do you ever get tired of being treated like crap?

[EDnursetobe]

hi everyone;

the last few nights I had a LOT of difficult patients (super demanding). I do my best to get them everything they need, but I can only do so much... (there's only so much I can do as an RN). I call the doctor and other higher-ups and inform them of situations... but beyond that I can't do much besides comfort measures (i.e. i cant write orders for meds)

Anyway, i think I'm getting really frustrated with being treated like crap... I do my best for patients. I try to provide them comfort. But if the doctor/higher up won't do anything (in terms of medication) then I'm pretty much stuck.

I'm tired of getting screamed at for not having pain medication to give. I'm tired of getting yelled at because the blankets are not thick enough. I'm tired of getting screamed at because the food is terrible...

iughhhh I'm just tired of gettin blamed for every single thing that is wrong with patients...

[~Mi Vida Loca~RN, ASN, RN]

I usually have had good patient experiences, I really can't recall any patients that treated me like crap. Now I recently had a nurse treat me like crap. I stood up for myself though and sometimes that doesn't always work so well apparently.

When it comes to patients though just try to not take it personally. People are hurting, sick, vulnerable etc. etc. Most times they aren't acting how they usually would and it's not personal against you. Sometimes if you can just try to sit down and talk to them. Their might be something else going on and once you get to know them and they see that you care they start acting better. That has always been my experience when I start a shift with a grumpy patient.

[carolmaccas66, BSN, RN]

I know exactly what you mean.

I stated on another ED thread not long ago that the nurses in ED - or anywhere really - get blamed for EVERTHING. I've even had a patient complain that no-one was available to go out and get him his KFC that he always scoffed for lunch - cos that isn't our job & we're busy (duh) and the volunteers had gone home. He honest to god got the NUM, SC & docs involved because of this! If u were in hospital, the last thing you'd be worrying about is ******* KFC!! Unreal.

The only thing you can do, and which I do, is be VERY firm with people, even aggressively polite. TELL them straight - any meds not able to be given by you, or any other complaints - they must see the doc first and tell THE DOCTOR. Deflect it away from you. You are not the be all and end all fixer-upper of everyone's life, but cos ur there, you get it. I always say to people there is only so much I can LEGALLY do - when you start quoting legal terms, they usually shut up & also the ones that nag me to go out 4 a smoke, I always say legally we have a duty of care to you, so no no-one has the time 2 supervise u when ur outside smoking. WE DO NOT HAVE THE TIME PEOPLE! I've actually said straight out to a patient once: we are busy helping people/kids who are very ill or even dying sir/madam and you're not dying! That shut them up quick smart. I was VERY frustrated that day!

I also always inform people if they aren't pleased with the service (or lack of it), they have a perfect right to complain. If they want more staff, they have to lobby their MOP 2 get more for the hospitals, then I usually say I'm it tonight, so basically we're stuck with each other.

We also have signs saying that any violence/rough behaviour/swearing is ZERO TOLERANCE - pain is no excuse - and the police will be called. And we stick to that. You can't just go around abusing people cos u have pain, sorry, I don't buy that for one minute.

Just keep deflecting & do stuff outside of work that relaxes you. Also keep complaining to the NUM, nag him/her if u have to to get help.

[Anna Flaxis, BSN, RN]

I know exactly how you feel. It is indeed tiresome to be griped at for things that are beyond your control.

With some people, you can chalk it up to them not being at their best due to their experiencing discomfort or fear, and if you take a few minutes to ensure that they feel heard and cared about, it can go a long way.

But, for some people, it doesn't really matter. These are the same people that will complain loudly to the wait person at a restaurant if the food takes too long to come, even if it isn't the wait person's fault. These are the same people who will complain to the flight attendant about the turbulence on a flight, or the bank teller if the line is too long, or the cable guy who's running late because the office overbooked him.

To these patients, you are the face of the institution. You are the person they can complain to. You personify all the horrible things they want to gripe about.

What I've found helpful is to make them my ally. I just agree with them. "Yes, the blankets here are horrible. I don't know how the hospital can expect people to feel comfortable with these crappy blankets.", or "Yes, the food here is awful. You'd think a hospital would have decent food.", or "Yes, the stretchers are really hard. It can feel like torture to be stuck on one for very long, but they are great for CPR."

Then I offer to do what is possible for me to do. I might not be able to bring them a *better* blanket, but I can bring them another one. I might not be able to bring them better food, but I can offer to look around for something they might like. I can't make the stretcher softer, but if they are stable enough, I can let them sit in a chair or dangle on the edge, and if they're not stable enough, I can get some extra pillows and try different positioning.

Agreeing with them that things are terrible, then offering to do what I can, even if it's not what they'd ultimately like, seems to work pretty well for most people. Of course, some people won't be pleased no matter what. When it is clear that I'm dealing with this type, I simply explain what I can and cannot do, and disinvest myself in whether or not they are satisfied. After all, I get to go home when my shift is over!

[nola1202]

Well when I learned I was a masochist and got my jollies from being treated like crap, I couldn't get my nsg degree fast enough. I have saved so much money on dominatrix calls.

[sissiesmama, ASN, RN]

Well when I learned I was a masochist and got my jollies from being treated like crap, I couldn't get my nsg degree fast enough. I have saved so much money on dominatrix calls.

He he he!!!!! :smokin:

Anne

[loriangel14, RN]

Fortunately I don't get much of this from patients. Usually my experiences are pretty pleasant.Most understand that these things are beyond our control.Even of some grumble they wouldn't yell.

[R!XTER]

Welcome to nursing...

I find that if they are reasonable, explaining things to them usually helps. Most people do not know the inner workings of the hospital. i.e. "when will my family member be assigned a bed?" answer: there is no way for us to know until the bed is available. Another patient will have to leave, and there is no way to predict when that will happen.

If they are unreasonable, just listen, smile, walk out, and shut the door behind you!

[nurseprnRN, BSN, RN]

remembering this won't stop others' behavior (we can't really control what other people do and feel), but i have always loved eleanor roosevelt's classic: "no one can make you feel inferior without your consent."

[Turtle in scrubs]

It can be super frustrating and emotionally devastating by the end of the day. You have probably tried everything, so this may not be of any help, but I will share what has worked a bit for me.

I try and explain everything and the reason for everything.... ie... "we are in a tough spot as far as your pain medications. While we want to control your pain we also need to take into consideration that too much of your pain medication can kill you".

At the beginning of each shift I come up with a mutual game plan for the day. This gives the patient some control and helps them to be involved in their treatment. ie... Up to the chair for meals. Incentive spirometer 10x q1 hr. Watch the first lovenox injection, and give themselves the second. Titrate O2 down to 2L as tolerated. etc.

I try and put the ball in their court, ie... "so the doctor has adjusted your medications as much as they feel is safe at this time, what else can I do for you that you think may be helpful that we can try... ice, heat, chg of position, pastoral care...etc"

Sometimes when they are just going off continuously I just pull up a chair and say "this is all really difficult for you, isn't it?". Often they just continue their rant.... but sometimes it stops them cold and they realize that all their unhappiness with their illness is just being projected off on me.

Many times I just have to remind myself that people often don't behave their best when they are scared and not feeling well. I would like to think I would be a great patient, but I can't really say how I would behave if I were in their shoes and I just hope when/if the day comes I will have someone who is patient and understanding with me.

But there are always a couple of patients I wish I could throw out the window, stick pillows under the sheets, and hope no one notices until the end of my shift :)

[Munch]

I agree it can be extremely frustrating depending on the day and patient load. When I am on the neurology/neurosurgery floor it can be very difficult to care for patients that are a day post-op. They are angry and it pain and want their pain medication increased, they want sedatives for anxiety or sleep and the only thing I can do is call for the neurosurgeons. Most of the patients aren't chronically ill so the surgeons are careful not to over do it with the medications. I try to empathize with these patients cause I too had neurosurgery(but I was followed by the pain service since I am a chronic pain patient..they had no problem increasing my medication and keeping me comfortable)....but having major surgery especially on your brain/neck is NOT fun or comfortable...and believe me these patients are NOT under medicated...they are cranky and think more medication will help. SO when the patients get testy like I said all I can do is call the doctors, give them warm blankets and pillows, ginger ale or juice if requested and give them pain medication and anti-nausea medication AS SOON AS it's due.

At times I work on the oncology floor and that's even more difficult. Some patients are admitted to the floor after having surgery to have a tumor removed, some are admitted for a post-chemo infection and some are admitted for their chemo treatments(some patients get their chemo as an outpatient but some chemo treatments the patient needs to be hospitalized to get it) and sadly some patients are admitted to be kept comfortable during their final days(though these patients are few are far between, most terminal patients are admitted to a hospice facility or are taken home and have hospice staff come to them). Anyway as far as patients and pain go, the doctors are WAY more liberal with the pain meds and sedatives, most every patient on the oncology unit has a PCA and standing orders for IV ativan, muscle relaxants and ambien for sleep. Also the unit I am on just cares for adults(peds oncology has their own unit as does bone marrow transplant). Its also easier because one nurse is usually assigned 2-3 patients per shift. But still it can get hectic when this one is due for chemo, this ones pain is still not being managed despite high doses of narcotics and sedatives, and this one is puking their guts up despite zofran, compazine and reglan.

No matter what floor I am working on the most frustrating thing of all is when a doctor does change/add orders they have to input it into the computer and sometimes they forget(doctors are busy too) and then I try to page/call them to put the order in and they don't answer until hours later, meanwhile they themselves came in to see the patient and told the patient that they can have more pain medication or something for anxiety. So the poor patient is waiting and asking me for their meds and I can't do a darn thing to help them...then they start yelling and getting mad at me as if I am choosing to withhold their morphine on purpose...man oh man sometimes I want to hide in the linen closet and tell everyone..the patients, doctors, patients family members etc to just GO AWAY.

ALSO my heart goes out to all you ED nurses. I have been in the ED many times(as a patient) and people can be so cruel..especially if they haven't been seen at triage yet or if they made it into the ED but a doctor hasn't gotten around to them yet. I considered being an ED nurse but I couldn't take the abuse.

[TrafalgarRN]

Always put your foot down...i will be stern and tell them that if they can't be polite then i can't help them and they can get another nurse to take care of them or they can sign out and go home and follow up with their doctor. I am polite but if you want to be nasty i will treat you the same. And i will involve my charge nurse who will inform you of the same....and in my hospital we are allowed to write up such patients. I have had people scream and i leave them and tell them when they are ready to be polite and respectful then we can have a meaningful conversation as to how i can help them with their problem. And i will not hesitate to AMA. No grown up should be allowed to abuse you unless they have dementia or are psych. My managers are also for the same and wish all managers would be supportive of their staff. Always document and have witnesses since there are your best friends against accusations.