How to Deal with Difficult Family Members in ICU: Advice from Healthcare Professionals

Dealing with a difficult family member can be very challenging, especially during an Intensive Care admission. It is important to remember that you are not alone!

Healthcare professionals deal with difficult family members all the time and have learned how to handle the situation with grace. We will discuss some tips from experienced healthcare professionals on how to deal with difficult family members in ICU.

Table of Contents

What to do when you're faced with a difficult family member in ICU

Remain Calm

First and foremost, try to remain calm. This can be difficult when you’re feeling stressed, but it’s important to remember that you’re the professional and you need to set the tone.

Understand their Viewpoint

Next, try to understand where they are coming from. It can be helpful to put yourself in their shoes and understand that they are probably feeling scared and helpless. For example:

  • A mother may worry about a child who may experience a limp due to an injury and get teased in school.
  • A husband may worry that his wife’s injury she sustained while working may not heal and the family will experience financial troubles.
  • A daughter might worry about her elderly father will not recover after a fall that has required him to have hip surgery when he was previously independent.

Establish Empathy and Connection

Once you’ve established that empathy, you can start to have a conversation with them about their concerns. It is important to listen to what they are saying and not dismiss their fears. Phrases that experience empathy includes:

  • “It sounds like you’re really worried about X.”
  • “This must be so difficult for you.”
  • “I can see how that would be scary.”
  • “I know what it’s like down here and you are not alone.”
  • “It sounds like you are doing everything you can.”

Brene Brown has said that “empathy has no script. There is no right way or wrong way to do it. It’s simply listening, holding space, withholding judgment, emotionally connecting, and communicating that incredibly healing message of ‘You’re not alone.'”

Address the Family’s Concerns

After you’ve listened to their concerns, you can start to address them. It is important to be honest and upfront with them. They need to know that you’re doing everything you can to take care of their loved one.

  • Address their treatment plan with the patient and family: “We’re going to be doing X, Y, and Z for the next 24 hours.”
  • Give the family updates on their loved one’s condition: “They are currently stable and we are monitoring their condition closely.”
  • Give the family a general idea of what to expect: “It’s common for patients in ICU to experience X, Y, and Z.”

Establish Boundaries

It’s also important to set boundaries with them. They need to know that they cannot control everything and that you are the expert in this situation.

One way to set boundaries with difficult family members is to be clear about what you can and cannot do. You need to be the expert in this situation and they need to understand that they cannot control everything. It is important to be honest with them and tell them what you are doing and what you are not doing. This will help to ease some of their stress.

Another way to set boundaries is to establish time limits for your conversation. It is important for both you and the family member to get some rest, so try and keep the conversations short and sweet. One big key piece of advice is to establish a spokesperson for the family. This is the one person who can call the ICU to get updates and will provide the updates to the other family members. This will limit the number of calls and discussions regarding the patient so you can provide the care they need.

Finally, it is important to remember that you are not alone! There are many resources available to help you deal with difficult family members in ICU. The hospital social worker can be a great resource as well as the spiritual care team.

Ways to stay calm and collected during this difficult time

  • Don’t take what the family is saying personally – It is important to remember that the family is going through a lot of stress and they are not thinking clearly. They are likely to say things that they do not mean. Try to take what they are saying with a grain of salt and do not take it personally.
  • Maintain distance when the situation is escalating – Sometimes, the best thing to do is to walk away from the situation. This can be difficult to do, but it is important to remember that you cannot reason with someone who is angry. If the situation is escalating, it is best to walk away and come back when they have calmed down.
  • Have a colleague come as a second witness if you have set boundaries and they continue to be difficult – If you have set boundaries with the family member and they continue to be difficult, it is important to have a colleague come as a second witness. This will help to show the family that you are serious about the boundaries and many times this helps to de-escalate the situation.
  • Find a support person to vent to – It can be very easy to feel overwhelmed in the Intensive Care Unit (ICU). There are a lot of emotions flying around and it can be difficult to keep calm. It is important to find someone to who you can vent to about the situation. This can be a colleague, friend, or family member. It is important to have someone who will understand what you are going through and can offer support.
  • Take breaks when you need to – It is important to take care of yourself during this time. Make sure you are taking breaks when you need to. This can be a quick walk outside, grabbing a cup of coffee, or taking a few deep breaths. If you do not take your breaks, it will be very difficult to handle a patient’s family member who is yelling at you for answers.
  • Eat healthy and drink lots of water – This will help to keep your energy up and your mind clear. When you are well-rested and have a clear mind, it will be easier to deal with difficult family members.

Don't Let the Family Members Bully You

Don’t let family members bully you with their demands. Your focus is on maintaining the patient’s stability and do not succumb to the requests of a ridiculous family member.

If you find that a family member is impeding your ability to provide patient care, it is perfectly acceptable to tell them to wait until after you have finished your tasks before engaging in a difficult conversation. You will never lose your job over prioritizing patient care.

If you have a difficult manager who does not support you in setting boundaries with families, document everything. This will help you if you ever need to take the issue up with a higher authority, if you need to file a complaint, or if you leave your position.

No one deserves to be treated poorly, especially not when they are trying to help someone in need. Remember that you are not alone in this and there are resources available to help you deal with difficult family members.

This advice is not meant to scare you as many family members are easy to deal with but this should help prepare you for the occasional difficult one.

If you have any tips on how to deal with difficult family members in ICU, please share them in the comments below!

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