Have you ever lost it with a patient?

Nurses Relations

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  • Specializes in ICU, Telemetry, PACU, Med-Surg.

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Indy, LPN, LVN

1,444 Posts

Specializes in ICU, telemetry, LTAC.

Oh yeah. In LTAC, a little patient looked, talked and kinda acted like Gollum. I don't know how I didn't lose it sooner. He would ask for all the drugs, I would give him all the drugs, and the nausea drugs, and he'd complain of nausea five minutes later. Ok. I would give ginger ale, and mind you both his hands worked. So he got mad regularly and dumped it in his own lap then would call for a diaper change. No really? So I made him clean himself up, and then sit in the chair and I changed his bed, then helped him back to a clean bed and said no thank you, I am not giving you another ginger ale just so you can pour that one out too.

So I went to nurse station and heard him talking on the call light about how I refused to medicate him. This was after a month of being a total... expletive deleted... he regularly bit his hands to cause skin tears so I would have to do wound care, etc. I just stormed down there, and told him off and apparently all could hear. I told him all about the boy who cried wolf and how he DIED and deservedly so, and how I could tolerate a lot but buddy you are not allowed to lie. This was basically the mean mama that he acted like he'd never encountered before in his life. All the limits were set down at that point and I did not deviate from them, then I insisted on keeping him in my assignment for the week, just so he knew I meant business. I had to hand him off to the DON the next morning and I thought, oh god I'm gonna get fired. So I told her what had transpired and that I wasn't too professional about it. She said, it's about time someone told that one off. Good job. I did a little dance when he was transferred out.

BrandonLPN, LPN

3,358 Posts

Hanging up the phone on annoying/demanding family members is very satisfying. You get the pleasure of snubbing them without the risk of saying something you can't take back. Also fun is to turn your back and walk away from them while they're still talking. I try to employ these methods rather than "losing it".

Personally I don't blame anyone for losing it when victimized by abusive patients, doctors, administrators, etc., but a lot of the commenters in threads think that it's tantamount to a mortal sin to ever start yelling, under any circumstances — end of story.

Specializes in LTC Rehab Med/Surg.

I've never lost it in front of the pt. Honestly. No lie.

I've exited the room and vented at the nurse's station. I've yelled in the med room. I've mentally dismembered some pts. But I've never spoken to a pt in a way that would warrant any kind of complaint.

I'm no saint. I simply can't afford to lose my job. My family depends on me.

Fear is a serious motivator to be good:).

Picklefreak

49 Posts

I wouldn't say that I lost it, but I really chewed out someone I caught smoking in her room. And when I was done, the charge nurse called the cops on her, and they came in and chewed her out. And confiscated her smokes and the RX drugs (not in her name) she had in the bed with her.

VictoriaGayle

139 Posts

3:52 pm by Hygiene Queen

Yep.

And anyone who denies it is a liar.

Or new.

Thats me. I've only worked in long term care as an RA/activities assistant. I would be stern as needed but I never yelled at a patient or anything. Not that I didn't want too some times. Some day I probably will. ANd when that day comes I will probably freak out and cry as soon as I'm alone.

I was lucky, most of our residents were great, even most of the "bad" ones liked me so I had less issues than most of the staff. The really difficult ones didn't seem to respond positively to other workers "loosing their cool" so I tried to avoid that.

But every patient and every job is going to be different. I knew my residents well enough, and had enough time to, redirect them and work with them instead of yelling. However I'm sure there are situations where you don't have enough time to use "possitive reinforcement" and have to "loose it" to keep someone safe.

So no judgement here unless you are just indiscriminately yelling at everyone.

celtchick68

57 Posts

Specializes in Emergent pre-hospital care as a medic.

Just last week.

Frequent flier, 3rd visit that week, drunk, high on Percocet, comes in to detox. (sure ya did, just like the other 2 times). He's loud, obnoxious, cussing up a storm, F bombs all over the place. I repeatedly asked him to keep it down and stop cussing as he's not the only pt in the ER. He says he's sorry and 5 minutes later same stuff. His iv infiltrated and a coworker stopped the fluids for me cos I was busy at the next bed over. Next thing I see is him cussing while tearing the lock out of his arm and flinging the bloody thing across the ER.

I lost it. Told him how difficult he had been since setting foot in the ER and how his behavior was unacceptable and nobody wanted to hear his dirty mouth. He apologized and said "I'm an a$$ hole". I said, "I think you're right"

Imagine my distaste to return after my 2 day break to find him sitting there again.

Alibaba

215 Posts

yep.

Some patients/family/visitors just need to hear how it is and how its gonna be. Enough hand holding

Guest343211

880 Posts

Guess I'm either a liar, or it depends on what you mean (extent) of "lost it." I have been firm with some patients or families, but I don't think I have ever "lost it." Now with some abusive coworkers, I have been firm and really assertive, but not foul or disrespectful--even when they were being loud, obnoxious, and foul with me.

Someone through work (not a nurse) tried to give me attitude on the phone the other day. I remember thinking, as he was sounding off like a total butt-wedge, "I wonder if he realizes how idiotic he sounds, and how much I couldn't care less about his hissy fit." (LOL) It was like he was trying to rile me up. To me it's like road-ragers. Some of them are looking for someone with whom they can get into a fight. I pull over and let them drive past. Why? Because they don't have the right to control me and live in my head. Same thing with the butt-wedge on the phone. He was really trying to get a rise out of me, but I just stayed calm and to the point. It really bothers people when you don't allow them to bother you. Sometimes if they can't get a rise out of you, they take it as a challenge to step up the game. If they can't do it one way, they try another. Sadly, they don't get that even if they somehow win, they lose. You can get your way, the wrong way, but you can't get your way by being wrong to others and keep your integrity. Someone has said, "You can be "right" or you can have relationship." When you are being wrong about "being right" (or getting your way--or just dumping on someone), you lose out b/c you can't have decent fellowship with the other human being.

I had some parents be quite nasty. (Most aren't. They are just scared IMHO.) A couple the other day were a bit pushy and demanding, but unwilling to listen to the required SOP, which we, of course, must document. I wasn't going to argue with them on the point, b/c it wasn't a big enough issue. I was respectful to them, completed my documentation, wished them well, and moved on.

I say try and picture them verbally abusing you are your own time. Would you waste your free time with nonsense? If someone cranked called you and verbally abused you, are you going to yell back like a nut or just hang the thing up? Come on. You'd hang up. You have better things t do. If they are venting that's one thing. If they are abusing others, you have to address it; but it doesn't help, at least not IMO, to get loud and nasty back. People may end up saying, "Hey. I am the patient or family. I am upset. People expect me to get upset, but not you. You're the professional."

Also, it just ends up escalating things, and the rising anger can block your ability to think for better solutions to the problem--like where your nearest exit is---LOL.

Now I can't say what I would do necessarily if some patient was screaming, as in the earlier example. B/c if you cause my fight or flight button to go off unexpectedly. . .lol. But I generally find that freaking back is utterly useless. I have, however, been loud and demanding when I haven't gotten help fast enough in order to code a kid. Felt a bit embarassed about it afterwards too.

tokmom, BSN, RN

4,568 Posts

Specializes in Certified Med/Surg tele, and other stuff.

I don't call it 'losing it' I call it limit setting:lol2:

And yes I have. I don't yell, but I do make them clean themselves up and I refuse to placate them when they are being unreasonable.

YES! A young woman (girl) was in the process of delivering her first baby and things weren't progressing very well. Her boyfriend (baby daddy) was all set to go into the OR with her...until her mom AND his mom stepped in and began fighting about who would be allowed to go. This poor girl was so scared and exhausted and they kept badgering her to make a choice, neither of them wanting Dad to be the choice. I lit into them about how disrespectful they were being and then proceeded to let them know Dad would be going instead. I told the Dr...and they had to stay in the hall. ;)

I have lost it with a patient, a particularly nasty woman in LTC who really does not like me, as I follow rules and procedures for safety and will not do things her way, which are dangerous to her and myself for transfers ect.

(I am fine with patients who are so demented and out of it that they do not know or understand what they are doing or saying, I feel for them and understand that it is the disease talking, not a true reflection of their feelings, but this woman is of complete mental soundness and is just nasty mean.)

One particluar night she started in on her verbal assault on me, to which I calmly respond back to, but finally I had enough of this woman when she would not toliet transfer safetly. I explained again that I would not transfer her "her way" as why is it was unsafe for her and for me, ect ect. She continued to berate me to the point I was at my breaking point. I finally looked down at her and said, "I guess you dont comprehend what I am saying to you, but I will NOT do things your way. I guess tonight you will sit in your own ****!"

I turned on heel and walked out of the room!

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