Customer Service? Maybe on your home planet.

Nurses Relations

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I usually have a high tolerance for rudeness and inappropriate behavior, but yesterday I reached my limit. This patient is always verbally abusive toward staff, speaking with an acid tongue and tone. He claims that the nurses write down the wrong time in the narc book. "No, she didn't give it to me at that time. Your clocks are all wrong; none of them say the same time."

The man has nothing nice to say, regardless of the issue.

Yesterday, I finally grew tired of apologizing for something I didn't do, and called him on his behavior, stating, "You are being rude. Do not speak to me that way."

He retorts, "I just give what I get. You nurses are always rude to me."

I reply, "I am never rude to you. In fact, I hardly say anything to you because you have nothing nice to say in return."

He says, "You were rude to me just now." "If I sense a sarcastic tone, I will be sarcastic right back."

I say, "I was not sarcastic toward you, and I do not deserve to be spoken to the way that you speak to people."

It turns into a bit of back and forth, and then I realize, what is the point? In no way do I want to be having an argument with this man, but I am tired of being treated like ****. Some people, sick or not, are just jerks. If I weren't in the professional atmosphere, I would have told this guy off. No joke. I have been around enough people that are verbally abusive to be able to put them in their place. However, I somehow do not defend myself in the professional atmosphere for fear of repercussions from management.

Now, I have never been written up nor do I want to be, but it was at the point with this patient that I was thinking, Oh well, if I get written up for refusing to be treated poorly, so be it. Then I realize, this guy was probably raised without any manners to begin with, and my "educating" him now is not going to change anything.

Funny thing is, later he winked and smiled at me. What the heck was that? Now he was being nicer to me? He still had the same verbally demanding and demeaning tone when asking for pain meds though from his PO med nurse.

Anyhow, I still haven't reached a "happy medium" when it comes to dealing with this issue. I know there has been ongoing debate on AN regarding the "customer service" attitude. Funny, the first thing this patient said when I refused to tolerate the behavior was, "The customer is always right." Wrong.

This is a reply to the earlier poster who stated that the patient does not owe us anything.

I beg to differ. The patient owes me the bare bones of respect. Not because I'm special, but because I'm a fellow human being and one who is trying to help him recover. I am not some football he can kick around.

And before someone remarks that the patient is paying my salary, I reply that, in many cases (and especially for the frequent flyers, who are also usually the most rude and entitled), my taxes are going to Medicare to help pay his hospital bill.

Specializes in Med/Surg,Cardiac.

I am able to show respect to everyone, but there are a couple of situations in my head now that I must say were difficult to tolerate :

1) patient has pain meds q2h. Meds were prescribed for muscular pain secondary to a ridiculously high potassium that was resolved 3 days ago. The 4th time I'm in the room, the patient, who has been rude and demanding all night, complains that his medication isn't being given exactly on the hour every 2 hours. I calmly explain that we do the best we can to bring medications when available, but situations arise with other patients that must be handled. I offer a blameless apology but the patient continues to yell at me for being 2 minutes late. I end up showing him the emar and stating "the most time your meds have ever been given away from exactly when you could have it is 11 minutes. He then sarcastically rolls his eyes while telling me to push his demerol quickly. I push it over a good 5 minutes and he complains the whole time and tells me that I'm a terrible nurse and when I give it slow it doesn't make his pain as decreased. Ugh. Annoying. And disrespectful.

2) patient is NPO for a CT at 700. He wakes up at 5 and throws a fit stating he will leave AMA if I don't either give him food or give him something strong to knock him out. I tell him that I'd be happy to call the doctor but there aren't many things they will give you to help you sleep another hour. I also tell him that most insurances won't cover your hospital stay if you leave AMA. He tells me loudly that Medicaid will pay and he will be back some other time and cussed me out. I ended up begging for some benadryl and gave it to him.

I deserve more respect than bring cussed at for being 3 minutes late with medicine and for keeping you NPO for a test you need. It is difficult to keep composure with entitled patients.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

Specializes in Pediatrics, Emergency, Trauma.
This is a reply to the earlier poster who stated that the patient does not owe us anything.

I beg to differ. The patient owes me the bare bones of respect. Not because I'm special, but because I'm a fellow human being and one who is trying to help him recover. I am not some football he can kick around.

And before someone remarks that the patient is paying my salary, I reply that, in many cases (and especially for the frequent flyers, who are also usually the most rude and entitled), my taxes are going to Medicare to help pay his hospital bill.

^Agreed...and last time I checked, my salary is based on merits and pt trends, NOT necessarily the pt...regardless, RESPECT is upmost to an interaction. I firmly believe that a rude pt can almost certainly transform into a violent pt...if they don't respect the person who is taking care of them, then what makes anyone think that they won't attack...

As for the comment that we OWE pts such and such...come back after a pt slaps you or they throw something at you.I find most rude pts that transform into "action" attack the ones who do tend to go the extra EXTRA mile...it's a form of control.

As for the ones who complain and want to sign out AMA...no problem...get the house sup and DR on call. You can't always enlighten irrationality. Let them scream and holler at the hospital when they get the bill from Medicare, Medicaid, and their insurance company. Most times those pts are calling a bluff...and some really don't care at all...hospital still gets paid, even at least 60-80%. Something is better than nothing, in exchange for

a pt who wants to wreak havoc...if they want to go home or risk dying on the street, it is their choice.

Customer service is something many nurses dont really grasp. Once you get on the wrong foot with anyone in any business it is very dificult to turn it around. As far as going ama, I would not try to stop anyone or threaten them with loss of insurance which is something I dont really have control of. Why would you push the medicine over 5 minutes? To punish yourself and the patient?

Specializes in Critical Care.
Customer service is something many nurses dont really grasp. Once you get on the wrong foot with anyone in any business it is very dificult to turn it around. As far as going ama I would not try to stop anyone or threaten them with loss of insurance which is something I dont really have control of. Why would you push the medicine over 5 minutes? To punish yourself and the patient?[/quote']

Bc sometimes it is the little victories in my day that make it tolerable. If someone is clearly drug seeking and rude, as opposed to a chronic opiate tolerance due to a condition, then I will not be some " street pharmacist" and get them high.

Having a patient tell me to "push it fast" almost puts in stone the next time they are "due" for pain rx I will take a potty break first.

Pt care is not a war requiuring victories. We attempt to provide services to maintain and preserve health. Some people are more compliant than others. There is an apropriate speed to push any medication and lenthening it for personal satisfaction is not profesional.

Specializes in Med-Surg.

Well see that's the thing. If you go in any other business and give them attitude, yell, swear, threaten, or actually physically attack, what happens? You get thrown out at the very least, might be told never to come back, and might even get charges pressed.

How many of you have been insulted, hit, yelled at, or just generally been treated like dirt and had to keep a smile on their face and bend over for more? Come on, show of hands!

And how about another show of hands. From those with their hands up, how many of you have had these patients or family members kicked out? How many of you were allowed, much less encouraged to, press charges when warranted?

People tell you all the time, don't act like a jerk to the person serving you food. How in the WORLD is it ok to do that to someone trying to make you better or save your life?!

Specializes in Med-Surg.

And like others have said, my job is in HEALTHcare. That means that my primary focus is the patient's health. If pushing your meds faster than recommended could cause severe problems, I'm not going to, no matter how much you yell. If handing you that bag of chips would through your dialysed butt into severe imbalances, nope, not gonna happen. If putting you on a bedpan when you are fully capable of walking to the bathroom, or at the very least being rolled there on a commode, would only reduce your autonomy levels, probably delay your discharge because of increased pain re:prolonged immobility, heck, maybe even cause some pressure ulcers...then I'm sorry, but you are going to get up.

You know, I'm not a fan of the whole universal healthcare thing, having worked in it seen how it is. BUT I do have to say that I will miss having the ability to tell a patient 'No' because it goes against what is in their best interest.

Specializes in Pediatrics, Emergency, Trauma.
And like others have said, my job is in HEALTHcare. That means that my primary focus is the patient's health. If pushing your meds faster than recommended could cause severe problems, I'm not going to, no matter how much you yell. If handing you that bag of chips would through your dialysed butt into severe imbalances, nope, not gonna happen. If putting you on a bedpan when you are fully capable of walking to the bathroom, or at the very least being rolled there on a commode, would only reduce your autonomy levels, probably delay your discharge because of increased pain re:prolonged immobility, heck, maybe even cause some pressure ulcers...then I'm sorry, but you are going to get up.

You know, I'm not a fan of the whole universal healthcare thing, having worked in it seen how it is. BUT I do have to say that I will miss having the ability to tell a patient 'No' because it goes against what is in their best interest.

Whoop Whoop!! :)

If in this country we can have the "good" parts of universal healthcare...the power to say "NO" because it goes against the pts best interest, then I'm for THIS, because this system of liaise-faire of the "customer is always right" gets in the way of the true "rights and responsibilities" in the Pt's Bill of Rights for the bottom line in greater than half the instances of escalating issues between nurses and patients.

I never mind reminding my patients of those "responsibilities", ever...no problems ever about that...Very matter-of-factly with lots of empathy...a balancing act I have perfected for years. Most instances, no issues.

It always amuses me when patients set the alarm on their phone to wake them up for their next dose of PRN pain medication:rolleyes:

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