The Disrespect Of Nurses

[TheCommuter]

I was at my workplace earlier this month when my supervisor told me about a volatile situation that was unfolding on a different floor between another nurse and a verbally abusive family member. This particular family member was at the bedside for twelve hours straight and refused to leave when gently prompted. She was confrontational, hollering, taking pictures with her cellular phone, and interfering with procedures that needed to be performed on the patient. Nothing seemed to please her.

And guess what? The verbally abusive family member was coddled by management and allowed to stay well beyond the visiting hours that other visitors are expected to follow. I suppose the old saying applies in this situation: "The squeaky wheel gets the grease." Too many members of the public know that they can act like loudmouthed fools, behave disrespectfully toward nursing staff, and basically get away with it.

I clearly recall another instance of blatant disrespect at the same workplace. A group of surly family members were yelling obscenities and threats at the floor nurse and supervisor after being informed that the patient contracted a urinary tract infection: "You haven't seen crazy until you've seen me!" "I will put my foot up your ***!" "You'd better get my mother out of this place before I get you out of the way!" To keep a long story short, the patient was sent to another hospital to receive the same intravenous antibiotics that my workplace had been providing.

These same instances of disrespect would be totally nipped in the bud at other places of business. For instance, the frustrated traveler who attempts to enter the cockpit and give the airline pilot a 'piece of his mind' will be jumped on by the air marshall. If I start acting out irrationally and refuse to leave the local new car dealership once closing time has arrived, the workers will call law enforcement to physically force me off the property. The customer who threatens the safety of the teller at the credit union will be escorted to the parking lot by security guards. If any of you try to walk to the back of the bakery to harass the staff and take pictures of the employees and equipment with your cell phone, you will not be in the bakery for very long.

According to polls, nursing is the most trusted profession. For the 12th year, nurses were voted the most trusted profession in America in Gallup's annual survey that ranks professions based on their honesty and ethical standards (American Nurses Association, 2012). However, trust must not be confused with respect. While nurses are certainly trusted, we are not respected by the public, management, or administration.

Although it is generally not constructive to babble about a problem without offering possible resolutions, I do not pretend to know of any solutions to this complex problem. For starters, it would be nice if we had the backing of management more often. Do you have any real life tales of disrespect from patients, visitors, families, or other members of the public? If the answer if yes, please share. And most importantly, please stay safe!

[3fins]

Simply put, it is because most nurses are women. Women have a tendency not to stand up for themselves. Therefore management allows the abuse in the name of patient/family satisfaction.

If the majority of nurses were male, it wouldn't be that way. I guarantee it.

[Soliloquy, MSN, APRN, NP]

3fins said:

Simply put, it is because most nurses are women. Women have a tendency not to stand up for themselves. Therefore management allows the abuse in the name of patient/family satisfaction.

If the majority of nurses were male, it wouldn't be that way. I guarantee it.

I don't feel like that's entirely true, though at times I feel we can spend more time gossiping and complaining than addressing the issue head on. ? We get "brainwashed" in nursing school and even in orientation when you start that when a patient reacts to you it's "not really about you" and you have to give a certain response and focus on patient centered care. And it's true. It's seldom ever really about you and you do have to give patient centered care. But that just doesn't give anyone the right to get physical or verbally abusive. Thick skin is necessary, but discernment too. You just have to stand up for yourself, in a respectful manner and if push comes to shove, then yes, security must be called because safety is so much more than just for the patient. It's for you too. I'd even argue that calling security wasn't just about your own safety, but also the safety of that patient and all the other patients on the floor because a hostile environment affects everyone.

[lindarn]

How come when patients/family, members, are not at their best, because they are, "scared, in pain, or just not feeling well", the only people who are yelled at, punched, screamed at, etc, is the nursing staff?

They manage to behave themselves when PT, OT, Pharmacist, Dietician, the Physician, comes in. Why is that?

Forget about nurses being voted the Number One for trust. Trust does not equal respect.

JMHO and my NY $0.02.

Lindarn, RN ,BSN, CCRN

Somewhere in the PACNW

[noblame]

I'm wondering of the possibility of there being a distinction between the intention to disrespect and the unthinking expression of one's own confusion or pain towards a situation. Perhaps that's the case of the person yelling at the nurse. Granting there is, i wonder how i can respond to the person yelling, assertively. i don't want to just ignore his yelling at me even if i don't take it as disrespect. Neither do i want to just ignore it by focusing on the patient's care. How can i do that?

noblame

[Sugarcoma, RN]

I just simply cannot wrap my head around the way some people think. I have been in stressful situations, where I did not know if a family member was going to live or die, where I have felt the care they were receiving was poor, and when I have been told things I really didn't like...like having to remain NPO etc. I have NEVER once taken my frustrations out on the nurse or tech that was treating me. My parents taught me how to express my anger or frustration constructively. They taught me that if I am in a bad mood I do not have the right to take it out on everyone around me. They also taught me that I am not the center of the universe.

I am SICK TO DEATH of hearing "there under so much stress." So what. So am I but I would certainly never tell the call light abusing can you move my little toe two inches to the right please patient what I really think of them. There are no standards for behavior anymore. Peoples expectations of nursing are so ridiculously high. You walk into the room and immediately they are confrontational. Hospitals are not hotels. Patient's are not "clients." Nurses are not waitresses. Medical care is medical care. There are no ala carte options! Either comply with your treatment plan or go AMA.

I have been slapped, spit at, had things thrown at me, threatened with harm, and been called everything but a child of god since I became an RN 3 years ago. I have had enough. I have taken a very assertive stance with problem patients and family members. I am never rude and maintain a very calm voice but you are NOT going to photograph me, follow me into other patient's rooms, hover over my every move, monopolize my time or abuse me if you are A&OX4. This works most of the time, but I am fully aware that if they make a complaint to the management I am at risk of losing my job.

I agree with Lindarn's post regarding the difference between how nurses are treated as compared to doctors, pharmacists etc. In my opinion part of the problem is this ridiculous notion that a nurse should be an all sacrificing angel of mercy at your beck and call. It is even more disheartening that so many other nurses buy into this same notion.

[rubato, ASN, RN]

lindarn said:

How come when patients/family, members, are not at their best, because they are, "scared, in pain, or just not feeling well", the only people who are yelled at, punched, screamed at, etc, is the nursing staff?

They manage to behave themselves when PT, OT, Pharmacist, Dietician, the Physician, comes in. Why is that?

Not always the case. My father told PT to get the F*** out of his room or he'd beat the s*** out of them. I had to do some very serious damage control that day! (I decided to become a nurse that day).

[Guest219794]

echoRNC711 said:

The times that we have involved security for psychotic pts they invariably only speak to the patient , (like that's gonna help )but do little more. Meanwhile the nurses are left carrying a biting,kicking,spiting pt whose goal is to claw at least one person's eye out. Yes, thanks security it just fills me with peace knowing you dutifully rush to the scene to WATCH it unfold!

But......

On a good day (We have so many::): ). OK on a rare good day.....I can distance myself, recognize that people "act out " only because they feel afraid. The less control they feel the more they will attempt to control by pushing back. My philosophy, yield. I don't mean yielding from a place of weakness. Yielding because I have learned that this person/ situation in front of me does not merit me carrying them on my back emotionally for the rest of the shift or home in the car with me or to sit in my living room to "let them out " on my family.

So what does this raging,arm flapping pt want? I have learned it is never "the problem " as its appears but rather the pt outcry -To be heard.To feel in control.To not longer feel afraid. So,in those better moments, that's where I go straight to the real problems. Remember Erickson? Trust vs mistrust, infantile behavior well it lives loud in hospitals. They regress and their families right on with them at the first sight of what they are perceiving a threat.

So do we want to be "right " or to solve the problem. Sometimes,that can feel like a tough call. It's about digging inside to find that better part. I'd say consider it's your child behaving badly so you can regain control ( In my case that wouldn't work as I have a teenage son who only escapes being drowned by me in the bathtub simply because he's just too big to get him in there!! ) ok, back to professional self....Keep it simple. The patient is scared. Respond to THAT not the behavior. The moment it becomes a power struggle you have already lost.

So for me,in situation like this I soften. If I am not going to remember this incident when I am sitting in my diapers in the nursing home it really isn't worth it . So with that beautiful future in diapers it seem to show me the future and present, Just let go!

If this doesn't work for you....May I suggest taking the pt to what I like to call the "cliff face " to the very edge of the abyss. You do this by saying "Aren't you just making a fuss over nothing", " Mr. X Please learn to be calm " " Mr. X. we both know You are not making much sense.Do you need a little time out" Then sit back and watch the fireworks!A full blown 4th of July. OK....Ok , I haven't done it but in those nights in the car where I am carrying one of those pt home with me on my back I like to dream . To dream it in full pantomime, where I give the pt a Ralph Kramden punch "Bang ,zoom To the moon Alice! to the moon! "

I am going to have to disagree with some of your post here.

Many abusive jerks are simply bullies. A nurse does not have the time or ability to deal with the underying causes that create bullies, only their behavior.

Remember, with rare exceptions, most of these a--holes are in complete control of their behavior, and choose behavior that meets their perceived needs. Once the behavior no longer meets their needs, they alter their behavior. For example, we had a spitter in the ER. He spit at me. My initial reaction was to draw back my fist to punch him. I stopped myself with myself with my arm kind of frozen there, to which he responded, "go ahead, punch me". He was in complete control, and almost got me, but I remebered that there is a rule against nurses punching patients. He tried that nonsense with a cop in the room, and the cop stuffed a pillow over his face long enough to get his attention. All of a sudden, this "out of control" pt is able control himself. While this jerk had a need for power and control, apparently his need to breath was stronger.

Regarding Erikson: An egghead academic who probably never dealt with an assaultive patient in his life. His theories are great fodder for academic dicourse. But, if somebody wants to hurt me, Ill take a taser over a textbook any day.

[Sacred eagle]

People disrespect nurses for manyreasons. From the early 70's toabout the 90's in my opinionmany nurses were evil and dida lot of nasty and disrespectfulthings to patients. Today's nursesare paying for the bad deeds theolder nurses committed.

[multi10]

Respect? I am struggling with this. While in my teens I was hospitalized as a result of 2 separate accidents. (One on the back of a motorcycle that crashed and the other the result of chicken fights in deep snow when the boys decided it would be fun to jump on our backs. Result: Torn ACL and rupture.)

I was hospitalized for weeks each time and came to recognize and appreciate the compassionate nurses. I also recognized the not-so-compassionate nurses. I decided to become a nurse as a result. I wanted to be one of the good nurses.

When I became a nurse on the floor, I came to realize how challenging it is to always be "the compassionate nurse." Outside (and inside) the door of the patient's room, we nurses can be treated very badly.

It hurt so much to get to the place where I had to accept the truth of nursing. We do what we can but there are forces beyond our control that frustrate us at every turn.

There is a happy ending. I finally experienced how good nursing can be: I worked ICU/CCU in California and it was different. I was changed.

We were able to truly care for our patients. I had many beautiful moments with post-CABG patients, such as the first time I ambulated a man post-op. I had seen him off to the OR the day of surgery, and held his hand. I could see the fear in his eyes. I said, "You are going to be fine. I'll be here when you wake up." When he woke up post-op I was there again. I had the pride and pleasure of ambulating him, in a leisurely fashion.

And talk about respect? We nurses moved above and beyond respect because we were part of an essential team. We ran the units and gave the July 1st interns advice. They paid attention.

[DizzyLizzyNurse]

multi10 said:

We get disrespected because we put up with it. It starts in nursing school. My instructors treated us like ignorant little sniveling street urchins. They were horrible. I can't recall a a single instructor who treated us with respect.

Then we graduate, pass the boards and get treated poorly each day on the floor. You just shrug and get used to it after awhile but it sure takes its toll in the long run.

I've said this myself.

Man is it good to work at a decent hospital. We are union. The place I worked at before (part of the same system) was in a horrible section of town and had signs up reminding patients and visitors that it is a felony in this state to assult a nurse. Worried me that they were up but I never saw anyone act like a crazy person.

The hospital I work at now (same system) security escorted out a Hospice visitor a while back who was screaming at a nurse. At first they just asked him to leave to cool down. He then threatened the nurse and then he was forced to leave and told not to come back. Then security was posted outside the door of that Hospice patient because of the difficult family. We were to call them if the family came in to visit.

I was used to working at a place where I was told to snivel and kiss the patients' feet. So at my new job, when some crazy person started yelling at me because she had asked someone else to do something, I was surprised when my charge nurse and another fellow nurse marched up to that woman and stuck up for me. They informed her she was not to yell at the staff and treat me that way and if she continued to do so security would be called.

[TheCommuter, BSN, RN]

Sacred eagle said:

People disrespect nurses for many reasons. From the early 70's to about the 90's in my opinion many nurses were evil and did a lot of nasty and disrespectful things to patients. Today's nurses are paying for the bad deeds the older nurses committed.

Very interesting, thoughtful outlook. Does any evidence exist (research, anecdotal, or otherwise) to support your notion that many nurses were evil and disrespected patients from the early 1970s to the 1990s?

[monkeybug]

conroenurse said:

Sad to say I witnessed a medical student and a nurse fall down elevator shaft while dealing with a violent patient. The Medical student died, the nurse paralized for life. I try to remember that when your dealing with patients, families, there are all kinds of family traditions, family drama going on, and nerves are high at times when family member is hospitalized......

That is the most horrifying thing I've heard in a long time. How horrible!