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.
ever heard the saying 'a little knowledge is a dangerous thing'?
i think the fact that both parents had some medical knowledge made the situation scarier for them. it's easy to think that since they have some medical knowledge, they should understand that labs take time/the baby needs ativan/the baby will sometimes have seizures despite it's medication protocol, but you also need to remember that if they're in the medical field, they've also probably seen what happens when seizures go wrong/labs get mislaid or misdirected/mistakes happen.
in such a scary, crazy situation, they probably grabbed hold of what they did know (ie. baby will seize if phenobarb levels aren't right) and hung on for dear life. focussing on something concrete and blocking out everything else is a classic coping strategy.
now.. all that said, i totally understand how this would have been so frustrating. i'm a tooth-grinder when i'm annoyed, and i reckon if i'd been there, my pearly whites would be tiny stubs!
you can try and try to calm them and educate them and reason with them, but the sad fact is, in the face of a crisis, it sometimes it goes in one ear and out the other.
lucky that you have allnurses to spill your guts on!
just think, you've just filled your 'frustration quota' for the next few months, so if all's fair and good, you should get a few months of clear sailing before another frustration scene!
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.
Welcome to pediatrics. I've done pedi for about 14 years. I've had families that showed little or no concern to families who "freaked" at the slightest alarm. Overall, I have found that you communicate and explain procedures as often and as simply as you can. You give them control in their child's care by involving them in decisions where appropiate and stop with the judgemental opinions. Never forget they are the parents and they love their child deeply and you can throw rationality out the window when they sense problems with their kids. Practicing these behaiviors will allow them to trust your competence and your caring. I have discovered that taking just a few minutes just to talk about what the baby's history was in NICU, making sure the parents do care where I can (ie changing diapers etc..) has worked wonders to calm the anxious family. They are not difficult --- they are scared --- never forget that. There is no rationality in fear.
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.
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Well , that's your opinion, but aren't we supposed to be non judgemental & keep our personal feelings seperate? How do you know she didn't care? Maybe that was just her way of dealing with the crisis......Never ever judge a family of the patient, no matter how hard it is to not do that. She could have other kids at home, she could be caring for sick relatives at home it could be anything really.
I have a 17 yr old who has had medical problems all her life since 3 weeks old and has been admitted to the hospital oh maybe 100x or more over her lifetime..... I do not stay overnight in the hospital when my daughter goes in unless it is life & death ....so does that make me uncaring as a parent??? All the people who work in the ICU where my child goes everytime she admits knows me very very well & have since my kid was a baby.....and they tell me to go home because they know the care she requires at home...so that time "away" is to refresh & regroup as I never have time away from her except for school, they even say they will call me if anything comes up during the night.But I am there everyday all day when I can be. So everytime she goes in it's like "here we go again". So please don't be so quick to judge ...just wonder, as one of my nursing instructors has told my class before with regards to how some people may view family members actions
Just a little info you may want to put in your pocket. All of us are guilty of judging patients & their families at some point...I have even done it but I tell myself to snap out of it & stop it & remind myself of my own situation with my child and that puts me back on the right track. I have made myself promise never to judge any patients again because I am there to take care of the patient not pass judgement of what is right/wrong/good/bad. Thats what makes us all individuals... good or bad. So I wasn't trying to start anything just trying to explain that you may not know the entire situation at hand...just be more open minded...I am sure you will be an awesome nurse!
I have to agree with a previous poster, when patients receive their Patient Bill of Rights, they should also receive and SIGN and UNDERSTAND a Patient Bill of RESPONSIBILITY! The responsibility should spell out in plain English that the patient and the patient family will be held personally responsible to treat the staff with respect, not to abuse the staff in any way.
I work in Peds, I get unreal parents all the time, I had a very difficult set of parents (and grandparents, aunts, uncles, cousins, etc) with this one very sick baby yesterday, it took all I had to deal with them. But as I told them, I was here for the baby, if they would allow me to, I would help their baby. One grandmother is a nurse, the other works for a Dr. office, they were barking orders, ignoring the admitting Dr. orders. Arrgh! All of this was several hours after the Dr. called for the admission when the parents finally showed up with the baby.
Sometimes you have to wonder about parents. But I'm getting off topic.
I still believe that patients (parents in Peds) should have some sort of responsibility they need to be held accountable to.
I hate to be argumentative, but I don't think parents bad behavior is always about fear. Some people behave badly in life regardless of the circumstances. One of my preceptors when I first started said most of them were just scared, but some of them were difficult before they had a baby and will be difficult afterwards too. In my experience parents will behave as well as they are expected to behave. I've seen mothers litterally throwing themselves on the floor in a fit calm right down when it was explained security would be coming to escort them out if they couldn't control themselves.
I have a 17 yr old who has had medical problems all her life since 3 weeks old and has been admitted to the hospital oh maybe 100x or more over her lifetime..... I do not stay overnight in the hospital when my daughter goes in unless it is life & death ....so does that make me uncaring as a parent???
Good point to remember- we don't know all the circumstances! No, this doesn't make you an uncaring parent... in fact, I think this makes you a great parent... you take care of yourself as well as your daughter. You mentioned that you know your daughter is being taken care of at school or in the hospital. That is a key point. You've temporarily transferred responsibility of care.
When I posted my comment about rather dealing with parents who are challenging than parents who don't care, I guess I should have more more clear, and for that I apologize. Unfortunately, I have encountered parents who don't care or don't understand, plain and simple. It's not a judgement, it's an observation. When someone tells me that they "didn't have time" or "forgot" to pick up their childs medication to manage a chronic condition, so I'm taking care of a child who is having complications from this condition. Or they didn't follow up as directed when they are given specific things to watch for and they admit they noticed them... long before it became critical. Denial or being overwhelmed? Maybe... but when this happens repeatedly with the same patient? There are resources available, and when people chose not to take advantage of them, and the same senario occurs again and again, I find it very discouraging.
Well , that's your opinion, but aren't we supposed to be non judgemental & keep our personal feelings seperate? How do you know she didn't care? Maybe that was just her way of dealing with the crisis......Never ever judge a family of the patient, no matter how hard it is to not do that. She could have other kids at home, she could be caring for sick relatives at home it could be anything really.
I have a 17 yr old who has had medical problems all her life since 3 weeks old and has been admitted to the hospital oh maybe 100x or more over her lifetime..... I do not stay overnight in the hospital when my daughter goes in unless it is life & death ....so does that make me uncaring as a parent??? All the people who work in the ICU where my child goes everytime she admits knows me very very well & have since my kid was a baby.....and they tell me to go home because they know the care she requires at home...so that time "away" is to refresh & regroup as I never have time away from her except for school, they even say they will call me if anything comes up during the night.But I am there everyday all day when I can be. So everytime she goes in it's like "here we go again". So please don't be so quick to judge ...just wonder, as one of my nursing instructors has told my class before with regards to how some people may view family members actions
Just a little info you may want to put in your pocket. All of us are guilty of judging patients & their families at some point...I have even done it but I tell myself to snap out of it & stop it & remind myself of my own situation with my child and that puts me back on the right track. I have made myself promise never to judge any patients again because I am there to take care of the patient not pass judgement of what is right/wrong/good/bad. Thats what makes us all individuals... good or bad. So I wasn't trying to start anything just trying to explain that you may not know the entire situation at hand...just be more open minded...I am sure you will be an awesome nurse!
Hey Kellie,
I don't know anything about your situation and I'm not sure why you feel you have to defend yourself at all. There is no judging involved as far as I'm concerned. The fact of the matter is, there are parents that do not care. I do not rush to judgement because a parent is on the cell phone or not in the room, come on! It makes no difference to me how annoying or uncaring the parents are, my care is all the same. I am just speaking for the patient's sake.
I've read this whole thread...I think one of the most pervasive and destructive ideas in pediatric nursing is that "you can't take care of children and their parents unless you are a parent yourself". Absolutely baseless, in my opinion. I spent 15 years in pediatrics and some of the best nurses I worked with were nuns. In addition to that, a lot of people got INTO Peds because "oh, I love kids" only to discover after they had their own children that they couldn't handle it emotionally.
Parents under stress can be extremely demanding. I always tried to make them part of the team of the child's recovery. If it would help the child in any way, I'd do it. If the child said to me: "please, don't let my Mom in for this procedure, she just makes it worse", I'd take it to heart and do my best for the child.
Families can and do freak out and take it out on us. It is one of the hardest parts of the job.
Welcome to pediatrics. I've done pedi for about 14 years. I've had families that showed little or no concern to families who "freaked" at the slightest alarm. Overall, I have found that you communicate and explain procedures as often and as simply as you can. You give them control in their child's care by involving them in decisions where appropiate and stop with the judgemental opinions. Never forget they are the parents and they love their child deeply and you can throw rationality out the window when they sense problems with their kids. Practicing these behaiviors will allow them to trust your competence and your caring. I have discovered that taking just a few minutes just to talk about what the baby's history was in NICU, making sure the parents do care where I can (ie changing diapers etc..) has worked wonders to calm the anxious family. They are not difficult --- they are scared --- never forget that. There is no rationality in fear.
And I've done NICU for 8 years. I'm not new to pediatrics by any means.
I communicate with my families just fine and rarely have problems. One of the most difficult situations we've had in the past few years was with the parents of one of my patients. They were threatening lawsuits, transferring the baby, said that we made the baby sicker, etc. Well guess what? By the end of that night, they would ONLY talk to me. At one point the attending - our unit director to be exact - was on the phone with the parents updating them on their baby and when he finished, all they asked was if they could talk to me again. I felt like I was talking down a suicide jumper most of the night. They kept calling me on the phone wanting repeated explainations for what we were doing and why their baby was getting worse instead of better, and at some points I just had to say, "I need to get off the phone now so that I can go take care of your baby. He needs me by his side right now. So please, let me go do my job and we'll call you back if things change." Instead of getting mad at those firm statements, they'd say, "Thank you so much for taking care of him." Within a few days he started getting much better and they were much nicer to everybody. The mom told me later that the reason she was so upset was that she kept asking us to just tell her that he was going to survive, and no one would tell her that. I explained that he was sick enough to die and we didn't want to give her false hope, and she said she understood that now, but at the time she was so scared she didn't even know what she was saying.
So yes, I know it's fear and love for their kids that make parents hard to deal with sometimes in pediatrics. Communication and honesty is the key to dealing with them, in my experience. Sometimes you have to be firm and set boundries so that you can do your job. We're there for the kids first.
Good point to remember- we don't know all the circumstances! No, this doesn't make you an uncaring parent... in fact, I think this makes you a great parent... you take care of yourself as well as your daughter. You mentioned that you know your daughter is being taken care of at school or in the hospital. That is a key point. You've temporarily transferred responsibility of care.
When I posted my comment about rather dealing with parents who are challenging than parents who don't care, I guess I should have more more clear, and for that I apologize. Unfortunately, I have encountered parents who don't care or don't understand, plain and simple. It's not a judgement, it's an observation. When someone tells me that they "didn't have time" or "forgot" to pick up their childs medication to manage a chronic condition, so I'm taking care of a child who is having complications from this condition. Or they didn't follow up as directed when they are given specific things to watch for and they admit they noticed them... long before it became critical. Denial or being overwhelmed? Maybe... but when this happens repeatedly with the same patient? There are resources available, and when people chose not to take advantage of them, and the same senario occurs again and again, I find it very discouraging.
Oh No! I'm sorry if I misunderstood your post! I see your point 100% and ya there is no excuse for that type of thing I agree.....I guess it's lack of education or ignorance on their part~ for a better word.....I gotcha now! Thankfully we have nurses that DO care ...like you! It has got to be frustrating I can imagine! I always do what I am told as far as this stuff you are mentioning which is why it probably didn't occur to me that some people don't "follow the rules" ...geez I can only imagine...and I am the type who always is worrying if I did everything I was told by the doctors/nurses thanks for the clarification by the way!
thanks for the clarification by the way! 
luv2yoga
238 Posts
Well, I know I won't be working in Peds.