A patient's family members come in all shapes and sizes and temperaments. The most important thing you need to remember is that they will have their own set of issues and coping mechanisms related to the patient's illness as well. They could also be the major focus of your nursing care plan if they present the problem with the highest priority.

Where Their Anger Comes From

A lot of times, family members will be your best allies in dealing with and helping the patient. They are often the primary caregivers. They know the patient best and can interpret and translate why the patient is having a certain reaction or isn't coping with a situation.

However, there will always be those who have no coping skills at all, cannot fathom that their loved one has this disease or illness, and wants everything (usually the most impossible things) done right now! They are never present when the physician is there or decisions are made, but appear at the most inopportune moments demanding a full explanation of everything that has been said or done in their absence.

This difficult person will flex his muscles, make multiple unreasonable demands, and threaten to have your head on a platter at the drop of a hat. All this is usually based in fear, misunderstanding, and feelings of inadequacy. Peel away the layers and you will discover the basis for his outbursts and anger.

Listen to Them

Communication does not always have to be verbal. When you listen to what someone else has to say you show respect and you validate their right to have those feelings. Sometimes they just need to hear themselves say something out loud in order to better understand it themselves. Sometimes they just want someone to listen to them vent. And sometimes they need you to listen and to help them sort out their feelings and find solutions.

What they don't need is for you to take the situation personally and react. If they are accusing or blaming you for a situation, they don't need or want excuses or reaction from you. They probably don't want an apology. You are not the problem, you are just the messenger. They just want it fixed. They want to know how to cope, how to make it better, how to accept it, how to regain control over this feeling of helplessness.

Listen and then ask what you can do to help them and be sure to enlist their help in fixing the situation.

Keep Them Informed

Many times problems can be avoided by anticipating needs and keeping patients and family members informed. Give them an approximate schedule of the day's events. If a family member wants to speak with the physician, let the person know what time the doctors typically make rounds. This is usually in the early morning and could be well worth the family member missing a few hours of work to get some important information. If this isn't possible, encourage the person to speak to the doctor's nurse and find out when he typically returns phone calls. Many times, physicians return non-emergency calls after hours. Usually family members have left work by then, are on their way to the hospital, and are at the boiling point! Have the family member leave a note for the M.D. with the patient, or you can place the note on the chart for the doctor. Of course, you'll need to understand your facility's rules about HIPAA and other privacy issues and have any necessary authorizations available as well.

In most cases, you'll defuse a lot of explosive situations just by listening and validating the person's right to be upset or afraid. Let him know that you are there to help and that you are on his side. Empower him by making him part of the team and giving him some responsibility.