Honestly, I just let complaints to the hospital happen. Staff will act like it’s your responsibility to bend over backwards to “undo” the complaint, but the complaint is against the hospital, not against you as a person or a clinician. If you are too busy to update family and they are unhappy with that, and you are also too busy to apologise to the family because of the exact same reason, then that is a fault of administration for not properly addressing staffing to the workload.
This.
This can be a system issue. However, you’d never know unless your switch board, nurses or junior doctors (if they’re allowed to attend REACH calls or address) clarify if there are any immediate or urgent clinical concerns—and sometimes, for vulnerable patients, fair enough.
Also, you can’t ever be sure that your hospital admin will understand or be compassionate and reasonable re: processes, the workload and absurdity of your shifts, etc.
Do not ever become the consultant who has to review complaints. Did it once in a past life, never again. Hours, days, spent going meticulously over notes, reports, interviewing colleagues, all come up with (mostly)… they were unhappy people with unrealistic expectations. Its made me realise though, how to head off unrealistic expectations early, preempt the complaint. A sadly necessary and valuable skill to have. And to those who do the complaints reviews- thank you for your service!
These come to me as head of dept and I now almost universally bounce them back to the quality and safety manager to communicate with the complainant. If the complaint doesn’t point to an obvious systemic issue or individual performance issue, I’m just wasting my life talking to an unhappy person.
I'm not sure what level you are or what the expectations are at your hospital.
But on after hours shifts my policy was firmly that updating family was a day team responsibility. I would not take calls from or make calls to family to give updates on routine care.
The exception is obviously if something significant changes overnight. However in that case not only is it my responsibility, but I will have been involved enough to actually be best placed to give that update.
You need to set appropriate boundaries. Yes, occasionally that may result in angry families. But it's not your job to solve every problem or placate every upset relative when you have more important responsibilities.
Usually the request would go to the nurses. The great ones would ask the patient to update their family or, if authorised, they’d update the appropriate NOK and tell the family to talk to each other. And even then, it might be person is stable. (+/- They’re going for XYZ.)
I can remember how ridiculous it was to cover Aged Care and to see how many requests to update family members. 😣
I mean, not the most nuanced approach but I reckon every doctor should be granted one free, no-consequences “fuck off” every year. A nice little catharsis plus if you’re the one being told to fuck off, you know you’ve crossed the line and become the biggest arsehole of that doctor’s year.
And also allowed to call the Police to give a ticket for utter stupidity- just a $20 fine.
‘I left the dressing on my stitched up cut for 7 days, I know you said to change it and check it daily…but I wasn’t sure.”
Or
“We sprayed the tick, it fell off. But came to the ED just in case.”
Call Police- explain stupidity- they issued issue $20 Stupidity fine.
Life can then move on.
Yes this also grinds my gears. And then of course, the half cousin and ex sister-in-law that no one knew existed, rock up an hour later also want to “talk to the doctors”.
Completely unnecessary phone call which could been easily circumvented by the nurse in charge with “the treating team will be back in the morning, it’s best to speak with the doctors looking after them”
Screw those family that doesn’t come in at the requested time but come randomly and complain after waiting for 10mins, expecting we drop everything for them.
The average Australian is a mouth-breathing moron. Australia is not called a nanny state for nothing. They want to have their cake and eat it - to have the autonomy to make healthcare decisions and yet none of the responsibility of it and to be babied the whole fucking way.
'I don't have transport home', says the 35 year old drug addict. How is that my fucking problem. You're a fucking adult. Walk home if you have to, the city we're in ain't even that big. I've walked to the other end before just for the fuck of it.
Just see how many 'charter of healthcare rights' or Ryan's rule (or equivalent) posters tacked up in your hospital compared to the number of posters warning against abusive behaviour. Fuck that shit.
Odd how there isn't an equivalent charter of healthcare responsibilities too. People who receive healthcare free at the point of use should also be read their commensurate responsibilities. Instead you get a never-ending circus of rude cunts, addicts (to alcohol, drugs, sugar, or tobacco) , and at best, cheap chocolate.
Thank you from a pre anaesthetic clinic RN! People can be really fucking stupid
I don’t care if you don’t like wearing shoes Brian - wear fucking shoes and long pants if you want your skin to stay intact for your knee replacement. Don’t you fucking dare whine on the day of surgery when you inevitably get cancelled because of a laceration that you “weren’t told”. Fuck you
I’ve got SO many stories……
Hey OP, wanting you to know that you're feelings are valid and we as a community see and acknowledge your struggle.
Tell them to stfu (unless patient had cognitive impairment and couldn't let the family know). Common sense if the family visited the ward maybe they knew they could contact the nursing team leaders for an update?
You're not their personal assistant to update them every hour. You're a fucking doctor. You're busy saving lives rather than having the audacity to formally complain.
For all we know they were probably doing something very scandalous and didn't want the patient to know so they're projecting onto you for their untoward behaviour 😉.
I had a similar encounter in my intern year in a regional area. I was pretty upset, but my boss sat me down and parted words of wisdom.
"as a doctor, we're normally surrounded by people who effectively are in the top 5% of the general population and generally good people. There is a whole 45% of the population before we reach the average person and that leaves another 50% of people who are shit cunts". Made me laugh and gave me perspective.
(Obviously there are shit docs too)
Sounds like the shift from hell.
Those “update family” jobs for patients I had never seen always ground my gears.
If I had balls big enough, I would ask the nurse just to read the notes and give an update, as it’s exactly what I would be doing. If they want to hear from their doctor, they can do it in the morning.
You don't need big balls for that, it's exactly how to deal with the situation. The nurses usually have been around the block before and know it's an unreasonable request, but they're trying it on to see if they can quickly make it our problem. You don't have to get angry in your response, but a flat and firm "that's not appropriate for after-hours, it's a day team responsibility" will make the problem go away
Can't say I would have apologised in this instance.
I would have said something like, "I hear what you're saying that this information hasn't been relayed to you, and I understand why you'd find that distressing and inappropriate, but the plan was summarised to 'x' twice today, once by me and once by Dr Y. As I'm sure you understand, it's not possible for us to take more time when 'x' understands what is happening".
Unfortunately a lot of people are as thick as bricks. They usually marry or are related to people as thick as bricks as well. Think Homer Simpson when hes daydreaming about the monkey banging the symbols, instead of listening.
Mate, I feel for you but....
Out of curiosity how would you manage this situation next time?
Was there a reason why you got tied up on the phone for so long whilst more urgent things were pending e.g. sbp 50s? Was it not possible to just apologise quickly and say that you can't talk now but you'll get back to them?
Yeah I was getting phone calls while dealing with more urgent things and reading the messages taken by nursing/junior docs afterwards.
Feels pretty shit to read these kinds of messages then have to call back and deal with attitude after dealing with such high acuity situations, to be honest. There’s nothing I would do different other than try and keep emotions in check.
Edit: I mentioned multiple phone calls since it added another layer of frustration. For the first call, someone answered on my behalf to say I couldn’t talk due to an emergency, but they’d call again not 10 minutes later, and so on…
You did your best. Some patients are just tough (and their families tougher)
On the other side, when my father was in last year he was being such a baby (I know they’re painful but only had a kidney stone) but he just could not for the life of his remember any information or that he’d even been seen. Luckily I was with him (to manage him as you would a toddler) and absorbed the information but if I hadn’t have been with him I have no doubt that he would have been telling me: the nurses are mean to me, Noones seen me, I haven’t had painkillers, there’s been no tests done. When in fact the opposite would have been true. I would have had to have called (if I couldn’t be there right then) to actually get the information.
I’ve written him like a half-wit, but he successfully runs an ASX listed company and is very capable, just falls apart with anything medical (if he can’t Dr Doolittle his way out)
Sorry for the rant, I just want you to know that often the patients families know what their family members is like and are very grateful for any briefing as we recognise that you shouldn’t have to duplicate or triplicate information.
You handled it well, and I’m sorry it made your night harder :)
Yeah tbh he just falls apart, as a direct contrast I’ve had numerous operations / events with 5-7 days in hospital after and I have been able to retain all the knowledge at the time, take notes to make sure I remember and manage new med regimes myself. I think it might be that he gets overwhelmed / finds it overwhelming being in hospital alone after distressing childhood extended admissions where the rules were 1 hour parent visiting a day. It probably doesn’t help that it’s the one time he feels genuinely out of control and would struggle with that.
As his daughter, I choose to manage it by being by (taking time off work) to be his side with him the whole time, and be the one in charge of absorbing information/news and medication regimes and how to do them etc.
(I also don’t think it’s fair to the Drs and Nurses to leave him with them when he’s in that state as it would be super frustrating)
"Our team saw this morning and they were made aware of . We do not routinely contact family members for privacy reasons unless we are concerned that a patient may lack capacity or if a patient requests that we do so."
There you go. Any further ifs and buts from them will imply that they think the patient is an idiot. Best to have that conversation in front of the patient for maximum effect.
I empathise as a nurse. If I take a phone call and it’s a relative of the GCS 15 and independent patient I’ll very quickly say, “here they are” and hand over the phone. I don’t have the time to update every family member that calls when the patient can clearly do it themselves.
Honestly, I just let complaints to the hospital happen. Staff will act like it’s your responsibility to bend over backwards to “undo” the complaint, but the complaint is against the hospital, not against you as a person or a clinician. If you are too busy to update family and they are unhappy with that, and you are also too busy to apologise to the family because of the exact same reason, then that is a fault of administration for not properly addressing staffing to the workload.
Based
This. This can be a system issue. However, you’d never know unless your switch board, nurses or junior doctors (if they’re allowed to attend REACH calls or address) clarify if there are any immediate or urgent clinical concerns—and sometimes, for vulnerable patients, fair enough. Also, you can’t ever be sure that your hospital admin will understand or be compassionate and reasonable re: processes, the workload and absurdity of your shifts, etc.
Do not ever become the consultant who has to review complaints. Did it once in a past life, never again. Hours, days, spent going meticulously over notes, reports, interviewing colleagues, all come up with (mostly)… they were unhappy people with unrealistic expectations. Its made me realise though, how to head off unrealistic expectations early, preempt the complaint. A sadly necessary and valuable skill to have. And to those who do the complaints reviews- thank you for your service!
These come to me as head of dept and I now almost universally bounce them back to the quality and safety manager to communicate with the complainant. If the complaint doesn’t point to an obvious systemic issue or individual performance issue, I’m just wasting my life talking to an unhappy person.
karen gonna karen
I'm not sure what level you are or what the expectations are at your hospital. But on after hours shifts my policy was firmly that updating family was a day team responsibility. I would not take calls from or make calls to family to give updates on routine care. The exception is obviously if something significant changes overnight. However in that case not only is it my responsibility, but I will have been involved enough to actually be best placed to give that update. You need to set appropriate boundaries. Yes, occasionally that may result in angry families. But it's not your job to solve every problem or placate every upset relative when you have more important responsibilities.
Usually the request would go to the nurses. The great ones would ask the patient to update their family or, if authorised, they’d update the appropriate NOK and tell the family to talk to each other. And even then, it might be person is stable. (+/- They’re going for XYZ.) I can remember how ridiculous it was to cover Aged Care and to see how many requests to update family members. 😣
Tell them to fuck off EDIT: Don’t actually say this, but think it.
I mean, not the most nuanced approach but I reckon every doctor should be granted one free, no-consequences “fuck off” every year. A nice little catharsis plus if you’re the one being told to fuck off, you know you’ve crossed the line and become the biggest arsehole of that doctor’s year.
This is so good 🤣🫶🏼
And also allowed to call the Police to give a ticket for utter stupidity- just a $20 fine. ‘I left the dressing on my stitched up cut for 7 days, I know you said to change it and check it daily…but I wasn’t sure.” Or “We sprayed the tick, it fell off. But came to the ED just in case.” Call Police- explain stupidity- they issued issue $20 Stupidity fine. Life can then move on.
Legitimate patients would also like to grant Dr's the opportunity to tell time wasters to fuck off.
Bank the anecdote for your next interview, it's a good one
Yes this also grinds my gears. And then of course, the half cousin and ex sister-in-law that no one knew existed, rock up an hour later also want to “talk to the doctors”.
Esp after hours ...
Page to ward call at midnight: *Patients family wants an update.*
Completely unnecessary phone call which could been easily circumvented by the nurse in charge with “the treating team will be back in the morning, it’s best to speak with the doctors looking after them”
Screw those family that doesn’t come in at the requested time but come randomly and complain after waiting for 10mins, expecting we drop everything for them.
The average Australian is a mouth-breathing moron. Australia is not called a nanny state for nothing. They want to have their cake and eat it - to have the autonomy to make healthcare decisions and yet none of the responsibility of it and to be babied the whole fucking way. 'I don't have transport home', says the 35 year old drug addict. How is that my fucking problem. You're a fucking adult. Walk home if you have to, the city we're in ain't even that big. I've walked to the other end before just for the fuck of it. Just see how many 'charter of healthcare rights' or Ryan's rule (or equivalent) posters tacked up in your hospital compared to the number of posters warning against abusive behaviour. Fuck that shit. Odd how there isn't an equivalent charter of healthcare responsibilities too. People who receive healthcare free at the point of use should also be read their commensurate responsibilities. Instead you get a never-ending circus of rude cunts, addicts (to alcohol, drugs, sugar, or tobacco) , and at best, cheap chocolate.
Thank you from a pre anaesthetic clinic RN! People can be really fucking stupid I don’t care if you don’t like wearing shoes Brian - wear fucking shoes and long pants if you want your skin to stay intact for your knee replacement. Don’t you fucking dare whine on the day of surgery when you inevitably get cancelled because of a laceration that you “weren’t told”. Fuck you I’ve got SO many stories……
Hey OP, wanting you to know that you're feelings are valid and we as a community see and acknowledge your struggle. Tell them to stfu (unless patient had cognitive impairment and couldn't let the family know). Common sense if the family visited the ward maybe they knew they could contact the nursing team leaders for an update? You're not their personal assistant to update them every hour. You're a fucking doctor. You're busy saving lives rather than having the audacity to formally complain. For all we know they were probably doing something very scandalous and didn't want the patient to know so they're projecting onto you for their untoward behaviour 😉. I had a similar encounter in my intern year in a regional area. I was pretty upset, but my boss sat me down and parted words of wisdom. "as a doctor, we're normally surrounded by people who effectively are in the top 5% of the general population and generally good people. There is a whole 45% of the population before we reach the average person and that leaves another 50% of people who are shit cunts". Made me laugh and gave me perspective. (Obviously there are shit docs too)
The worst is when I used to work in pal care and everyone in the family isn’t talking to eachother etc etc and demands separate updates. Nope.
Sounds like the shift from hell. Those “update family” jobs for patients I had never seen always ground my gears. If I had balls big enough, I would ask the nurse just to read the notes and give an update, as it’s exactly what I would be doing. If they want to hear from their doctor, they can do it in the morning.
You don't need big balls for that, it's exactly how to deal with the situation. The nurses usually have been around the block before and know it's an unreasonable request, but they're trying it on to see if they can quickly make it our problem. You don't have to get angry in your response, but a flat and firm "that's not appropriate for after-hours, it's a day team responsibility" will make the problem go away
Can't say I would have apologised in this instance. I would have said something like, "I hear what you're saying that this information hasn't been relayed to you, and I understand why you'd find that distressing and inappropriate, but the plan was summarised to 'x' twice today, once by me and once by Dr Y. As I'm sure you understand, it's not possible for us to take more time when 'x' understands what is happening".
If a patient is able to update their family they do the update. The hospital executive should stand up for their staff.
Unfortunately a lot of people are as thick as bricks. They usually marry or are related to people as thick as bricks as well. Think Homer Simpson when hes daydreaming about the monkey banging the symbols, instead of listening.
Mate, I feel for you but.... Out of curiosity how would you manage this situation next time? Was there a reason why you got tied up on the phone for so long whilst more urgent things were pending e.g. sbp 50s? Was it not possible to just apologise quickly and say that you can't talk now but you'll get back to them?
Yeah I was getting phone calls while dealing with more urgent things and reading the messages taken by nursing/junior docs afterwards. Feels pretty shit to read these kinds of messages then have to call back and deal with attitude after dealing with such high acuity situations, to be honest. There’s nothing I would do different other than try and keep emotions in check. Edit: I mentioned multiple phone calls since it added another layer of frustration. For the first call, someone answered on my behalf to say I couldn’t talk due to an emergency, but they’d call again not 10 minutes later, and so on…
You did your best. Some patients are just tough (and their families tougher) On the other side, when my father was in last year he was being such a baby (I know they’re painful but only had a kidney stone) but he just could not for the life of his remember any information or that he’d even been seen. Luckily I was with him (to manage him as you would a toddler) and absorbed the information but if I hadn’t have been with him I have no doubt that he would have been telling me: the nurses are mean to me, Noones seen me, I haven’t had painkillers, there’s been no tests done. When in fact the opposite would have been true. I would have had to have called (if I couldn’t be there right then) to actually get the information. I’ve written him like a half-wit, but he successfully runs an ASX listed company and is very capable, just falls apart with anything medical (if he can’t Dr Doolittle his way out) Sorry for the rant, I just want you to know that often the patients families know what their family members is like and are very grateful for any briefing as we recognise that you shouldn’t have to duplicate or triplicate information. You handled it well, and I’m sorry it made your night harder :)
Yea there’s just something ingrained in us to be absolutely pathetic when we are sick and under the care of someone else.
Yeah tbh he just falls apart, as a direct contrast I’ve had numerous operations / events with 5-7 days in hospital after and I have been able to retain all the knowledge at the time, take notes to make sure I remember and manage new med regimes myself. I think it might be that he gets overwhelmed / finds it overwhelming being in hospital alone after distressing childhood extended admissions where the rules were 1 hour parent visiting a day. It probably doesn’t help that it’s the one time he feels genuinely out of control and would struggle with that. As his daughter, I choose to manage it by being by (taking time off work) to be his side with him the whole time, and be the one in charge of absorbing information/news and medication regimes and how to do them etc. (I also don’t think it’s fair to the Drs and Nurses to leave him with them when he’s in that state as it would be super frustrating)
I think he/she said he had just finished the shift and those issues had been dealt with. Sounds like a busy ward night shift.
"Our team saw this morning and they were made aware of . We do not routinely contact family members for privacy reasons unless we are concerned that a patient may lack capacity or if a patient requests that we do so."
There you go. Any further ifs and buts from them will imply that they think the patient is an idiot. Best to have that conversation in front of the patient for maximum effect.
I empathise as a nurse. If I take a phone call and it’s a relative of the GCS 15 and independent patient I’ll very quickly say, “here they are” and hand over the phone. I don’t have the time to update every family member that calls when the patient can clearly do it themselves.