Uh...Security Please?

Nursing is definitely a customer service based profession.  Nurses deal with people which can make it very frustrating, because people can be very difficult to handle at times. 

In my experience as a nurse, one of the many areas of healthcare that needs vast improvement is communication skills.  This is an important skill that all healthcare professionals should possess, however many times patients/family members are left wondering if there are any communication skills present in the healthcare profession. 

As part of my job as resource RN, it is my responsibility to handle any customer service issues that may arise on my shift.  I’m going to be honest and say that I HATE this part of the job and would much rather be able to hand it off to someone else.  Unfortunately that is not an option. 

A few nights ago, I was called to one of the wings by a nurse who was having a problem with a patient’s wife, daughter and son.  When I arrived, the nurse informed me the family was upset because they were under the assumption that the patient was going to have surgery that evening and it was getting late and they were curious as to why he had not left for the OR.   As the nurse continued explaining the situation it became clear, the plan of care did not include surgery of any sort, rather the patient was going to be discharged as soon as possible and evaluated at the outpatient clinic. 

As the nurse was explaining this to me, we heard yelling and screaming coming from down the hall.  As we went to investigate we found this particular patient’s family carrying on about the plan of care.  They were irate and yelling at everyone who crossed their path.  Now there are many problems with this situation.  First this patient was in a semi-private room, meaning there was another patient being exposed to the angry tyrant.  Second it was the middle of the night and the rest of the patients were trying to sleep, trying being the key word at this point.  And thirdly, the patient in question was lying in bed with a stressed out look on his face.  He was trying to calm his family down with no success.  As the family continued yelling, the patient began to look sicker and sicker.  Upon checking his vital signs, it was discovered his blood pressure was 210/267, which is extremely high.  At this point, this had become a patient safety issue and the situation needed to be handled. 

We tried to talk with the family members, but there was no calming them down.  We paged doctors on call and they came up to discuss the plan of care with the family.  This just resulted in the daughter storming out of the patient room, and entering the waiting room, where she began to throw around the coffee cups and coffee packets.  At this point, I realized there was really nothing I could do to diffuse the situation and had only one option.  So I paged security and asked them to escort the family out of the hospital. 

Security arrived and told the family to take it outside.  This resulted in one last loud and abusive tantrum before security removed them.  As soon as the family left the floor, a sense of quiet entered the wing once again.  The patient distressed rather quickly and his blood pressure returned to normal.  He was able to get some rest and by the time his family returned a few hours later, they had calmed down and was able to talk about the plan of care with clear heads.   As it turned out the problem resulted from one team of doctors telling the patient/family they were going to do surgery before discussing their decision with his primary team who had decided surgery was out of the question.  If there had been just a little bit of communication between these members of the healthcare team, this situation could have been averted and my night would have been a lot quieter.