What's the reason for a RN to be snippy to a new post op pt. ?

Nurses General Nursing

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OK. I don't want to fluff any feathers. I'm simply trying to get an opinion to experienced nurses and try to see this from the nurses point of view. I'm a nursing student so my POV is still very different from that of a seasoned Nurse and I understand this fact.

My mother had surgery today. She was scheduled to have a Hysterectomy and a Tummy Tuck. Her Hematocrit was too low (25) to do the tummy tuck so she just had the hysterectomy and will do a tummy tuck in roughly 6 weeks when she has healed and hopefully brought her iron back up. She has lost tons of weight and kept it off through diet and exercise alone. She quit smoking after 20+ years as well. Needless to say, this was a big day full of ups and downs for her and the whole family. (myself, dad, sister and brother)

Once she got to her room 2 hours post op she was doing as well as can be expected. She was of course in and out of it but pretty much knew what was going on. My dad, sister and I were there in the room. My sister had planned on spending the night with her and helping her with anything she needed. I was helping her with positioning, drinking fluids, answering any questions she or my dad had. My family has always believed that family involvement is very helpful to the nurses and we have always wanted to do as much as we could knowing that nurses are extremely busy and their time is precious. That all being said. My mother's nurse was less than enthusiastic that my mom would get talkative with her, my mom simply does this out of nervousness (esp with people she just met). I told the nurse I was a student and just about to graduate. I could make sure she did her incentive spirometer, kept and eye on her O2 sat, and let her know if we needed anything. Well, there were only 2 chairs in the room. We were all fine with one of us standing and being busy or just simply standing looking out the window during quiet times. My mother however was a typical mother and insisted that there was a third chair in the room. I asked the CNA, my sister also asked the CNA. We were told no problem and she would bring one back when she found one. Two hours pass and my sister and dad go to eat. When they come back my mom, once again in and out of a morphine nap, insisted there be a third chair. When the nurse came to the room my mom asked for a third chair very sweetly with a raspy dry voice. The nurse, in a not so nice tone said she'd try to find one. Moments later, she came back and said "Well here you go but just so you know now the room next to you has to be without a chair because of you. I hope you're happy".

Of course her tone didn't sit well with my mom, dad, or sister. I brushed it off and said she probably has a big workload and is tired. Then a couple hours later my mom was starting to have more pain that she thought she should. I know that the nurse needs to hear from the pt. herself the description of the pain so we called the nurse. Well, she was less than happy to have to discuss this with my mom and simply just said "well I gave you Toradol so any pain you have you just have to deal with"

To me, this is very uncompassionate care. I understand that nurses see a ton of different people, pt's as well as their families. But for my family, this wasn't a daily thing. This was a stressful and difficult day physically and emotionally. My mom and dad don't do this everyday, they paid a lot of money via insurance as well as out of pocket. Of course my mom was upset and didnt' feel comfortable with her nurse. I really wanted to go speak to the charge Nurse about it but I didn't, I left it alone.

Is my family wrong in feeling that this was very unprofessional as well as uncompassionate or as a nurse is everyone supposed to just bow down and be glad you even came to their room and answered the call?

Specializes in Med/Surg.
Keep in mind that my mom; an immediate post op, morphine pca using pt, was the one insisting....she wasn't being rude to the nurse....she was drugged up and it was something that was bugging her. We told her to not worry about it and she said she "insisted". I don't know why...she doesn't even remember anything else except this from that first day.

We tried to leave her alone..she didn't want us to! She didn't want to have to wait on the nurse if she needed a drink of water or needed to reposition herself. In just asking her if she would have rather have had us leave her alone or been there....undoubtedly she would rather us have been there than to have to rely on staff whom she understands is extremely busy and can't always come to help right away immediately post op.

Fine if it's not making you do anything any differently, but I'm sure someone reading this, myself included, will think twice about their attitude towards pts. someday....it wouldn't hurt you or your pts if you did too.

DO NOT make ANY assumptions about my attitude or my patient care. You are crossing the line.

I am seriously laughing out loud after reading some of these posts. The nurses with the attitude of "the family is a big pain in the butt" all seem to come from critical care or emergency areas. The ones that say "help the family help the nurse" comes from the floor nurses. Perception is one's reality.

Being an ex-critical care nurse now working a surgical floor I can tell you it is to totally different worlds. And yes, staffing is the 800lb fart in the middle of the room! It makes a lot of difference when you have two patients vs seven patients.

I remember the days when I had two and even the dreaded nights when I had three patients in the ICU/CCU. I whined and complained loudly. And my attitude was "if you shoot a family member every hour they will stop coming in and asking me questions after a while." Now that I am a floor nurse with six or seven heavy duty patients, most of whom would have been in ICU 13 years ago, my first question every morning is "where is your family? Who is going to be here with you today? Are they able t help you bath? Brush your teeth? Walk you to the bathroom? Walk you in the halls? Do they know how to empty your urinal and record the I&O? Help you order your meals? Fix your tray for you? Get you ice and drinks from the pantry?

Sure, these are all things we "use" to do for our patients. Not any more. This is the real world we work in now. Economics make the rules, not professional standards or nursing ideology. One PCT for 17 patients. Who is going to clean up the patient in 58? Who is going to feed 49? Who is going to walk 51? I can't do it, I have to admit the new post-op, discharge the patient in 62, start the blood in 53, change the PCA syringe in 61 and pass all the 9 O'Clock but do the accuchecks and get all the insulin administered before 7:30a. In today's real world of nursing on the floors if the family doesn't pick up a huge portion of the more menial tasks then you are going to drown. And not a darn person cares on your floor. Miss one little nursing round documentation on the electronic medical record and you will hear about it. It might cost the hospital a $1 and they care more about the money than the patient.

So my attitude has become "families, I love you and I need you. God bless you for being here to help me make it through my shift. You are the missing link to holistic patient care. I am so happy to see your lumpy little bodies lying on the window seat bed in the morning I want to run over and hug you. There is hope as long as you are here. Again, bless you. Now bathe your mother please." :bow:

AMEN!!!!

I couldn't say all of this because I'm not a nurse yet but I do know this is how it all goes down. Families are an integral part of great pt. care! The families matter too and go through a lot to help the pt. It's not easy or fun or even always comfortable, but necessary in today's society!

Thank you for this post...maybe some of the sharks will get off my back

Actually, maybe it is because I am a critical care nurse, but I would never let the family do any of those things, especially walk them in the halls or record their I&O's. We always walk our own pts because lots of them just had a sheath pull or hematoma. As far as I&O's are concerned, well, that is NEVER a family member's job, especially in ICU. I&O's are very important - I don't even let the techs do my pts' I&O's.

Sharks, huh? Momofqc, all I have to say is, good luck in your career. You aren't likely to find many comrades on whatever unit you land a job on with an attitude like that.

Specializes in CTICU.

The problem is not your message, but the delivery. You do not respond to logical posts but only those that agree with you. Any that don't, you accuse of being burnt out with crap attitudes.

Take a look in the mirror.

You really need to learn about communication skills before becoming a nurse - it's a team effort, and you will not win many friends with your attitude.

LOL! Again pinksugar, it is a matter of perspective. When I worked ICU, we would measure urine in a medicine cup to get the accurate ouput. On the floor, you just want to know if they went to the bathroom, much less how many cc's they put out. Go work on a med/surg floor for a 12 week cycle, you might find it is an entirely differently world than the one you are use to working. I find myself everyday saying "when I was an ICU nurse I would never dream of letting someone else do ...." My, my, my, how that attitude changes when you have 24 hours of work to do in 12 hours. Just two weeks ago I got yelled at by the wound care nurse because my patient in 54 did not have the pictures of her wounds taken and on the chart within the 48 hour time limit of her admission, even though this was day 4 of her admission! And it was my fault! So stop what you are doing, and got take down the 48 inch sacral dressing and take the photos, print them and mount them and put them in the chart. Now would I have let the family hold the patient over and the PCT take those pics? You betcha! The blood that needed to be started in 51 was much more important than taking those pics.

Again, it is all a matter of perspective. But I understand where you are coming from. I would like to do it all myself as well.

LOL! Again pinksugar, it is a matter of perspective. When I worked ICU, we would measure urine in a medicine cup to get the accurate ouput. On the floor, you just want to know if they went to the bathroom, much less how many cc's they put out. Go work on a med/surg floor for a 12 week cycle, you might find it is an entirely differently world than the one you are use to working. I find myself everyday saying "when I was an ICU nurse I would never dream of letting someone else do ...." My, my, my, how that attitude changes when you have 24 hours of work to do in 12 hours. Just two weeks ago I got yelled at by the wound care nurse because my patient in 54 did not have the pictures of her wounds taken and on the chart within the 48 hour time limit of her admission, even though this was day 4 of her admission! And it was my fault! So stop what you are doing, and got take down the 48 inch sacral dressing and take the photos, print them and mount them and put them in the chart. Now would I have let the family hold the patient over and the PCT take those pics? You betcha! The blood that needed to be started in 51 was much more important than taking those pics.

Again, it is all a matter of perspective. But I understand where you are coming from. I would like to do it all myself as well.

I externed on a med-surg oncology unit while I was in NS, and that is not for me. More power to any nurse that can handle that. I don't know how anyone could take really good care of that many patients ... it just isn't happening with 1 LPN or RN and a tech.

I could never work the floors. I wouldn't feel comfortable relinquishing control over important aspects of my patients' care. So, props to those of you who go and do that everyday. :bow:

Specializes in Cardiac, ER.
I would expect if a pt is profusely bleeding from their chest that the focus better be on them!!!! That's what I would want for myself or a family member no matter what...but this was a case where the pt. was stable. There is a way to enforce what ever policy or rules there are without being rude. The results are much better for everyone.

Perhaps part of what you're missing here is that your Mom was stable....but what about the other 30pts on the floor. I'm not a "grumpy" person by nature. I am a happy person and for the most part I really do love my job. I generally see the benefit of making the best of a bad situation and honestly understand that just because I'm having a bad night doesn't mean I should ruin it for everyone else. With that said,..I'm sure there are times when something I've said, or the way I've said it has come across as "snippy" when I didn't intend for it to.

There are times when my priorities as a nurse MUST come before the comforts of pts or visitors. I spend a great deal of time at triage. There are times when I have to make people wait for hours, even when I know they don't feel well, they are uncomfortable, they are cold/hot/hungry/tired. I think people think I'm exaggerating when I explain that we have three traumas, 2 acute MI's, 4 stoke like sx and an infant with O2 sats in the 60's in the back all at the same time. Then of course there are the other 30pts with various C/O and 3 EMS units less than 5min out. The average person cannot understand that. If you have been up to the triage desk 4 times in the last 3 hours asking about the wait, and every time I've explained that I honestly don't know the answer to that question and we will get you back as quickly as we can, then you walk up again and ask if I can get your wife a Sprite with ice and a straw...I might sound a bit snippy when I explain that there is a vending machine in the waiting room.

Would this whole scenario have made you feel better if you knew that A) this floor had 2 RN call in's that shift so every nurse had 3 more pts than normal. B) one of her pts was a post thyroidectomy and was bleeding more than normal and required suction every 10mins. C) one of her pts was post hip replacement and confused, he was trying to get out of bed and had pulled is IV 3 times in her shift. D) One of her pts was a DNR and was actively dying. E) This nurse has an 8 mo daughter at home with a fever of 103 and a terrible cough. She came to work because she didn't want to leave her co workers in a bind. Her husband has called 5 times to make sure he is giving the right amount of tylenol/cough medicine/fluids etc. This is a completely feasible story line for any floor in any hospital at any time. Would that perhaps make you "over look" what might not have really been meant as snippy,..just not a priority at the time?

I'm not excusing rude behavior, but I agree with an earlier poster,...look back at this a year or two after you've been working as a nurse. You can't possibly have been aware of everything else that was going on outside of your mothers room. Maybe other pts needed their nurse more than your Mom needed an extra chair. The important issue is that your Mom did well, she received good medical care and is home now,..does the other stuff really matter? If you want to be pampered go to a spa. If they are snippy than find another spa!

Specializes in ICU.

OP: I am not going to beat around the bush here. Your posts are condescending and judgmental. Your only experience as a nurse is as a nursing student in a "perfect NCLEX hospital". In that perfect world, we would not be hungry, tired, overworked, overstressed, or even need to pee. We would be able to be endlessly chipper, and each of us would have only one patient to care for and all of the chairs and other equipment in the world at our disposal. We wouldn't need orders from doctors to get whatever meds our patients need, and we surely wouldn't have to wait on pharmacy to bring said meds up right away. And in an ideal world, the nurse would never be out-of-sorts.

Unfortunately, that is not what the real world is like. Hospitals are not perfect, and nurses especially are not perfect. We are human beings just like everyone else. We can't endlessly be the perfect nurse. Nursing is so much more than just smiley, happy, have-it-your-way customer service.

I can assure you that almost every one of us keeps trying to be that nurse, despite all the difficulties that are put in our way. Your statements that anyone who is not perfect is jaded or should find another profession are judgmental. They are also uneducated in the sense that they are not based on experience and understanding of what it is actually like to work in this profession. That is why you have been told repeatedly to come back after you have had a year or two of experience working in the field.

I'm not saying nurses should just go around being snippy. Compassionate care should be the goal of every nurse. But what I am saying is, we are human, and we have our limits. If our limits our exceeded, we might just have a very human reaction of being snippy.

You asked for our point of view, and we have given it to you. No, in theory the nurse should never have been snippy. But something, whether your/your family's actions, understaffing, the patient coding/dying four rooms down, or something in her personal life, exceeded her ability to provide compassionate care. It happens. It happened to you. Don't take it personally. It might have had nothing to do with you. Either do something to change it, like talking the the nurse's manager, or quit wasting time and energy worrying about it and move on with your life.

:twocents:

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
maybe snippy, like beauty, is in the eye of the beholder.

"snippy" is in the eye of the beholder. and all we've gotten is one take on the situation, by someone who is rapidly losing any credibility here!

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
well, i would expect a nurse to do that if there are unruly and belligerent people running around. i'm glad you know the difference between the situations!

and it's unfortunate that you don't get the similarities between situations. you just don't get it.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
maybe this makes some think twice about how their attitude would get optimal results and cooperation from pt's and families. there's more than one way to enforce policy and rules. and of course, how could pt's and families and yes even nursing students know what the job of an rn entail? does an rn know what the job of a np entail completely? of course not. you can't expect people to understand it because they don't live it. it would be totally unfair to expect anyone other than another nurse to understand.

yet here you are, on a board for nurses, preaching about how your poor mother was abused by some mean (and probably old, fat and ugly) nurse. you aren't interested in anyone's input. we get it. you and your family were angels, that nurse was totally out of line. but it seems as if you're not getting anything anyone is trying to tell you. nursing school must be very difficult for you.

OP: I am not going to beat around the bush here. Your posts are condescending and judgmental. Your only experience as a nurse is as a nursing student in a "perfect NCLEX hospital". In that perfect world, we would not be hungry, tired, overworked, overstressed, or even need to pee. We would be able to be endlessly chipper, and each of us would have only one patient to care for and all of the chairs and other equipment in the world at our disposal. We wouldn't need orders from doctors to get whatever meds our patients need, and we surely wouldn't have to wait on pharmacy to bring said meds up right away. And in an ideal world, the nurse would never be out-of-sorts.

Unfortunately, that is not what the real world is like. Hospitals are not perfect, and nurses especially are not perfect. We are human beings just like everyone else. We can't endlessly be the perfect nurse. Nursing is so much more than just smiley, happy, have-it-your-way customer service.

I can assure you that almost every one of us keeps trying to be that nurse, despite all the difficulties that are put in our way. Your statements that anyone who is not perfect is jaded or should find another profession are judgmental. They are also uneducated in the sense that they are not based on experience and understanding of what it is actually like to work in this profession. That is why you have been told repeatedly to come back after you have had a year or two of experience working in the field.

I'm not saying nurses should just go around being snippy. Compassionate care should be the goal of every nurse. But what I am saying is, we are human, and we have our limits. If our limits our exceeded, we might just have a very human reaction of being snippy.

You asked for our point of view, and we have given it to you. No, in theory the nurse should never have been snippy. But something, whether your/your family's actions, understaffing, the patient coding/dying four rooms down, or something in her personal life, exceeded her ability to provide compassionate care. It happens. It happened to you. Don't take it personally. It might have had nothing to do with you. Either do something to change it, like talking the the nurse's manager, or quit wasting time and energy worrying about it and move on with your life.

:twocents:

:twocents:

No my only experience is not in an NCLEX perfect situation thank you very much. I didn't come across condescending until I got that first. But I understand nurses wanting to justify/defend their own kind...it's human. I have limits too and yes they have been reached before....you all don't know me and I don't know you. There's no reason to think I don't know what it's like to have to work hard with tons of demands...I do. There's no reason to think that I couldn't possibly fathom what it's like to work 15 hrs, pump breastmilk every 2 hrs, have issues at home with hubby and babies, go home only to be called in 30 mins later and be there for another 24 hrs....been there done that and yes lives depended on me. Just because it wasn't as a "RN" doesn't mean it wasn't important and trying. Because I'm a nursing student does not mean that nurses have to talk down to me. (and no, not everyone on here did) I responded to posts that were on both sides and went through and gave kudos to everyone whether I agreed with them or not.

I know how to communicate and in my job...I definitely know how to communicate with the people that are above me.

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