So Sick of Pushy Patients and Verbal Abuse

[applesRN]

For the most part, I am described by others as being extremely patient and kind. But my fuse is wearing thin! with the increasing number of entitled, demanding patients, as well as verbally and sometimes threatened physically abusive nature. ( Everyone I am describing is alert and oriented. I can handle the person with brain injury or the mentally ill that have less control of their behavior and words. It's the perfectly with-it adults who should know better). I am so sick of demanding patients that my attitude towards them has changed- I go in and do my minimum assessment and work, get them what they need, and remind them that verbal abuse is not tolerated. I have gone to managers. I work in a float pool so thankfully I rarely have the same person twice. What makes a person think they can call us stupid idiots? When they have little clue about what is policy and procedure, and expecially if other nurses have given in and done what they wanted or how they wanted it. Sometimes joking around can help dissolve some situations- I have seen nurses fire back insults at the patient in a joking manner (that is not my way) and I've seen others give in to whatever they want (giving shots in unapproved sites), or getting them their coke while they are cussing. Excuse me, if you want your coke you are going to ask for it nicely, and no I am not neglecting you or refusing your care. Your immediate need of a carbonated beverage is not essential to your health and healing. I just want to say "put on your big girl panties and behave." The attitudes of patients seems to be getting worse lately, and it is stressing me out. I would like to begin a program at my hospital system based on mutual respect, with some sort of measure to curtail the verbal abuse by patients on staff. Or family members to staff. I, and many of my colleagues, are highly trained nurses with the interest of excellent care for the patient. We did not get our license out of a cracker jack box, and even if we did, no one deserves to be spoken to that way. I don't care if that's how they are raised, or just their way- they need to be accountable for their words and actions. We are not doormats. This, along with the stress of med-surg, is running me out of bedside nursing.

If your hospital or facility has any program or action plan in place, would you please share? Does it work?

Thanks!

:tku:

[divaRN*]

I find that the very sick patients are not the ones giving you crap (most of the time) they are thankful you are helping them and keeping them ALIVE and the ones that are in for a minor condition think they are on vacation. ughhhhh. I had a patient ask to file a "grievance" because we would not give him klonopin (when he was being treated as an out pt for polysubstance abuse, including klonopin) this was at change of shift and I did not have time to deal with his antics so i gave him a progress note stamped with his blueplate and told him to write down the issue and i would give it to the manager (thinking he wouldnt do it). He covered the entire sheet front and back. Sorry that still wont get you your fix. I also had to call security and put a pt on grey precautions because i would not push his narcotics fast enough for him. I calmly explained to him how i can knock out his rsp drive by pushing it fast, he proceded to throw a soda can at me. He bought himself a security guard :)

[JBudd, MSN]

The one that bit me bought herself felony charges and jail time.

[CBsMommy]

I've had a patient cuss at me because his hand wasn't under the covers all the way. A simple, "Please do not talk to me like that, I am trying to help you" in a very nice tone, went along way. In fact, he would ask for me by name and was VERY polite when I went into the room. This doesn't work for everyone but it does work often.

I also understand that this is the way people exert control over an otherwise uncontrollable situation HOWEVER this is no excuse to be rude. And this is also coming from a mother whose child was ill and had to have several surgeries. If it weren't for my team of health care professionals and ESPECIALLY my nurse, I wouldn't have made it through. People need to learn not to bite the hand that feeds them, so to speak....or just maybe some common manners all the way around.

[applesRN]

Thank you to everyone who weighed in on my post. I still don't know what the answer is.

I recently went to Jamaica on a medical missions trip. People walked miles to come see us for medical and vision care. I just want to tell that to the next trivial request or stupid demand.

Press Ganey's have driven some hospitalists to give pain meds when they wouldn't have otherwise. They have told me so. What in the world are we doing as a society? Code H (Code Help) is almost never for a legitimate reason. (Our rapid response team is initiated by the nurse, although a real family or patient concern code result in a Met Life call. Whether it is legitimate or not, several people have to go to a Code H, taking them away from real issues.) Is it any better in unionized hospitals? Do patient's get away with so much there?

As a med-surg float nurse, I find that the diabetic and renal patients overall are the more demanding, with pulmonary, ortho, and surgical close behind. And families are bad everywhere.

We are shooting ourselves in the foot by allowing this. If I were a manager, I don't think I would last very long. I wouldn't allow my staff to be treated that way. Press Ganey scores can be improved without tolerating threats and abuse, and without giving in to demands that are incongruent with best practices. In fact, nurses that feel secure in their positions and believe their managers will have their back make for a more pleasant environment for everyone.

[umcRN, BSN, RN]

Thank you to everyone who weighed in on my post. I still don't know what the answer is.

I recently went to Jamaica on a medical missions trip. People walked miles to come see us for medical and vision care. I just want to tell that to the next trivial request or stupid demand.

Press Ganey's have driven some hospitalists to give pain meds when they wouldn't have otherwise. They have told me so. What in the world are we doing as a society? Code H (Code Help) is almost never for a legitimate reason. (Our rapid response team is initiated by the nurse, although a real family or patient concern code result in a Met Life call. Whether it is legitimate or not, several people have to go to a Code H, taking them away from real issues.) Is it any better in unionized hospitals? Do patient's get away with so much there?

As a med-surg float nurse, I find that the diabetic and renal patients overall are the more demanding, with pulmonary, ortho, and surgical close behind. And families are bad everywhere.

We are shooting ourselves in the foot by allowing this. If I were a manager, I don't think I would last very long. I wouldn't allow my staff to be treated that way. Press Ganey scores can be improved without tolerating threats and abuse, and without giving in to demands that are incongruent with best practices. In fact, nurses that feel secure in their positions and believe their managers will have their back make for a more pleasant environment for everyone.

Ha, I work in a unionized children's hospital...trust me, the parents get away with too much!

[anotherone, BSN, RN]

Hate to break it to y'all but even under universal healthcare this still happens. Every Canadian has access to medical care whether or not they have paid their premiums. Their sense of entitlement has quadrupled my nursing career.

They elders feel their are special "because I built this country". The young because "I pay taxes".

I've been told the ice water isn't cold enough. We'd never give any patient a milkshake or a pop because the system doesn't supply these items. You want that you pay for it yourself.

. .

I have had the same complaint. I just told the pt, " the cup is filled with ice." It got me a super dirty look and an angry patient. I think many of these people have undiagnosed mental illnesses of some sort they seem to enjoy attempting to humilate or scream at others. Or they are so used to be on the low end of society they like to yell and scream at someone and have a personal servant/waiter? I dont know.

[AngelfireRN, MSN, RN, APRN]

Pardon the stupidity, baby brain is in full force...but what does SMH stand for, please?

[sandygirl123, CNA]

And this is why I prefer working with kids over working with the elderly. People ask me how I can work with kids all day my responses to that is I have more tolerance working with kids. They always look at me like I am a monster when I say that but, it is true. When a child is rude or his/her behavior is completely ridiculous/disrespectful or is being a drama queen/overreacting to something that is not that serious they are reprimanded for their behavior which is a good thing. But, when you are working with the elderly you are not suppose to say anything and that is not right. I don't think that anyone could degrade an elderly person at all but, if your behavior is hurtful or if you are becoming combative then sometime needs to do done. The supervisor or the administrative personnel needs to step in and take action immediately.

[TheCommuter, BSN, RN]

Pardon the stupidity, baby brain is in full force...but what does SMH stand for, please?

I know you asked this question many moons ago, but SMH stands for shaking my head.

[ceccia]

I know you asked this question many moons ago, but SMH stands for shaking my head.

or 'so much hate'.

[TonnyaLPN]

I wish I had good news for you.

I currently work at an LTAC that has just been taken over by the 4th new DON and the 2nd NHA in a year and a half.

Currently, we have a patient that was previously homeless, is here now, and is so incredibly verbally abusive not only to staff but to other residents as well. Because of him verbally abusing a heavy set nurse (called her a fat, stupid b*tch, among other things) the other resident came to her defense and they ended up moving HIM to a different unit. When he has been an established patient for more than 5 years, and when the abuser has only been here a few months.

My management (including our admissions director who thinks shes a nurse) really baby him.

They feel bad for him because he was previously homeless ect. So he continues to get away with verbally abusing everyone. Literally, everyone.

Well tonight, he rolled over to my unit and was looking down the hall as if he was looking for someone. I asked him politely "You doin' alright? Can I help you with something?" to which I got a rude "What the f*ck do you care?" I stated "Its my job to care. You're a patient here, and Its my job to help make sure you have what you need" He then proceeded to say several condescending things to which I paid little attention, and then he asked my name and left.

I alerted his nurse that he was on my wing, doing what I thought was looking for the patient he had kicked off his unit that I previously mentioned. I didn't say he WAS doing it...I said he LOOKED like he was. We chart behaviours, and I figured this would be a prime time to make a note.

Not 10 minutes later he came rolling back and screamed "So what the f*ck? you call my nurse and tell her Im over here looking for {name}! When thats a bold fu*king lie!?" I calmly stated "No, I said I thought you were here looking for him." Which I doubt he even heard over calling me an idiot, threatening my job, threatening to turn me in ect. Then he called me a stupid ***** and rolled away. I had had enough. I told him to get away from my desk and when he called me a stupid ***** I straight up said "Shut up."

According to my NHA, and DON....nurses do not have the right to defend ourselves. We have to just take it when a patient is being abusive.

As it has been mentioned, I can understand patients that are not in their right minds (psyche, dementia ect). But, like this patient is, I refuse to be verbally abused by a patient that is in their right mind, Alert and oriented x3-4 and he knows exactly what he is doing.

Of course, my RN manager was in her office, not 10 feet away from where this happened, so, fearing at least a write up, I went and spoke with her. She is the more level-headed of all of my managers, but she still was compelled to say "Well, obviously he's not in his right mind" .....

I thought being A&Ox3-4 was pretty damn "in his right mind". But she wouldn't hear of it.

Tonight was actually the straw that broke the camels back, and I turned in my 2 weeks notice because I KNOW when my NHA and DON get here Monday morning and see that he has turned me in for telling him to shut up that anything I have to say will go in one ear and right out the other. There is absolutely ZERO protection for nurses. We are expected to smile and say thank you when we are called ******* and everything else under the sun for doing our jobs. I have only been a nurse for 4 years, and Im already burned out. Best of luck to you my dear.