New grad dealing with angry/yelling patients - page 2

Hi all, I am a new grad of 4 months working on a busy Ortho/Trauma floor. It has gotten to be an almost daily occurence that I come home crying because a patient/family has decided to take out... Read More

  1. by   angel337
    anytime you work with people, including retail, customer service, tourism,etc.. you can expect rude behavior. more so in healthcare. i work in the ED, where people are known to be very difficult. it really doesn't bother me. i am very pleasant (patients tell me that all the time) and don't have too many problems with people. but of course you will always get patients that will take their frustrations out on you. i just ignore it. that's the best advice i can give you. if a patient is on a ranting binge about how this took so long, how that is so terrible just politely say "i am sorry that you are upset but we are doing all we can to help you right now" they usually tone it down a bit after that. i agree that you have to develop a thick skin, if you don't, nursing won't work for you. don't expect people to say thank you. just do the best you can and the rest will follow. you'll be fine
  2. by   NannaNurse
    Being human, our first response when yelled at is to 'yell' back. We are not perfect, but as nurses, others do see us as just that, perfect.
    I try to put myself into the shoes of those patients and family members. They have experienced at 'life' altering event, some kind of trauma and they are having experiencing pain, fear, questions, and more questions.
    I've been on the other end, as a family member and a patient and I looked to my nurse as a 'haven'...someone to talk to and confide in.
    I try to put on my best smile 'brace my shoulders'.......take my heart off first.......and listen with my ears, heart and eyes. I offer kindness, understanding and sympathy. Usually, I get a heartfelt apology, a hug, a special card, flowers or that 'look' that goes way beyond words and that makes up for all the 'turmoil'.
    I know it's hard not to take some things personally, but try to remember that about 95% of the time, they don't mean it personally either......
    Good luck and best wishes....!!!! :kiss
  3. by   futurenurse2
    Hi,

    When I'm in a situation like this, I have something that I just automatically say back, which will diffuse some of that energy and give my mind a clue to not take it personally.

    I work in a psych department (not as a nurse) and have often used "I'm sorry you feel that way" or "I'm doing my best, we're quite busy". If someone is going on and on I might say "What can I do to help you at this present time? If they keep going on and on, I will say, "What can I do to help you now?" People often like to tell me about how past doctors, etc. have wronged them. I try to keep my/their focus on the present, as there's nothing I can do about their past problems. I have had people complain and complain and when I say, "What would you like me to do to help you now", they have apologized and said they just wanted me to listen.

    These things might be totally inappropriate/unpractical as a nurse, I have no idea about nursing etiquette (bad spelling), but it's just a thought.

    Good luck. Not taking things personally is a personality trait, but can be improved upon with practice and age. You'll do fine!
  4. by   zenman
    Wonder what would happen if you burst out crying in front of the abusive patient...and just stood there sobbing! :chuckle
  5. by   Hellllllo Nurse
    Generally, when a pt or family member gets verbally abusive, I immediately drop whatever I'm doing and leave the room, without saying a word. I just walk out on them in the middle of their tirade. I'll come back a few minutes later, and they are usually quiet. If they do start yelling again, I again stop whatever I'm doing and leave without saying a word. Most of them figure out that they're not going to get anywhere. They usually shut up after they figure out that I will leave the room every time they start. And..what are they going to tell my boss? "That nurses won't stay in the room and let me finish yelling at her!" ?
    This strategy has worked pretty well for me.
  6. by   Tweety
    It hurts when you do your best and it isn't good enough. I can relate very well to what you're saying. It does get better with time. Just don't become an old hag battleaxe like me.

    Good luck.
  7. by   Farkinott
    Quote from RN4NICU
    This is a wonderful idea -- maybe American hospitals will take notice and follow suit - The sooner the better

    Edited to add - it should apply to family members too. They should not be allowed to visit if they can't behave themselves. Family members with disruptive or abusive behavior, even if directed at staff and not the patient, certainly don't contribute to the healing environment for the patient.

    -----------------------------------------------------------

    Abusive patients face zero tolerance

    Patients who are violent towards NHS staff are to be barred from treatment for up to a year under new guidelines.

    Health Secretary Alan Milburn says he wants to create a "zero tolerance zone" for abusive behaviour within NHS hospitals and clinics.

    Patients could also face treatment bans for verbal abuse of staff, threats, vandalism and drug or alcohol abuse on hospital premises.

    The guidelines, first trailed in June and due for publication later this week, will balance the duty to provide health care with the need to protect staff, Mr Milburn says.

    Some 65,000 assaults on NHS staff are reported each year.

    Two London hospitals - Bart's and the Royal London - have introduced their own yellow and red card system to warn abusive patients that treatment may be withheld.

    In 1998, the Government announced a target of reducing violent incidents against NHS staff by 20% by 2001 and 30% by 2003.

    Under the new guidelines, NHS trusts will each draw up their own local policies on what behaviour is to be regarded as meriting denial of treatment.

    Mr Milburn is due to outline the plans during a speech to the Community Practitioners and Health Visitors Association conference in Bournemouth.

    Patients will normally be given a verbal warning, followed by a written warning before being denied treatment, but in exceptional cases, when staff feel under imminent threat, care can be withheld immediately.

    http://www.ananova.com/news/story/sm_438301.html

    My workplace (and whole organisation) has a zero tolerance of violence/abuse towards staff. Obvioulsly there are situations where meidation or placation may be warranted but the safety of the staff member is paramount.
    My facility has posters everywhere displaying that abuse/violence towards staff will NOT be tolerated.
  8. by   Farkinott
    Quote from Hellllllo Nurse
    Generally, when a pt or family member gets verbally abusive, I immediately drop whatever I'm doing and leave the room, without saying a word. I just walk out on them in the middle of their tirade. I'll come back a few minutes later, and they are usually quiet. If they do start yelling again, I again stop whatever I'm doing and leave without saying a word. Most of them figure out that they're not going to get anywhere. They usually shut up after they figure out that I will leave the room every time they start. And..what are they going to tell my boss? "That nurses won't stay in the room and let me finish yelling at her!" ?
    This strategy has worked pretty well for me.
    Brilliant advice! This is my preferred tactic!
  9. by   Hellllllo Nurse
    Quote from Farkinott
    My workplace (and whole organisation) has a zero tolerance of violence/abuse towards staff. Obvioulsly there are situations where meidation or placation may be warranted but the safety of the staff member is paramount.
    My facility has posters everywhere displaying that abuse/violence towards staff will NOT be tolerated.

    When i read you post above, I just knew you were not in the U.S.
    U.S, companies would never put up posters promoting discouraging violence towards staff . It might offend the "customers" and cut into profit$.
  10. by   MelissaRN
    Alot of it is that patients are going through the worst experience of their lives and they are frustrated and scared and maybe even angry. The hospital environment sometimes brings out the worst in people, couple that with the fact that some people are just jerks any way and you've got double jeopardy. The patients that are wonderful and appreciate are the ones that make it all worth it.

    I remember one night I was right out straight busy and I had this poor little old lady that had come to the hospital for a knee replacement. She ended up having MRSA and then C-Diff. We had a rectal tube in her that was leaking and she had terrible maceration on her bottom from all the contact with liquid feces. We were turning her and cleaning her constantly and she was just so greatful. To top it all off her husband was coming to the hospital that morning for surgery for colon cancer. Despite it all she was a pleasure to take care of. The sun came up that morning and she was singing and saying that it was going to be ok somehow.
  11. by   leslie :-D
    Quote from Farkinott
    My workplace (and whole organisation) has a zero tolerance of violence/abuse towards staff. Obvioulsly there are situations where meidation or placation may be warranted but the safety of the staff member is paramount.
    My facility has posters everywhere displaying that abuse/violence towards staff will NOT be tolerated.
    :imbar wow farkinott, i can't even begin to imagine the u.s. proposing that. i think our slogans would read more like:

    "physical, emotional and verbal abuse is welcome at this facility. we strive to please you, our customers.....because you're worth it (and we're not)."
  12. by   Jailhouse RN
    The first thing you need to do is "walk away" when this kind of thing starts. You do not have to tolerate that kind of abuse. Simply STATE "I know this is a difficult situation for you but I will not tolerate your abuse". Where I work things are much different but when I worked the floors that was what I did, it worked.
  13. by   ktwlpn
    [QUOTE=pumpkin]Hi all,
    I am a new grad of 4 months working on a busy Ortho/Trauma floor. It has gotten to be an almost daily occurence that I come home crying because a patient/family has decided to take out their frustration on me. When I was in school, I always had the idealized dream that I would get out and help people, and they would be appreciative. At least once in a while, I would get a "thank you". That has yet to happen. The patients/families who I've had problems with are patients who all the nurses have problems with - so I know it's not me. However, this doesn't help me from taking criticism personally. I hate just gritting my teeth and standing there while someone chews me out because it took me 20 minutes to bring in an extra pillow. Sometimes I can understand where they're are coming from - it's a teaching hospital and it can be frustrating trying to deal with the many different interns. But most of the time, these patients are just generally rude, or crazy, people to begin with. If the floor wasn't so busy, I would be able to talk to my colleagues to find out how they're able to deal with these patients. But we rarely get to eat lunch as it is.
    Can anyone give me some advice on how to handle them? How can I not take this so personally? Is there some mental trick I can play in my mind so I'm not thinking "I don't get paid enough for you to yell at me, you crazy old bastard"? Any advice at all would be greatly appreciated.

    [/QUOTE...I know EXACTLY what you mean....Those feelings of " I suck" get worse for me when my depression kicks in....I KNOW I am a competent nurse but sometimes I'll lie awake at night-completly exhausted but my mind keeps racing and I can't sleep-I'll fret about a pt and take complete responsibility for stuff that really is in no way my responsibility.....If I am tired or not feeling well this happens more often....The first year of your nursing career is so hard.....you have had alot of life changes and it is easy to get overwhelmed.....My best advice to you is to first do a personal inventory and determine if you do have symptoms of depression..If you do then it's an easy fix...If you don't believe depression is a factor then follow other's advice and don't stand there getting abused (that just takes your time away from everyone else) Deliver the care to the pt and address the pt directly and then scoot. You are a professional and you don't have to take that ****...bottom line-if the complaint is of a medical nature you pass the buck and encourage the complaintant to call the MD themselves..If it is a complaint regarding you not answering their call fast enough because you are swamped then refer them to your supervisor or nurse manager right away...Let them deal with that crap.......Whatever you do DO NOT stand there and let someone yell at you...no one should..If it is happening to you and your co-workers frequently then something is very wrong and it needs to be addressed by your management before someone gets hurt....Maybe staff needs some ducation regarding violence in the workplace...It's no joke...maybe your facility has let the situation get out of hand....Good Luck-it will get better---but we all have good days and horrid ones.That never changes......

close