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?

I've never sniped at familes before but I sure have enforced the rules such as chairs and visitation and bediside stays over night. I do it in the best interests of the patient not because I'm mean and heartless. People misconstrue that often because they don't understand what our job entails. When I take care of a patient who is profusely bleeding from their chest, I want to be able to focus on them until they are stable, not the family. When the patient is stable, then I will shift part of my focus to the family.

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.

I have spent the last 3yrs on night shift in a busy ER trauma center. I must admit that I have been "snippy" on occasion, and honestly felt it was appropriate for the situation.

IE,...19yr old male pt "just minding my own bussiness when these two dudes jumped me". It's 3am,.the pt is very intoxicated and 3 teenage girls show up with 4 children under 3yrs. The ER is packed, 40 in the waiting room. All 3 girls are also obviously intoxicated, pt has already been to CT (neg) and been sutured and cleaned up,...sleeping off the ETOH so he can get home.

Girl#1 sitting quietly at bedside,....girls 2 and 3 along with 4 small children decide to get comfy on a hall bed. Two of the small children are running up and down the halls. I need that hallbed for a pt. The kids aren't safe running the halls. I walk by the hallbed to ask a nurse about an empty bed for an ambulance that is 2min out.

Girl #2 on hallbed (whom I wasn't even looking at) stated very loudly "go ahead and make some noise kids, if we P&%# them off enough they'll let us F***** get out of here". I ignore her and cont my conversation with the other nurse. Girl #3 adds to the loud trash talk.

I very calmly turned and explained that A) you guys need to lower your voices and watch your mouths B) you need to go to the waiting room because you're on a bed I need for a pt.

Both girls consider this a challenge,..spouting off about "right to freedom of speech" and other nonsense. They both threatened to "kick my little white A$$" because of course they have rights. This got ugly real fast and of course security was there in two seconds with guns. Yes I got snippy. Yes they deserved it. No, I don't feel bad about having them arrested and hotlining them for having 4 small children in a car while they were intoxicated!

Asking for warm blankets when I'm busy gets a totally different response BTW:rolleyes:

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!

Specializes in ICU/Critical Care.

My point is, is that there are family members who are distracting to the point of "All eyes on me". I've been there and done that. It gets old. That's why when I have a sick patient such as the one I posted, I make family wait in waiting room until I am ready for them to come back. Yeah, I will admit I've been snippy, especially when I've explained visitation, "Please ring the buzzer to let the secretary know you are here, please don't walk back because we could be in the middle of a situation"....family members do that repeatedly, walk right back, don't ask if its ok. I've had a family member walk in while I was bathing the patient and I sure sniped at them about the rules and that they need to step out in to the waiting room until I say its ok to come back. And I sure didn't feel bad about it.

Specializes in Nephrology, Cardiology, ER, ICU.

Will merge these two threads per OP's request.

Maybe snippy, like beauty, is in the eye of the beholder.

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.

My point is, is that there are family members who are distracting to the point of "All eyes on me". I've been there and done that. It gets old. That's why when I have a sick patient such as the one I posted, I make family wait in waiting room until I am ready for them to come back. Yeah, I will admit I've been snippy, especially when I've explained visitation, "Please ring the buzzer to let the secretary know you are here, please don't walk back because we could be in the middle of a situation"....family members do that repeatedly, walk right back, don't ask if its ok. I've had a family member walk in while I was bathing the patient and I sure sniped at them about the rules and that they need to step out in to the waiting room until I say its ok to come back. And I sure didn't feel bad about it.

I understand being short with a family member after there was a valid and reasonable explanation.

Specializes in Med/Surg.

Honestly, what kind of answer would you like? It certainly seems as if you are looking for something in particular, so if you can be more specific, it'll be easier.

Do you WANT specific examples (if anyone feels there are any)? Do you want everyone to say, no, it's never ok? I am on the side of, "no, it's never ok," but having read your other thread also, I know that's your opinion of the nurse's attitude and I wasn't there. You used the word "insisted" when you talked about your mom (again) asking for another chair. I might get "snippy" too. The biggest problem (for lack of a better term) with having family members present constantly is that the patient worries more about their well-being than his/her own. They feel the need to entertain said family and remain engaged in conversation, and they don't get the rest that they should (no matter how many times the family tells the patient to rest/sleep and not worry about it, the patient doesn't, and I know this from being the PATIENT and not the nurse........when I had company, I felt like I should be awake and engaged).

You have your opinion about how the situation went down. You have made it abundantly clear that no one is going to change your mind, so to try to act like you are working towards a different/better understanding is transparent. Take it to that hospital's higher-ups if you are that concerned, otherwise let it go. You only respond by going off on tangents that are for the most part unrelated (who really cares if the gas station guy is rude, that has nothing to do with anything).

Your agenda is crystal clear, and while this nurse *may* have had a crummy attitude and not been *compassionate* enough for your liking, nothing here is going to change it now. It's not making me do anything differently, because I'm not that nurse. If anything, use the experience in your OWN practice, once you are a nurse, and call it a day.

Specializes in CTICU.

As I said, learn to speak up and say "Hey, I'm not sure why, but you really sound annoyed - is there something wrong?". 99.99 percent of the time, the cranky person will say "Oh sorry, I have been doing .... or ... happened" etc. Often it's just not about you.

Of course dismissing someone's pain is not right. Noone said it is. You seem to be missing a couple of points:

1. Everyone agrees, based on your post, that the nurse was in the wrong. No question.

2. You asked for REASONS why the nurse may have been cranky - you got them.... end of story.

Heehee. Posts like these make me glad we have a two visitor limit policy. As soon as a third person starts bugging me for a chair (and these are tiny rooms, mind you) I get on my sweetest face and say "Oh, I am so sorry, I didn't realize that there are three visitors in there - we only allow two visitors at a time. One of you will have to leave." As long as they don't bother me or ask me for things, I let extra people stay, but once they irritate me, they are outta there.:D

That being said, I usually do try to be as polite and professional as possible. The only time I was ever actually 'short' with a visitor is when I had a patient that needed to be intubated immediately - the doctors couldn't get to the bedside because pt's wife was standing there. I asked her politely several times to move, as the pt's sats kept dropping, and finally I told her to "Move!!!" pretty loudly. When she stepped out of the room the attending slammed the door in her face. We were all so irritated.

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:

Honestly, what kind of answer would you like? It certainly seems as if you are looking for something in particular, so if you can be more specific, it'll be easier.

Do you WANT specific examples (if anyone feels there are any)? Do you want everyone to say, no, it's never ok? I am on the side of, "no, it's never ok," but having read your other thread also, I know that's your opinion of the nurse's attitude and I wasn't there. You used the word "insisted" when you talked about your mom (again) asking for another chair. I might get "snippy" too. The biggest problem (for lack of a better term) with having family members present constantly is that the patient worries more about their well-being than his/her own. They feel the need to entertain said family and remain engaged in conversation, and they don't get the rest that they should (no matter how many times the family tells the patient to rest/sleep and not worry about it, the patient doesn't, and I know this from being the PATIENT and not the nurse........when I had company, I felt like I should be awake and engaged).

You have your opinion about how the situation went down. You have made it abundantly clear that no one is going to change your mind, so to try to act like you are working towards a different/better understanding is transparent. Take it to that hospital's higher-ups if you are that concerned, otherwise let it go. You only respond by going off on tangents that are for the most part unrelated (who really cares if the gas station guy is rude, that has nothing to do with anything).

Your agenda is crystal clear, and while this nurse *may* have had a crummy attitude and not been *compassionate* enough for your liking, nothing here is going to change it now. It's not making me do anything differently, because I'm not that nurse. If anything, use the experience in your OWN practice, once you are a nurse, and call it a day.

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.

Specializes in Med/Surg.
So she came home last night because she was doing so good. She was walking down the hall and low and behold....a room with extra furniture in it. Not damaged furniture, extra....hmm....kinda silly.

My mom didn't feel compelled to put on a show for us. There wasn't excessive family members, she wanted her husband and daughters there with her. Is that really so unreasonable? We were quiet unless she talked to us, we were out of the way and didn't even talk to the nurse unless she talked to us.

I wasn't the one that piped up and said I was a student, my mom had already said that before I got to the floor. And once again later. I think she was talkative because she was on morphine and she does that when she's nervous or going through something rough. She is used to taking care of the "pt's" not being one and is uncomfortable being one, we were her source of comfort.

Come to find out, there was a new charting system implemented last week. We found this out because another nurse was snippy to her but apologized later and explained this. Still, no reason to be snippy to a pt. It causes unneeded stress.

It sounds to me like a lot of people on here are putting up an attitude of being "high and mighty". Maybe this comes from having so much responsibility. Don't you think that other people feel this way about their job as well? This whole experience along with previous experiences similar only reiterates to me that to deserve respect means you need to give respect. It doesn't just come with a degree. That's not how most people work nowadays. Nursing is a special profession and I hope a lot of nurses understand that they aren't dealing with patients and families at their best. So when a family(including the pt) , not an overly demanding or troubling family, but a polite and respectful family are in their presence...they aren't exactly at their best. They are in an uncomfortable stressful situation. The staff that works with them should already understand this.

I know some of you see what I'm trying to explain and others just don't. I don't know if it's burn out, if you're taking the most extreme situations you've been in with families and applying it here but it's unnecessary and doesn't apply. I hate when people do that, you try to explain something and they automatically conclude the worst scenario they can think of. So not the case.

For those of you that understand what I'm talking about, thank you, you understand what it means to be a pt and what it means, as a nurse, to have control of your emotions in the situation. You understand that you, as a nurse/primary caretaker, set the tone and by being calm, comforting, and compassionate you have better cooperation from your pt and their families. The pts and their families are much more likely to listen and respect what you have to say during their stay, esp when teaching.

I can't even get my HEAD around this post.

Now you've made me angry.

Anyone that doesn't see your POV is now automatically jaded and burned out? And that we don't know what it means to be a patient or the family member of a patient?? I've been a patient WAY more times than I should have been by now, so I understand it EXTREMELY well. Sounds like YOU don't understand a lot of things.

We know that nursing is a "special profession." WE ARE NURSES, YOU ARE NOT. Time to get off of your soapbox, really. You're making it worse for yourself, and looking more and more unreasonable, every time you type something else.

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