Picture of the month – December CXR

Picture of the month - December

Something is very, very wrong with this patient…

Families and the nature of ingratitude

As far as being a nurse goes, I believe that I do a bloody good job. Throughout my years as an RN, I have had the privilege of working with good people, who (for the most part) do a bloody good job.

As part of a team, I have been involved in the care & treatment of hundreds of patients, with varying degrees of illness and length of stay. Some of these patients and their families take the time to actually say “thank you” for the care that they or their loved ones have received; many do not. Fortunately my self-esteem isn’t dependent on the gratitude of others. It is nice when people thank you for caring for them, but I’m not in the job for the thanks and chocolates.

One thing, however, that I cannot abide by is what can generously be referred to as RAUFS, or Rude Aggressive Ungrateful Family Syndrome. Even worse, is than this is a management group that enables this behaviour, and does nothing to stop it.

An example of this could be the hypothetical young adult admitted to hospital following an act of gross stupidity, resulting in catastrophic injuries that will inevitably lead to a lifetime of major physical and cognitive impairment. As much as I hate the term, they are going to be a vegetable for the rest of their life; planted in a nursing home, waiting for the respiratory tract infection that will one day mercifully end their life and any suffering that they may be capable of experiencing.

It should be pointed out that, typically, such a hypothetical patient has generally had multiple trips to ICU and theatre, and has had multiple opportunities to be allowed to die with some sort of dignity; but has parents who love their son or daughter so much that the refuse to allow them to die, and belligerently insist that their comatose dead horse be flogged and flogged.

A year later, and their son or daughter is still alive with the reflexes and quality of life of a turnip, and somehow it is all our fault.

“You did this to him”

“It’s your fault she’s not better”

“You people are useless – you have no idea of what you are doing”

I’m sure you get the idea…

This sorts of statements are often backed up by formal complaints.

One patient’s family, the mother in particular, was the straw that broke the camel’s back with me, marking my descent in jadedness. Their child (an adult) was the typical example listed above. Their parents were manipulative and made the typical statements listed above. After lodging complaints about nearly every nurse on the ward, it was my turn. And, holy shit… what a doozy it was – a one page rant with the most God-awful grammar and spelling outlining a laundry list of fictitious actions that I was alleged to have perpetrated. And it was nasty… really nasty – ladened with a vitriol that dripped from it’s poorly written page and threatening to burn like acid through the floor.

You bitch. You fucking nasty piece of work. Exactly what the fuck had I, and my colleagues, done to deserve this sort of attack against ourselves, personally, and against our professionalism at work?

Now some would say, “Hey Penguin, you need to be understanding… These people are going through a tremendously hard time. Stages of grief and all that… You need to offer understanding and compassion. Turn the other cheek, etc… It’s not about you; it’s about them… You need to help them cope and offer them a shoulder to lean on.”

Get stuffed.

Yeah, I agree that it is not about me, or about my colleagues, but rather about the parent’s inability to cope with the situation. As far as the rest of the sanctimonious touchy-feely bullshit – give me a break. As I looked around at the other long-stay patients, and as I thought about every other long-stay patient I had looked after, it became apparent, that although their families were grief-stricken, they did not behave is such a hideous fashion. Grief and the inability to cope with a situation, brought about by a combination of stupidity and the selfishness of not allowing a loved-one to die with some shred of dignity, does not excuse or really explain such disgusting behaviour. Nor does it excuse being complete arseholes on every visit.

Despite this, we all did our jobs and, in my opinion took exceptionally good care of the patient – after all it wasn’t their fault that their parents were such total fucktards. I’m sure that, in some twisted way, the patient’s mother thought that the high standard of care was a direct result of her kicking arse and taking numbers. In reality, it was because of the professionalism of those of my colleagues who had not yet refused to look after the patient.

In the end, the patient left our care after a year spent on our ward – during which time, despite being completely immobile, they developed a grand total of zero pressure sores.

And so they left. And the parents said nothing.

Not a “good bye”.

Not a “get stuffed”.

And certainly not a “thank you”.

Ungrateful bastards.

I don’t expect thank yous, sunshine, or lollipops; but I do expect that my colleagues and I can do our jobs free from malicious, fictitious and libelous complaints.

I also expect to be supported by my superiors when such malicious complaints are made. And I expect that my superiors will take the appropriate actions to prevent this from happening again, rather than pandering to the twisted egos of such complainants. But then again, I am a dreamer… After all the policy of “zero tolerance to violence and aggression towards staff” is simply just another fairy tale…

The moral of the story is that I strongly believe in providing whatever support patients and their families need in order to get through the, often horrendous, situations that they have invariable found themselves in. However, there is a line – a line that is generally drawn along the boundaries of human decency.

Cross that line, and you can go fuck yourself.

Perspective

I don’t know why, but it appears to be a common perception on the wards that all ICU nurses do is sit around on our arses and do nothing.  After all, we only have one patient.  I mean, really… how busy could you be with only one patient to look after?

I went down the other night to say hell to the guys I used to work with on the ward.

“You ICU guys have it easy – you send all of your difficult patients down to us to look after – and we have to look after at least four of them!” they howl.

Yeah, been there.  Done that.  Now shut your word hole and don’t be a wanker.

Now while I freely admit that I have looked after sicker patients on the ward, and that a slow respiratory wean isn’t the most challenging of patients; looking after just one critically ill patient often involves a hell of a lot more work than 4 or 5 healthier ward patients.

The same nurses who chastise me also like to have a dig at the guys in ED.  And to be truthful, I once did too.  Then I spent a shift in ED.

I guess it’s all just a matter of perspective.  After all, it is very easy to criticise and pass judgement on what you don’t really know.

That being said, I’m still sure that mental health nurses do three-eighths of bugger all…