Tips for dealing with patients’ difficult family members

Communication, education and involvement can help alleviate tension and fear

I’ve often said I would have become a teacher, but I didn’t want to deal with difficult parents. Nurses must feel the same way about patients’ families sometimes.

Spouses who read an article about how you should treat their significant other.

Children who don’t understand why you can’t give their mom more painkillers.

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“You may encounter family members who are verbally aggressive, inappropriate, or even come to the bedside clearly intoxicated causing all kinds of chaos,” Amy McCutcheon, RN, founder of Real Desert Mama, wrote for nurse.org. “Then there are those family members who just can’t comprehend what the nurse’s workload is, and will hit the call button with another question every 5 minutes.”

Having had her share of difficult patient families, McCutcheon shared six tips she’s used to deal with these situations.

Be honest and set realistic expectations

McCutcheon suggests checking in with the difficult family at the beginning of your shift. Let them know they will see you thoughout the day, but don’t be specific. Nurses can’t predict what will happen on the ward.

“When you leave the room, try saying something like ‘I will be spending the next hour or 2 passing morning medications and doing assessments on the rest of my patients,’” she suggested. “‘I will plan on checking in with you again after that. If you need anything before you see me again, please push your call button and we will send someone in to assist.’”

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Communicate, then communicate some more

Once in the room of the “difficult” family, don’t rush things. Explain what you’re doing and why, while taking the time to review test results and talk about any procedures that day.

Write down any questions and requests — even put them on the white board. This can help to avoid unnecessary doctor calls.

Get to know them

Sometimes a family member acts the way they do because they’re scared. As a nurse, you can help take their mind off the situation by getting to know them and the patient. Talk to them about sports, pets or hobbies. You can even lighten the mood with small jokes.

Cluster your care

Coordinate as much of the patient’s care as possible throughout your shift, McCutcheon suggests.

Change dressings, give baths and change the bed during the same room visit. While doing so, continue to educate the family and give them updates.

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Involve the family

Teach the patient’s spouse or children how to change bandages, feed the patient or simply how to make them more comfortable.

Remember, McCutcheon wrote, “patients will be going home with them, not you. For that reason, it is super important to start the involvement early and frequently.”

Set boundaries

Sometimes nothing you do can stop a family member from being rude, inappropriate or hostile.

If you’re faced with a visitor who crosses the line, it’s important to set your boundaries. McCutcheon suggests saying something like: “I will not treated and/or spoken to this way. I understand you are upset, so I will leave the room now and come back when you are ready to speak to me in a calm and respectful manner.”

If that doesn’t work, call for security or backup.

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