You Know It's True - Just Don't Say It!

Every nurse has experienced patient that just... Oh, but, that's not professional to say or even think that way! Nurses Announcements Archive Article

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You Know It's True - Just Don't Say It!

As nurses, we're taught that every patient has challenges, rights, and deserves our respect. And, this is true. But, it's also true that not every patient is respectful, cooperative, or just nice. Nurses are taught that we must be "therapeutic" in providing care; and we must learn to "put the patient's needs first."

Many nurses do this everyday-we put our patients first, and push our needs to the back burner. We can't even go to the bathroom or enjoy our break, off the floor, much of the time, because we are doing just that-putting our patients' needs first. If we're honest, more often than not, as nurses, we are working through most of our shift non-stop, from the time we hit the clock, and even, after we hit the clock, our thoughts and minds are scattered with so much information and data bits that we can't even get a good night's sleep. And, I won't even mention trying to get a decent vacation without getting that infamous phone call, "Are you able to work an extra shift?"

But, can I be real? Or, am I being selfish, petty, or "un-therapeutic" when I say some patients can be a real you-know-what!

I know I'm not sounding professional and maybe I'm not being the bigger person. But, that's just it-I AM a person, with feelings, too. It's not that a particular patient can drive me crazy or be so difficult, rude, and downright indignant, what's more frustrating is when I go out of my way to provide the best service, the best communication, and prioritize my time to make sure I check-in on this patient a little more, purposed with a smile, and then this patient is still not satisfied.

Also, it seems that in many cases, patients like this are not acting our or responding to their pain or present condition. No, these patients are acting like this because this is who they are-this is their personality. Even more, when I document the patient's rudeness and disrespect, supervisors and managers do or say nothing, nilch, nada! That is the ultimate form of professional disrespect, in my never-to-be-humble-opinion.

Yes, we've all had stressful days and some days we just wanted to walk off the job. But, I believe the silence on dealing with these type of patients is contributory to the burn out and job dissatisfaction experienced by nurses and documented in many research studies.

Research has recorded nurses as being, "Stressed out," "under-staffed," and with "too many patients." Also, research demonstrates why some nurses leave their professions because they feel, "burnt out," "dis-respected," "un-appreciated," or even ignored. Nurses have left their jobs or transferred out of a unit because they feel trapped and some nurses have stated they feel their managers and supervisors never defend them. Worse, some nurses feel their managers and supervisors only see them as bodies for the staff or census coverage.

Should we as nurses toughen up? Maybe, in some cases we should. But, as professionals, we must be able to discuss touchy subjects with our colleagues and managers, and expect that they will listen. As professionals who want to better our units and our profession overall, we must be able to provide viable solutions that are able to address real-time issues when they happen. Sometimes, those issues include sensitive events regarding our therapeutic relationships with our patients.

Please, nursing profession, if we want to attract and retain good nurses, who are happy with their jobs and feel connected to a unit, employer, profession, then, please, let's start having real conversations about issues that no one wants to talk about. Silence is not always golden!

Eschell2971 is an RN, currently working on a busy med-surge unit!

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middleagednurse

554 Posts

Specializes in nurseline,med surg, PD.

This whole customer service thing is so over done. Yes, people should be treated with respect, and that includes nurses and other health care providers. Letting patients get away with disrespecting and abusing their healthcare providers needs to come to an end. If a patient chooses to be uncooperative or demanding they should be discharged. And if they are sick, too bad.

Specializes in SICU, trauma, neuro.
Many nurses do this everyday-we put our patients first, and push our needs to the back burner. We can't even go to the bathroom or enjoy our break, off the floor, much of the time, because we are doing just that-putting our patients' needs first. If we're honest, more often than not, as nurses, we are working through most of our shift non-stop

I agree completely; we need to put on our own O2 mask before assisting other passengers. There is nothing professional or virtuous about holding our bladder or going a whole shift with no food/H2O.

Also, it seems that in many cases, patients like this are not acting our or responding to their pain or present condition. No, these patients are acting like this because this is who they are-this is their personality. Even more, when I document the patient's rudeness and disrespect, supervisors and managers do or say nothing, nilch, nada! That is the ultimate form of professional disrespect, in my never-to-be-humble-opinion.

I just did my annual training which this year included workplace violence. My hospital considers violence against nurses unacceptable, including verbal violence. Sure we can't fly off the handle and fight verbal abuse with more verbal abuse, but there is nothing wrong with saying "it is not ok to speak to me that way."

Specializes in Hospice.
I agree completely; we need to put on our own O2 mask before assisting other passengers. There is nothing professional or virtuous about holding our bladder or going a whole shift with no food/H2O.

I just did my annual training which this year included workplace violence. My hospital considers violence against nurses unacceptable, including verbal violence. Sure we can't fly off the handle and fight verbal abuse with more verbal abuse, but there is nothing wrong with saying "it is not ok to speak to me that way."

I have told many patients "it is not okay to speak to me that way".

I once had a patient let out a whole tirade of verbal abuse on me and then had the nerve to say, "And YOU have to be nice to me." Well, I must say it was not one of my better days and told him. "No, I don't HAVE to be nice to you! I HAVE to take care of you to the best of MY ability!" And walked out of the room.

Another problem that I have witnessed at my hospital is the lack of consideration for a fellow nurse. It seems some nurses are only concerned with their own patients and will not help another nurse that is struggling. Or leaving tasks that could have and should have been performed prior to the oncoming shift. For example, recently there was an order for PRBC at 0930, and then at 1030 another order for FFP. The nurse informed me at 1920 that she had a really busy day and did not have time to initiate the blood products. The patients Hgb level was 5.2. Oh, yeah, I filed an in-house incident report on that.

Leaving extra work for the oncoming shift is quite common at my work--on both shifts, and it is not considerate. I understand that we have busy days and I don't mind picking up where the other shift leaves off, but putting patients at risk for unfavorable outcomes is not acceptable.

I don't like giving NuLytly, but I will administer it as ordered and not wait until 1 hour prior to me leaving, neither will I give 0600 Lasix at 0659 just because I don't want to toilet the patient before I leave.

OK, I will get off of my soap box now :mad:

Daisy4RN

2,221 Posts

Specializes in Travel, Home Health, Med-Surg.

It is all very true. The problem is that administration only cares about the bottom line, which of coorifice is the almighty dollar. This leaves the bedside nurse with too many tasks to complete on any given day, everyday! The answer? Either stick it out and do the best you can to please both sides (adm and pt) but more importantly take time to care for yourself (take all your breaks, go outside at lunch etc). If you try to please everyone you will drive yourself crazy. When it just becomes too much to bear start looking for a different job before you completely burn out.

Ponynurse

1 Post

I believe that not setting limits is a disservice to patients. We are to provide holistic care, hence why it's important to teach patients social skills, communication skills, and help develop their coping mechanism. Letting them attention seek, yell, curse, bellittle, or swing at us should not be tolerated. We should be able to set limits with consequences. When a person misbehaves anywhere else in society they are not offered a narcotic PEZ dispenser, someone to fluff their pillow, and another to clean up their flung feces.

I can be compassionate towards confused patients, but rude... oh NO!

Specializes in PICU, Pediatrics, Trauma.

Generally speaking, obviously not always, people do not speak to police officers, fire fighters, physicians or the clergy in the way they do with nurses. How many times have I had patients complain to meabout their doctors, only to be sweet as pie when that same physician walks in? I can't count. It is a respect issue? The roots of which I cannot explain fully. Are we considered "service personnel"? Is it because traditionally, it has been a women's profession?

I am not saying I agree with these as excuses, just wanting to figure out the cause.

Mhsrnbsn

104 Posts

Specializes in Huntingtons, LTC, Ortho, Acute Care.

I feel like what really needs to happen is that anytime a patient becomes rude or disrespectful, it is time to switch nurses.... It could be a personality issue, it could be just the way you look.... I had a patient treat my like the dirt on their shoe my first shift with him, and in the middle I said to them, "sir I am being nothing but nice to you, I need you to stop being rude..." His response "you look just like my ex wife and are probably a bish just like her"... Sometimes the nurse honestly does NOTHING wrong, and it's a patients prejudices that create the perfect storm for a shift from hell.

At least on my unit... No one even offers to switch when a patient is horrible because they don't want to inherit that headache... And the only time patients assignments change is when a patient or family member requests it. THIS needs to stop... I had that horrible man for three days, I told my charge nurse I didn't want him as a patient and why, and our conversation, on day two... Her response was that "continuity of care is important, and you can't deny a patient just because you don't get along"... And guess what still had to meet with my unit manager cause surprise surprise he also filed a complaint about me.

I thoroughly documented our interactions and his treatment of me, and even documented that even at caregivers request the charge nurse refused to change assignments. We need to stop being selfish, we need to band together. NO ONE wants to be abused mentally emotionally, verbally... But to let one nurse take the brunt of it for three days straight because you don't want to deal with it, is just not acceptable. I even asked co workers to switch a patient out despite my charge nurse telling me no and they all left me to hang in the wind. When it comes to difficult, rude, demeaning patients sadly we should share the wealth.... No one should have a patient that is that taxing multiple shifts in a row, and who knows... The other nurses may have loved him, he was medically not a complicated person... Just a horrible personality.

Leonardo Del Toro, RN

1 Article; 730 Posts

Specializes in "Wound care - geriatric care.

"Here is your room sir"

"Now...do you know what the hell you're doing, you better know what you doing!"

"Ok sir, anything else I can do for you"

"Well of course there is. You better but this bed in the right place"

Looking for the pedal to move the bed I look down, and can't find the pedal, and of course I can't find it because the bed doesn't have any pedals

"Now you see what I'm talking about, this nurse has no idea and doesn't know what d f*** he is doing"

"You better do this job right because you have no idea of what I'm going to do to you"

"I'm sorry sir I need to leave now... actually I don't have time to help you anymore because the only time I "would" have to help you will be spent charting every detail of what an A****** you are"

Of course that last sentence I didn't tell him.

I agree completely; we need to put on our own O2 mask before assisting other passengers. There is nothing professional or virtuous about holding our bladder or going a whole shift with no food/H2O.

I tell people this all the time and they look at me like I'm nuts.

No one will tell me I can't pee, and if you don't take two minutes to go pee or even only 15 minutes to eat (we've all had those shifts - and we've all had that shift where it's just not possible, I get that) you have only yourself to blame.

cagjlg

31 Posts

No one should have a patient that is that taxing multiple shifts in a row, and who knows... The other nurses may have loved him, he was medically not a complicated person... Just a horrible personality.

This is exactly why we have some patients who are assigned to a different nurse every shift. Personality issues are real & it's better for the patient AND staff if there is a rotation.

Specializes in Emergency.

Well...sadly since corporations now drive healthcare, and if we "must" use the standard customer service bull***...then the "customer" is NOT always right...simply put...in any "retail" scenario, there is...always has been and always will be horrible people...corporate America cares very little for actual customer satisfaction...only profit...ONLY! We simply gave it all away hence we have reaped what we have sewn...welcome to the oligarchy.