New grad dealing with angry/yelling patients

leslie :-D · Jul 20, 2004

Kust walk away from those people
smiling sweetly and singing
"Hit the road Jack"
dont you come back
no more no more

desparate times call for desparate measures, yes tom? go get 'em tiger.

leslie

teeituptom, BSN, RN · Jul 20, 2004

Im too old too fight or fuss

waste of time and energy

nerdse, MSN · Jul 29, 2004

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

:) So cool an idea! We really DO need it here, our pts are so spoiled compared to the NHS pts in GB.

Having seen the NHS up close I can see how they get abusive, really, some operations that you can get here in a month or less have a 5 - 10 yr waiting list there & if you "contribute" to your illness you don't get the surgery - one example is a knee replacement isn't given to anyone who's ever been overweight, they have to pay for it, or did when I was over there (it may have changed for the better but I wouldn't count on it). So I am not surprised there is violence; powerless people are usually violent at some point & often adapt it as a habit.

But w/ our spoiled (spoilt?) pts here getting whatever they want, I think we definitely need to do something similar. They aren't getting denied care when they are swinging at you. I was once told that if someone tried to hit me I could not hit back so I said what about blocking the hit & was told that was the same as hitting back. And we wonder why we have a health care professional shortage...needless to say I ignored that and did block pt's "haymakers" when they got violent (usually b/c they got something on the tray they didn't like, or the water tasted bad, or they wanted a name brand soda and not a generic one; sometimes, tho', they were in the DTs & didn't really know what they were doing so I cut them some slack).

The demanding people usually take time away from pts who really need us. I think that's what our young friend is upset most about. And what NHS is trying to prevent from happening in their facilities.

My grandma used to say, "Consider the source." She explained to me that if the person was hurt or angry, they were lashing out at you b/c you were safe & you could defuse the situation by zeroing in on its source - "It must be really hard being here trying to cope with this situation." Then laying down the law - "I will do what I can to make it easier for you, BUT we have a unit full of people with similar problems and I have to make sure all of them get their share of my time & attention in accordance with what is wrong with them. I am sure that you would not want me to ignore you for someone else, especially if your needs were urgent, so I am sure that in future you can find it in your heart to understand that we're all doing the best we can in difficult circumstances. Thanks for understanding." Even if they don't right away, you may find that later on they will come to you privately & apologize & if they don't they will stop acting out so much. Keep really good eye contact, open posture, professional tone of voice, and remember that most of the time they are not angry at you but at their situation.

For the ones who are twits, Grandma's advice means not taking offense at an idiot but pitying them instead. She used to say pity was worse than hate b/c it assumes you are incompetent. I have found that an attitude of pity is actually a potent weapon. People would rather be hated. I have even said to people that I feel sorry for them b/c they have no other way to cope with problems than to yell at someone.

Hope some of that helps.

Farkinott, RN · Jul 30, 2004

:) So cool an idea! We really DO need it here, our pts are so spoiled compared to the NHS pts in GB.
Having seen the NHS up close I can see how they get abusive, really, some operations that you can get here in a month or less have a 5 - 10 yr waiting list there & if you "contribute" to your illness you don't get the surgery - one example is a knee replacement isn't given to anyone who's ever been overweight, they have to pay for it, or did when I was over there (it may have changed for the better but I wouldn't count on it). So I am not surprised there is violence; powerless people are usually violent at some point & often adapt it as a habit.
But w/ our spoiled (spoilt?) pts here getting whatever they want, I think we definitely need to do something similar. They aren't getting denied care when they are swinging at you. I was once told that if someone tried to hit me I could not hit back so I said what about blocking the hit & was told that was the same as hitting back. And we wonder why we have a health care professional shortage...needless to say I ignored that and did block pt's "haymakers" when they got violent (usually b/c they got something on the tray they didn't like, or the water tasted bad, or they wanted a name brand soda and not a generic one; sometimes, tho', they were in the DTs & didn't really know what they were doing so I cut them some slack).
The demanding people usually take time away from pts who really need us. I think that's what our young friend is upset most about. And what NHS is trying to prevent from happening in their facilities.
My grandma used to say, "Consider the source." She explained to me that if the person was hurt or angry, they were lashing out at you b/c you were safe & you could defuse the situation by zeroing in on its source - "It must be really hard being here trying to cope with this situation." Then laying down the law - "I will do what I can to make it easier for you, BUT we have a unit full of people with similar problems and I have to make sure all of them get their share of my time & attention in accordance with what is wrong with them. I am sure that you would not want me to ignore you for someone else, especially if your needs were urgent, so I am sure that in future you can find it in your heart to understand that we're all doing the best we can in difficult circumstances. Thanks for understanding." Even if they don't right away, you may find that later on they will come to you privately & apologize & if they don't they will stop acting out so much. Keep really good eye contact, open posture, professional tone of voice, and remember that most of the time they are not angry at you but at their situation.
For the ones who are twits, Grandma's advice means not taking offense at an idiot but pitying them instead. She used to say pity was worse than hate b/c it assumes you are incompetent. I have found that an attitude of pity is actually a potent weapon. People would rather be hated. I have even said to people that I feel sorry for them b/c they have no other way to cope with problems than to yell at someone.
Hope some of that helps.

nerdse,

You do make some salient points but the crux of the matter is that nurses should not and will not be exposed to violence at work. Could you imagine a social security office or bank or supermarket accepting the violence because there is a "root cause" and if they come up and apologise later it is all alright?

I work in a workplace that defends my right to an abuse/aggression free workplace. Abuse/aggression is NEVER ok!

cnyrn · Jul 30, 2004

Yesterday at the risk mgt. mtg. (with the CEO, etc.) psycho old man family memeber of pt. busted his way in, tried to cane an administrator and threatened to kill everyone. They had to call a Dr. Strong. Yep, his wife will still be on my med-surg floor as a pt. this weekend, and yes, they still allowed him to come in for a visit that very afternoon.

Wonder which color scrub set co-ordinates best with body armor?

RN4NICU, LPN, LVN · Jul 30, 2004

Yesterday at the risk mgt. mtg. (with the CEO, etc.) psycho old man family memeber of pt. busted his way in, tried to cane an administrator and threatened to kill everyone. They had to call a Dr. Strong. Yep, his wife will still be on my med-surg floor as a pt. this weekend, and yes, they still allowed him to come in for a visit that very afternoon.
Wonder which color scrub set co-ordinates best with body armor?

Were the police called? I think they should have been. Sounds like this calls for a restraining order.

cnyrn · Jul 30, 2004

The whole incident was kept quiet as it would have been the headline in the local newspaper police report. I agree that something be done to protect the workers exposed to this wack-o.

Paleobug · Jul 31, 2004

I'm starting nursing school in the fall. I worked for years in a casino on the Las Vegas strip. I worked in slots. On busy days such as holiday weekends, players would yell at me for having to wait to have their machine filled or to have their jackpots paid. Often times, they would exaggerate and say they've waited 30 minuntes when it was only 5 minutes. I would just tell them that I would be with them as soon as possible, and then walk away. We never had much support from supervisors. They would always side with the customers.

cnyrn · Jul 31, 2004

Were the police called? I think they should have been. Sounds like this calls for a restraining order.

The nut job was back today, he tried to get me to accept a donation for the March of Dimes. I told him the hosp. fund raiser was over but I'm sure that he could independently donate on his own. Today he was wearing a headband that was really the waist band he cut off a pair of white Fruit of the Loom briefs (well, techically the undies were once white) like a demented and aged Rambo.Actually, he behaved alright today, just really obnoxious.

moia · Aug 1, 2004

In the beginning I too wanted everyone to love me...I got over it....

I made a real choice to expend all my mental angst energies on the people who do already love me...patients and their families?....not a chance.

If I have a family member problem I ask them politely to accompany me to a quiet room and ask them politely why they are behaving like an idiot..if they don't have a good answer I give them the nurses bill of rights and underline the parts they have abused..I give them one warning and I tell them if the problem continues I will need to call the manager or house supervisor....I always give them the opportunity to explain their behaviour...if it is about taking to long to get a pillow or water I say to them directly...no one behaves that rudely over a pillow or water...what is the real issue here and how can WE solve it...always we...because they need to own their own mess.

I am more than sympathetic if they break down and howl over the injustice of their loved ones illness...it sucks and they need support but I am clear that I am ONLY AVAILABLE FOR SUPPORT...if they need to abuse someone they need to choose someone who has to put up with it... like a member of THEIR family.

ICU is a blessing..we can toss them out after a minute if they get obnoxious.

chris_at_lucas_RN, RN · Aug 4, 2004

I give them the nurses bill of rights

There's a nurses' bill of rights? Can you post it (new thread maybe) or provide an URL?

Thanks! (Can I come and work at your hospital???)

RN4NICU, LPN, LVN · Aug 4, 2004

there's a nurses' bill of rights? can you post it (new thread maybe) or provide an url?
thanks! (can i come and work at your hospital???)

[color=#3366cc]the american nurses association's bill of rights for registered nurses

registered nurses promote and restore health, prevent illness and protect the people entrusted to their care. they work to alleviate the suffering experienced by individuals, families, groups and communities. in so doing, nurses provide services that maintain respect for human dignity and embrace the uniqueness of each patient and the nature of his or her health problems, without restriction with regard to social or economic status. to maximize the contributions nurses make to society, it is necessary to protect the dignity and autonomy of nurses in the workplace. to that end, the following rights must be afforded:

1. nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care.

2. nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice.

3. nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the code of ethics for nurses and its interpretive statements.

4. nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution.

5. nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities.

6. nurses have the right to a work environment that is safe for themselves and their patients.

7. nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings.

http://www.nursingworld.org/tan/novdec02/rights.htm

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

the ana code of ethics for nurses was also amended in 2001 to include the provision:

the nurse owes the same duties to self as to others. (see #5)

http://classes.kumc.edu/son/nurs420/unit1/code_of_ethics.htm