Nurses are front-line providers who are regularly face-to-face with patients and their families. That comes with some unique challenges. One of those challenges can come in the form of a rude or difficult family member.
Maybe this situation sounds familiar: You’re a nurse doing your best to care for one of your patients. You’re just doing your job when one of the patient’s family members becomes angry and starts shouting at you. They might act hostile, use foul language, give you orders, or make unreasonable demands. How are you supposed to respond?
Having the patient’s family involved throughout treatment is important. After all, the American Medical Association reports that family-centered care improves patient outcomes for all ages. Unfortunately, not all family members are polite or friendly. When a relative is intimidating, aggressive, or overbearing, it can make it extremely difficult for nurses to perform their jobs. Here are some tips and tricks for dealing with unruly or difficult visitors and relatives.
1. Pause and consider your state of mind
Before jumping to address the problem head-on, take a moment to evaluate your stress level and mental state. Are you exhausted? Hungry? Having a bad day? Take a second to breathe, and try to be mindful of your emotions. In one study that explored strategies used by nurses to diffuse conflict, nurses were encouraged to slow down and “attend to their stress so that they can respond skillfully.”
2. Build trust
The best way to avoid conflict with patients’ family members is to start on the right foot. It may be difficult for you to spare the time, but try your best to introduce yourself, ask for their names, and make it clear that you are glad they are there to support the patient. Ask them if they have any questions, and if they seem confused, let them know what is happening to the best of your ability. Sometimes you can gain family members’ trust with something as simple as explaining what time the doctor will arrive.
3. Consider why a family member might be upset
When a family member is acting rudely, try to understand the situation from their perspective. Health concerns are incredibly stressful, frightening, and confusing. It’s easy to feel helpless when your loved one is hurt or ill. One study found that patients’ families often wish to express their feelings to nursing and medical staff. However, it’s easier said than done to admit that you’re afraid, so relatives may resort to rudeness instead to cope with their emotions.
4. Acknowledge their specific concerns or complaints
If a family member has a specific problem, try and address it rather than ignore it. For example, if they’re angry that the patient’s diet has been restricted, clarify why those restrictions were put in place. If the problem is something reasonable that you have the power to solve (for instance, if they want a drink of water or a more comfortable chair) then act on the family member’s request, even if it’s not your job.
5. Apologize if you make a mistake
No one is perfect. Nurses don’t have easy jobs, and they are often working under difficult conditions. Miscommunication can happen. The important thing is to deal with errors quickly and correctly. If you do end up making a mistake, be honest about it and apologize. Let the family know that you are doing your best to rectify the issue. Sometimes, the error might not even be your fault. Don’t directly take the blame, but still offer an apology for the situation.
6. Establish firm boundaries and clarify expectations
The first time a family member does something inappropriate, make it clear that you will not tolerate that kind of behavior. Stand up for yourself and politely but firmly explain that you will call security and have them escorted out of the room if they continue to be disrespectful or rude.
Let them know all staff members should be treated with respect. If you are ever threatened or harmed by a family member, call security. Don’t allow your safety, or the safety of the patient, to be compromised by family members.
Not sure how to say it? Here are some good examples:
● “I am here to help. I will answer your questions and address your concerns, but I can’t do that if you are yelling at me.”
● “We are in a hospital. I need you to stop. You are disrupting patients and visitors right now.”
● “What you just did/said was not acceptable. If you continue, I will have to ask you to leave.”
7. Keep the charge nurse updated
You don’t have to deal with this situation alone. Inform the charge nurse about any issues occurring on the floor. If there is a communication issue or misunderstanding, they are a great resource to help with service recovery. They can reinforce the boundaries you set with patient’s families and back you up. If the issue escalates, they can help you call security or get additional administrative support.
8. Document incidents
If you’re being treated poorly, take the time to make note of it. This will let others know that you dealt with the situation as best you could, and will prepare future providers to deal with difficult family members. Creating a record of such events may also be necessary for future legal reasons.
9. Come up with a plan
You’ll probably encounter angry family members more than once during your nursing career. Create a plan for dealing with these types of visitors and stick to it. Knowing that you have a plan in place can help you calm down when you’re feeling overwhelmed or stressed out. If you know in advance that you’re going to be dealing with a difficult family member, inform the other nurses so that they can be prepared, too.
10. Don’t ignore bad behavior
Your job as a nurse is not to be abused by anyone. It is to advocate for the safe and efficient care of your patients. When nurses, patients, and family members are not on the same page, it increases frustration and dissatisfaction for everyone involved. The sooner you address poor behavior, the better. You may be tempted to put up with a little rudeness, but if you allow relatives to treat you poorly, they might take this as an invitation to mistreat other staff members.