ER Nurse Attitude

Nurses Relations

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I guess, as a nursing student, my question would be:

Is it more efficient to blow off a client who is seeking reassurance, acknowledgement, and help, and then deal with their mistrust and anger later on when trying to build the therapeutic relationship, only to blame it on them later,

-or-

Is it more efficient to politely, calmly, quickly say that you understand they are worried/upset/frustrated, you will be with them as soon as you absolutely can be, and possibly direct a tech in their direction to get them started, which may circumvent some of their ***** behavior later on?

SionainnRN

914 Posts

Specializes in Emergency Room, Trauma ICU.
I guess, as a nursing student, my question would be:

Is it more efficient to blow off a client who is seeking reassurance, acknowledgement, and help, and then deal with their mistrust and anger later on when trying to build the therapeutic relationship, only to blame it on them later,

-or-

Is it more efficient to politely, calmly, quickly say that you understand they are worried/upset/frustrated, you will be with them as soon as you absolutely can be, and possibly direct a tech in their direction to get them started, which may circumvent some of their ***** behavior later on?

Well if your other pt is LITERALLY dying, I really wouldn't care at that time to placate them as I was trying to save a life. You'll understand better once you're actually on the floor.

dudette10, MSN, RN

3,530 Posts

Specializes in Med/Surg, Academics.
I guess, as a nursing student, my question would be:Is it more efficient to blow off a client who is seeking reassurance, acknowledgement, and help, and then deal with their mistrust and anger later on when trying to build the therapeutic relationship, only to blame it on them later, -or-Is it more efficient to politely, calmly, quickly say that you understand they are worried/upset/frustrated, you will be with them as soon as you absolutely can be, and possibly direct a tech in their direction to get them started, which may circumvent some of their ***** behavior later on?
IMO, the latter. You might not avoid a tongue-lashing later on by the higher ups who get an earful from the patient/family, but you can give your side of the story with honesty, dignity, and integrity. As an aside, we are all human, and we nurses can be treated with contempt and mistrust. It would behoove you to know that some acting is required on the part of a nurse. You dislike the family member because he/she has given you and others unwarranted grief for 12 hours? Never show it. Pretend that at the end of the day, you will win a Golden Globe for your performance. It is necessary for them, and for YOU.

dudette10, MSN, RN

3,530 Posts

Specializes in Med/Surg, Academics.
Well if your other pt is LITERALLY dying, I really wouldn't care at that time to placate them as I was trying to save a life. You'll understand better once you're actually on the floor.
I respect your opinion, but if she starts out with a genuine understanding of the stresses of nursing, she will be more able to placate family members as best she can in the fewest words possible in those situations. It requires a LOT of self control, but the quicker she learns it, the better off she will be.

SionainnRN

914 Posts

Specializes in Emergency Room, Trauma ICU.
I respect your opinion but if she starts out with a genuine understanding of the stresses of nursing, she will be more able to placate family members as best she can in the fewest words possible in those situations. It requires a LOT of self control, but the quicker she learns it, the better off she will be.[/quote']

You're also assuming the nurse said what the mom said she did. That's a lot of hearsay. The nurse could have been sweet and caring but it fell on deaf ears.

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant.
Plus, certain people can escalate if you don't watch your approach and tone. Why make an already stressful situation worse? Being compassionate, professional, and doing the priorities can be done, but if for some reason, you miss the mark one day, strive to hit again the next day. I'm just saying, it's good to try and keep it in check. No one expects anyone to be perfect, Press Ganey or no Press Ganey.

Why is that people are assuming that the nurse in the OP got up from her Facebook and went in to be rude the family member? Maybe she was just in a code involving a 6 year old patient that ended poorly. On her way to talk with the child's family she was confronted by the family member who wanted to get on her case about wait time. Perhaps the code was still in progress and she was going to get the other family so that they could be there and be updated on the situation. No, she shouldn't have said the bit about bleeding and the infection, but there is a good chance what got perceived as rude was just a manifestation of coming from a situation that emotionally wore her out. If she was rude, ok, shame on her. However, there may be a whole lot more to the situation that just she isn't compassionate and that she lacks empathy. Haven't you encountered a similar situation during your time in the ER?

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Oh I agree, but that matter of fact is I am just one person and cant be in all 6 of my rooms at once and unfortunately that means that yes, some people are not important to me....at that specific time. I try my hardest to make everyone feel important and that they are worthy of my time, no matter how trivial and stupid their complaint can be. But you cant be everyone at once.

That is also why I put in the part about peoples perception. We have people complain that they never saw a doctor their entire visit in the ED. When the doctor has been in 5-6 times and introduces themselves as the Doc/NP/PA EACH TIME. So maybe someone did put a dressing on and said something about the bleeding. We will never know. And the really sad part about the perception is that everyone perceives their specific problem as an emergency. Treat me now. I am more important than anyone here. No you arent. We even have a sign stating you will be seen BASED ON MEDICAL NECESSITY in triage.

In the end what I would have done is called someone else who I knew wasnt drowning in patient load to help out, take a quick peak in and see what they could do. It is something I do all the time. Just quickly say "hey would you mind checking blank and blank, I havent had the chance to run in there yet". It is a simple solution to at least have someone make some contact. Like you said, there has to be at least one person.

I agree with a lot of what you say. I think it is the ED newbie in me shining through a little.

((HUGS)) and that's OK.....trust me I wasn't in the Zen Zone for a LONG time......but I am also one of those people who doesn't fluster easily. For me..."All the worlds a stage and all the men and women are merely players" Shakespere....I should win an Oscar!

OCNRN63, RN

5,978 Posts

Specializes in Oncology; medical specialty website.
I think that all I can say is that it would have been nice if the nurse had been able to be more reassuring and polite. Patients and family can't be expected to know the workings of the ER or the triage process. An attitude of respect and consideration on the part of the nursing and medical staff goes a long way.

Since you weren't there, how do you know she was not polite? All you have is a second-hand account of what happened.

Susie2310

2,121 Posts

Since you weren't there, how do you know she was not polite? All you have is a second-hand account of what happened.

That's right, on allnurses all we often have are second hand accounts. I am willing to believe the nurse said to the OP's mother what the OP reported she said under the circumstances the OP described. But, do I know first hand that this is what happened? No, of course not. I wasn't there, neither were you, neither was any one else. If the OP's account is correct, the nurse's behavior, experienced by the OP's mother, told to the OP, and described by the OP to us on this forum, and understood by me, was less than polite. I don't know the situation in the ER, or what the nurse was involved in at the time, or anything else. My post was my response to the OP. Feel free to post your response.

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant.
Since you weren't there, how do you know she was not polite? All you have is a second-hand account of what happened.

Exactly...the nurse did not give the message the daughter wanted to hear, so it was automatically rude.

Guest343211

880 Posts

Why is that people are assuming that the nurse in the OP got up from her Facebook and went in to be rude the family member? Maybe she was just in a code involving a 6 year old patient that ended poorly. On her way to talk with the child's family she was confronted by the family member who wanted to get on her case about wait time. Perhaps the code was still in progress and she was going to get the other family so that they could be there and be updated on the situation. No, she shouldn't have said the bit about bleeding and the infection, but there is a good chance what got perceived as rude was just a manifestation of coming from a situation that emotionally wore her out. If she was rude, ok, shame on her. However, there may be a whole lot more to the situation that just she isn't compassionate and that she lacks empathy. Haven't you encountered a similar situation during your time in the ER?

psu,

I acknowledged, more than once, that we/I were/was not there. All I am saying is strive to be respectful of all people--even if you feel they haven't earned it. I have seen patients escalate something fierce, b/c nurses didn't learn to keep it short but respectful and then go do what they have to do. You can't take the stuff that comes from patients and families personally.

Yes, right. The bit about bleeding, etc, was silly. I feel like it's a little discernment on my part to see a lack of maturity and an attitude in that reply. I mean if you are busy coding, at least when I have been, I could give two craps what people are saying. By that I mean, I may respectfully and briefly reply, and then I keep moving. If I am moving and concentrating on the code, I don't allow my mind to be crowded by nonsense. This interferes with doing the best I can and my thinking. But you don't have to get up on some pedalstool about bleeding and/or infection, yada, yada. Frankly, I don't have time for that if I am coding someone. Immediately life-threatening short of an advanced directive kind of trumps everything else. To the families, as Esme said, those other families/patients may not understand that. You can only be brief and respectful and keep moving. If you are a nurse and have time to deal with them, than as a nurse professional having been educated in being supportive and active listening, you should. Don't argue or tell them things they can't relate to. Share that their loved one or they would receive the same priority level treament if they were in imminent risk of dying within a matter of minutes. Tell them that someone will see and treat their loved one or them as soon as they are freed up from other crises. But if this is the case, and then they see people laughing and carrying on with BS, don't blame them for being ******, period.

I can't speak for anyone else, but when I am in a code, I focus in on what I am doing for the patient and to help the team at that particular moment. I block everything else out. That's kind of the mode you have to function in at that moment, and you deal with other things after. But in doing so, I am not going to be unduly short with people. You can easily make an already bad situation worse in such an area or situation. Please don't add to it with needlessly disrespectful or curt comments. They aren't going back into the code room or area with you.

We have coded kids in bays in front of other families, and while they were moved away or the situation was contained with curtains, most of the time, the families could see we were doing everything in our power to help the child that was coding. At least I have never had a patient complain about the non-lifethreatening needs of their kids while we were cracking a chest open on a kid on the other side of the bay. Hell, if they had asked for something inane, I probably wouldn't have heard it or processesd it in the midst of the code. But when others jump in or are doing stuff, and I am no longer needed in the immediate, I have addressed the concerns of others and those patients. Why wouldn't I? If enough hands are on deck for coding child, that doesn't mean the needs of other kids/pts can continue to be ignored. Address them if you are literally free to do so.

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