How do you deal with explosive customers?

Nurses Relations

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I know you're supposed to remain calm, but that seems to add fuel to the fire...

Specializes in pediatrics, public health.
It would be unfair not to say that the family member did have an absolute right to be livid. I would have prefered that he would have asked for who was in charge and make his case. I was totally taken aback and just tried to stay composed. I tried to explain but at that moment it was pointless.

In that situation, I wouldn't wait for them to ask you is in charge, I would offer to tell the person in charge without being asked. I would say something to the effect of "I am so sorry that happened. I will inform PersonInCharge immediately, and will let them know you'd like to speak with them." If they wanted to continue to vent a little, I might let them do that for a while, but then would say, "Thank you for filling me in on what happened. I will go tell PersonInCharge now." Then, I would walk away and let the person in charge know (including giving them a heads up that the family member was very angry).

GLORIAmunchkin72,

I did noy read your last post. My walking away comment was geared towards people that scream about everything for no reason. I would do the same as noahsmoma, if there was a serious legitimate problem.

Frankly, the more "out there" they get, the more calm I become. It marks a clear line of who the reasonable party is and who the reasonable party is not.

Usually I ask them plainly what I can do to make them happy right in this moment. Sometimes that takes them aback and they admit honestly that nothing would, they just need to vent. Sometimes they name something totally outrageous and then I am able to smoothly let them know I will need to get others involved as that is outside of my scope of control. And sometimes it stop the fit in its tracks and a goal is named that I can then meet, thus discharging the situation completely. No matter what the reaction winds up to be to that question, it helps get on the table what we are really dealing with - a solvable problem? A vent session? Or unrealistic expectations?

100% agree. The hotter the "customer" .. the cooler your head must remain.

I have never been unable to calm down an angry person(psych not included).

Simply listen..

Acknowledge..

Apologize.. (even if it was not warranted).. Promise to fix the problem that that caused the outburst.

Usually will take 5 minutes if delivered sincerely.

Specializes in Oncology; medical specialty website.

Call the bomb squad?

Specializes in NICU, PICU, PACU.

We were taught the acronym LAST in our patient coordinator class...

Listen, Apologize, Solve and Thank

Listen to the client, " I am so sorry this happened/was said,etc to you/familymember,etc. I will look into this and do XYZ. Thank you for letting me know.

Actually this does work, sometimes, they just need to be heard. But, if they escalate, then security gets called.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

while i'm not offering this as a strategy, i've had some of my best success with "explosive personalities" when i laugh. it's a good outcome if they realize how ridiculous they sound and save face by pretending they didn't mean it or were joking or got carried away. or even if they pause, realize how ridiculous they sound and then immediately change gears to something we can work with.

the other day, i had a male patient in his 30s who had elective surgery. while i wouldn't dream of naming names, i'm reasonably certain that a certain person of the gas passing persuasion assured him that he would have no post op pain because "the nurses will give you something to make you comfortable." nothing short of a visit from his friendly neighborhood dealer and some quality time alone with his easy-access central line would have made this individual comfortable . . . . but when i explained to him that we couldn't completely take his pain away unless we were willing to sacrifice breathing, he began to kick apart the footboard of his bed, shake the side rails and wail exactly like a toddler having a tantrum. the guy was the size of a linebacker.

i'm working night shift. i'm brain dead sometimes. maybe most of the time. all i could do in response to this scenario was laugh. once i started laughing, i couldn't stop. i tried to stay behind the curtain where the patient couldn't see me, but one of the nps came rushing in with alarm and bulldozed into the curtain (with me on the other side) exposing me like the wizard of oz.

took the wind right out of the patient's sails. he visibly deflated. he was quite withdrawn and quiet (although still nasty) the rest of the shift. and when the np calmly informed him that his "childish temper tantrum" had quite possibly made his pain far worse than it would have been, but that wasn't getting him more drugs, i had to sneak out of the room to do a fist pump.

Frankly, the more "out there" they get, the more calm I become. It marks a clear line of who the reasonable party is and who the reasonable party is not.

Usually I ask them plainly what I can do to make them happy right in this moment. Sometimes that takes them aback and they admit honestly that nothing would, they just need to vent. Sometimes they name something totally outrageous and then I am able to smoothly let them know I will need to get others involved as that is outside of my scope of control. And sometimes it stop the fit in its tracks and a goal is named that I can then meet, thus discharging the situation completely. No matter what the reaction winds up to be to that question, it helps get on the table what we are really dealing with - a solvable problem? A vent session? Or unrealistic expectations?

Excellent post!

They are not customers. They are either patients or families of patients.

I have never had a patient complain about me personally, but it's usually about what kind of 'cesspool' we run and what a moron the nurse is, and why the **** medications are late. How do I deal with it? I don't, because I don't know the whole story. I just refer them to someone who might, such as the nurse or our social worker.

while i'm not offering this as a strategy, i've had some of my best success with "explosive personalities" when i laugh. it's a good outcome if they realize how ridiculous they sound and save face by pretending they didn't mean it or were joking or got carried away. or even if they pause, realize how ridiculous they sound and then immediately change gears to something we can work with.

the other day, i had a male patient in his 30s who had elective surgery. while i wouldn't dream of naming names, i'm reasonably certain that a certain person of the gas passing persuasion assured him that he would have no post op pain because "the nurses will give you something to make you comfortable." nothing short of a visit from his friendly neighborhood dealer and some quality time alone with his easy-access central line would have made this individual comfortable . . . . but when i explained to him that we couldn't completely take his pain away unless we were willing to sacrifice breathing, he began to kick apart the footboard of his bed, shake the side rails and wail exactly like a toddler having a tantrum. the guy was the size of a linebacker.

i'm working night shift. i'm brain dead sometimes. maybe most of the time. all i could do in response to this scenario was laugh. once i started laughing, i couldn't stop. i tried to stay behind the curtain where the patient couldn't see me, but one of the nps came rushing in with alarm and bulldozed into the curtain (with me on the other side) exposing me like the wizard of oz.

took the wind right out of the patient's sails. he visibly deflated. he was quite withdrawn and quiet (although still nasty) the rest of the shift. and when the np calmly informed him that his "childish temper tantrum" had quite possibly made his pain far worse than it would have been, but that wasn't getting him more drugs, i had to sneak out of the room to do a fist pump.

ha. i thought of that as soon as i read the first post! sometimes i do find myself struggling not to laugh during some outbursts. a couple of times i have. lol

Specializes in med-surg, psych, ER, school nurse-CRNP.

I have found that calmly repeating 'There is no need to yell.' works well. It either stops the tantrum, or escalates it top the point that I walk away, after just as calmly stating "When you are ready to discuss the matter in a calm manner, I will be back."

I refuse to be a doormat anymore. It solves nothing and it reinforces bad behavior.

Thanks everyone for your inputs. I truly appreciate it.

Specializes in Rehab, critical care.

I calmly try to talk them down, and explain all that is going on, and answer all of their questions and/or address their tirades, do what it is that they ask me to do (if it's reasonable, and good for the patient) (fortunately, these explosions you speak of don't happen often, and I typically only see them when I come in on my shift, and the person is already upset about something before I've even met them or the patient really). And, no one's ever exploded on me, only been upset with something or someone and making a big issue out of nothing.

Once I try all of that, and they're still upset, I get my supervisor to come talk to them or if it is really bad, I would have to ask them to leave the unit so that I can take care of my patient. I would say, "I have addressed your concerns, and at this time, I need to take care of your son, mother, etc to ensure he/she is getting quality care since this discussion is now impeding patient care. If your needs haven't been met, I would be happy to get my supervisor to come talk to you." I haven't had to actually say anything like that to a family member or had to ask them to leave as talking with me or asking my supervisor to come talk to them has worked thus far in the few instances this has been an issue.

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