suggest to the parents that they attend a support group for parents of ill children or contact their local epilepsy support group. They obviously need support and reassurance and more information.:icon_hug:
Hope your next shift is much quieter,
ahsitters