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  • 29

    You had a patient that presented to the ED stating they had attempted suicide. You seem to think that because his drug screen came back negative, he doesn't have a psych issue. Just the fact that he went to the ED and said he had attempted suicide should be enough for you to assume a psych issue.

    Then your behavior toward him caused him to escalate from ignoring you to screaming and punching himself in the head.

    You stood there and mocked him by saying he was pathetic and his behavior was terrible. How did you think that would de-escalate the situation?

    Other staff had to call security for a patient who had been calmly talking to his friend until you started lecturing him and demanding he respect you.

    What part of this interaction do you think you handled well?

    Yes. His behavior was inappropriate. He is not the professional. You are.

  • 17

    There's a time and a place to have someone face the consequences of their actions. This wasn't it.

    By setting up a you-against-him atmosphere, and lecturing him in front of his mother (did you really think she was going to thank you? That's a family dynamic you aren't going to get close to unraveling in an acute care setting), what you did was ensure that he wasn't going to tell you anything, and mom was going to request another nurse.

    You say he wasn't really trying to kill himself. Maybe not, but something happened to induce the behavior. That's what the Psychiatrist and counsellors are for.

    Believe me, over the years I've had rude, obnoxious, and snotty patients and family members. I've practically shredded my tongue at times holding reactions in. Yes, he was rude and disrespectful. Sounds like it's pretty much his MO.

  • 16



    Not a great situation!

    Sometimes we have to be mindful of our own pts and families and the different backgrounds and situations that they come from; when it comes to an admission where a psychosocial issue is at the forefront, you even have to take pause before diving in.

    I agree about the cellphone issue, however, the eye contact could've been feelings of shame or embarrassment; along with other internal and external issues resulting in maladaptive behavior that we have nothing to do with us.

    My issue is from your own post:

    Quote from hwknrs
    Tonight I got a 20 y.o. pt from the ED who came in saying he tried to harm himself by benzo OD. A&O drug screens neg. I went to his room to check vitals and get his admission history done. He was talking to his friend and did not stop to respond or even acknowledge that I had entered. he complained that he wanted to be released ASAP in the AM and that he didn't even have his cell phone charger with him. When I asked for his emergency contacts he sighed and rolled his eyes at me then went back to talking to friend. Then mom came in from the hall. Pt then started playing with his cell phone and would not make eye contact. Just incredibly rude and snotty. I asked him to please put his phone down, show some respect and make eye contact so we could get this done
    The bold and

    At that I told him it looks as though he has a lot of growing up to do and said that this is unacceptable behavior how he is acting towards me. I reminded him that he is here because of a choice he made and not to get smart with me as I'm trying to help and it's not my fault that he's here.
    There could've been a more levelheaded response for addressing his needs, even if they weren't the priority; you response interpreted to him (even though he was wrong) was dismissive; then to reduce what was the cause of his behavior and his admission was also dismissive.


    Words and tone are important; sometimes we have to remain even keel even when others are being nasty.

  • 14

    Quote from hwknrs
    Obviously his mother has never told him this is wrong and I beleive that SOMEBODY needed to let him know this is not right.
    Yes, somebody needed to tell him. You are NOT that somebody.

  • 11

    I read this article on CNN yesterday. Ok, if it is correct, what do we do about it? It sure gets the public up in arms, but changes need to come from the top and the article I read gave very little advice related to solving this problem (well except for recommending patients question their Dr or nurse). I work in acute care and give the best and safest care I can possibly give. I give everything I have for my patients. I also have spoken out to administration concerning staffing, acuity ratios, unsafe conditions, etc. I critically think and prioritize. What else can I, and other hard working nurses possibly do?? Nurses are human, physicians are human.

    If the public wants to solve some of this issue, maybe they need to support nurse ratios. Perhaps they could fight Press-Ganey and let the nurses handle real issues, instead of harping on getting ice or a warm blanket quickly. Maybe some of the customer service BS could go bye-bye.

  • 11

    I would have documented his behavior, deferred the admission history, assessed him and moved on. Remarking that he's got a lot of growing up to do, especially in front of his mother was a sure fire way of ramping him and the mother up.


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