We have all looked after patients where we feel that relatives can be very demanding.
This is a story about a mum and daughter that I looked after on the ward several years ago. I will call the mum Beth and the daughter Zara.
Zara was a 6 year old girl with complex health needs who was frequently admitted to the ward with seizures. We knew the family well and due to her behaviours at times, Beth was soon labelled as "difficult". She placed several demands on nurses and doctors and her behaviour was bordering on the aggressive side. Beth was devoted to Zara and would be by her side on every admission. It was difficult to get Beth to leave the hospital and she would often say to me, she had to be by her side because she was Zara's voice.
Zara was sometimes very sick when she came to hospital and it was difficult to cannulate her at times. I remember one time when the doctors really struggled and Beth was furious. She started shouting at me to get a particular consultant who had managed to cannulate Zara first time on her previous admission. I explained that the consultant was not around and there were doctors on the ward already who would be treating Zara. Beth was not happy with this and kept demanding I get the consultant. Luckily the ward doctors did manage to cannulate Zara and Beth eventually calmed down. This incident was not isolated and Beth would often request that only certain staff look after Zara. She certainly wasn't afraid to speak out.
Sadly Beth passed away a few years ago which was devastating to hear. I had spent many shifts looking after Zara and I really got to know Beth well. She would tell me her hopes and fears. She would tell me how scared she was that if something happened to her who would look out for Zara. The love she had for Zara was profound and that's what made it so hard to hear of her passing. The way in which Beth advocated for Zara has stuck with me throughout my nursing career and it is something that I have always done for my patients. Whilst I never agreed with Beth's behaviour, I did admire her strength and determination and the love she had for Zara.
You could argue that Beth was advocating for Zara and only had her best interests at heart. Did Beth deserve to be labelled? Could Beth have advocated in a more calm manner?
Nurses will come across many situations like this and will indeed start labelling parents when they display behaviours like Beth's. Parents are vulnerable when their children are admitted to the ward as they feel they have no control over their children's condition and illness. After all they are the ones that usually protect and keep their children safe. This vulnerability can often be chanelled as fear which can lead to aggressive behaviours. Parents need to advocate for their children and in the case of Zara, Beth was her only voice and therefore she made demands on staff to get the best outcome for Zara. It is difficult when faced with these behaviours as clearly nurses want the best outcome for patients too. When parents are shouting it can be very distracting and sometimes cause panic amongst staff, we need the parents to calm down.
It is unacceptable for parents or relatives to shout at staff and make demands on them no matter what the situation is and therefore we need to set boundaries. We need to foster open and honest communication and build a trusting relationship showing empathy and compassion. Let's understand what is driving these behaviours and what we can do to support the parents. However, we do need parents to also understand that nurses will not tolerate any form of aggressive behaviour. Parents can still advocate for their children in a calm and civil manner.
Do you think Beth deserved to be labelled?
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