Catching Hell

Nurses General Nursing

Published

I am a Nurse Case Manager fo a major Medicare HMO, and caught the wrath of GOD yesterday afternoon from a Member's son, even though I had nothing to do with our Medical Director's decision to deny placement for her in a skilled facility.I was told to discuss Home Health Care for her with him, and he informed me, among other things, that I was a f----idiot. Every other word was marked with expletives, even though I was trying to help him. It just goes to show that we're blamed for everything..

Put yourself in his shoes,YES,his behavior was unacceptable.But don't you think his situation was also unacceptable to him at this time. Can you not imagine the frustration he was feeling? Don't you think he was afraid for his mother as well as the responsibility he, himself was forced ,due to circumstances, to take upon. How many men are caregivers to the eldery or even the young for that matter. You are the professional. It is your job to eval.the situation. "Well if this doesn't work,here's our options."Case management is an on-going process & maybe this guy needed a little more time to grieve his losing his identity.Sorry to preach,not in your shoes,just seeing the other side.PLK

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I disagree with most of the nurses here. It is NOT okay to be screamed at, cussed at, or made to feel like something less than a human being by ANYONE including the patient or a patient's family member. I personally would have told the caller, "Sir, until you can speak to me in a civil manner, this conversation is terminated. Call me back when you calm down, and we will discuss this further." ... . I am a nurse, a professional, and a human being. I could care less what someone may be feeling, if he or she speaks to me in a profane manner, the conversation is over. Incidentally, I used to be cashier for a major supermarket chain for years, and I was NEVER spoken to in that manner. When I used to work in customer service, we had the support of the management to hang up on an abusive customer. Nurses take alot of flack and get blamed for so many things that are beyond our control... especially by doctors, administrators, and supervisory personnel. This is not something that should be taken lightly or responded to by other nurses with a "suck it up" kind of attitude. It is because of nurses like that nurses are used as punching bags. Do you think they put up with this in the business world? NO!!! But what do you expect from a female dominated profession where women spend more time stabbing each other in the back than helping each other out? I know this will offend some of you, and for that I apologize, but that is how I feel. So Pam, take my advice... don't put up with the abuse... and if you are terminated for not putting up with it, file a wrongful termination suit.

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I've been "spewed" at a few times at least...lol,and in my experience the best way to fight a fire is to cut off the source.

Let them vent,you get paid by the hour.Then when they are at a loss for words(that could take a little while)and they're tapped out just look at them with empathy and say "I understand that you just want to help your mother.If I was in a similar situation I would want a son like you.It must be frustrating,but I want to help you now with what I can.Can I help you now?"

Whose gonna say no to that? Provided that he is silent through your statement,you shut up.

The next time he speaks if he does not answer your question ask it again.don't let him ignore the truth.In reality neither one of you can move on from there with any "posturing".

Get him to focus on the fact that you want to help him help give comfort to his mother.

You're not there to defend the HMO or even your self respect.You are there for the same reason he is there.To give the best care given the circumstances that you both can.

If you can't get to his human side with that then certainly you will have to use a Tazer or some such other electronic "communicator".

lol..lol No seriousely though.Quote:"if you make the bull run at the red flag, make sure you are not standing behind it"

I wish you luck in your "bull fighting".

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Originally posted by NurseMark:

I disagree with most of the nurses here. It is NOT okay to be screamed at, cussed at, or made to feel like something less than a human being by ANYONE including the patient or a patient's family member. I personally would have told the caller, "Sir, until you can speak to me in a civil manner, this conversation is terminated. Call me back when you calm down, and we will discuss this further." ... . I am a nurse, a professional, and a human being. I could care less what someone may be feeling, if he or she speaks to me in a profane manner, the conversation is over. Incidentally, I used to be cashier for a major supermarket chain for years, and I was NEVER spoken to in that manner. When I used to work in customer service, we had the support of the management to hang up on an abusive customer. Nurses take alot of flack and get blamed for so many things that are beyond our control... especially by doctors, administrators, and supervisory personnel. This is not something that should be taken lightly or responded to by other nurses with a "suck it up" kind of attitude. It is because of nurses like that nurses are used as punching bags. Do you think they put up with this in the business world? NO!!! But what do you expect from a female dominated profession where women spend more time stabbing each other in the back than helping each other out? I know this will offend some of you, and for that I apologize, but that is how I feel. So Pam, take my advice... don't put up with the abuse... and if you are terminated for not putting up with it, file a wrongful termination suit.

Nursemark, I agree with you. On my 2nd response to this topic, I indicated that no assaults from anyone should be acceptable.

I'm not completely convinced, in this particular case, that the gender of the nurse is at issue. I've worked in areas, including insurance, where some employers do not have a policy on abusive calls or mistreatment by the public. Therefore, when you go to management to report these problems, in far too many circumstances, the situation gets mishandled-by management, of course. Management will twist the story, fault the employee, and contact the patient or family apologizing on behalf of the hospital or company. It's asinine. That's the reason that so many posters on this bb endorse writing up some type of incident report to cya.

PS: What's worse is that there are employers that DO have policies on abuse and do not enforce them (see other topics).

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Of interest is the below ruling made by the Supreme court of Oklahoma. A similar situation.

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Legal Eagle Eye Newsletter for the Nursing Profession (4)11 Aug 96

The nurse had grounds to refuse further care without legal liability for abandonment of a patient after the patient's son confronted the nurse, threatened the nurse on the phone, and said he would be contacting his attorney.

The patient must be notified there has been a decision to refuse further care and given an opportunity to seek out care from other sources. SUPREME COURT OF OKLAHOMA,1996.

A patient underwent diagnostic testing which revealed she had a herniated disk which would require surgical intervention. However, as the patient also suffered from high blood pressure, atherosclerotic coronary artery disease, angina pectoris and chronic obstructive pulmonary disease from many years of heavy smoking, the surgeon wanted an internist to see the patient to evaluate the safety of going ahead with surgery.

The internist expressed concern over an apparently occluded carotid artery, and advised against surgery, pending further testing. The surgeon sent the patient home for the weekend.

According to the Supreme Court of Oklahoma, the patient's son at this point became irate. He angrily confronted and threatened a nurse in the physician's office. The son later phoned the office, repeated the threatening language, and stated that he was in the process of contacting his lawyer.

The physician, on the grounds that the mutual trust necessary to the physician-patient relationship was no longer present, called the son back, told him he could not offer further care to his mother, and gave him the names of three other physicians to contact.

The court ruled that threatening language or conduct toward a nurse or other caregiver constitutes valid grounds to refuse further care to the patient, without incurring legal liability in a civil suit for abandonment of a patient, assuming that the patient has been notified that further care will be refused and afforded the opportunity to seek care elsewhere. Sparks vs. Hicks, 912 P. 2d 331 (Okla., 1996).

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Pamela A, You incurred the wrath of an angry subscriber, God would be more tolerant. I acknowlege the stress of the situation and tell the person that I will not tolerate the behavior. I have been in mgmt and am back at the bedside. I have a better understanding of what my obligations and resources are. Altho I firmly believe in patient advocacy I believe there is always a way to grease the wheels. I try to pass this on to those who are trying to hoe the difficult path to good health care for their loved ones. Sometimes you just need to point out that certain behaviors give a person minus points. Letting these kinds of experiences run off our backs is never easy, takes practice. Backup from mgmt is key. In any job.

D.

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Natalie-

What an awesome post! It takes an awful lot for me to refuse to care for someone- it has only happened a couple times. But it's nice that someone somewhere is recognizing that health care professionals are not punching bags that can be required to take any abuse dealt out without recourse, including the right to say "no more."

The article says the doc refuses to care for the patient any more but doesn't mention a restraining order so I wonder how much of the reaction was legal and how much was in support of his nursing staff but still, kudos!

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Let's see, is taking verbal abuse in all its' forms listed here in my job description or in the Nightengale Oath? Not on this page. No, not here either....

Oh, then I won't be taking it either. I accept that they are angry but tell them we will discuss it when they are more able to discuss it and walk away.

Oh, and Ruth, I like the idea of door greeter at wal-mart too but it isn't easy. Have you ever looked at a site called walmartsucks.com? Those folks are NOT HAPPY either. It demonstrates that jobs bring terrible stressors and illustrates that people feel very free to vent all over others even (or especially) when it is NOT that persons fault. We are human but my gawd can we not control our mouths and actions just a little bit? Societal issues being what they are, violence in every aspect of life, and the expression of personal rights all over us, drives the poor behaviors we see all around us.

This drivel doesn't solve the problem but I like to express it anyway. I am sorry Pamela that the man had no better way to express his frustration and fear than to throw it all over you. You didn't deserve it. And it is your job to get her the care you can. So you have two choices, get past it or get away from it. We need nurses who can help heal this sick world, but not take the abuse. I hope we find a way.

[This message has been edited by bbnurse (edited February 17, 2001).]

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