Antagonizing patients--just a vent

[Isitpossible, LPN, LVN]

I have been in psych now about 7months. I am very disturbed at some of the behaviors exhibited by experienced nursing. Why do some nurses antagonize these patients. Patients are there for a reason, is it really necessary to be sarcastic and use foul language with these patients? could this behavior happen or even be tolerated on any other type of unit?? why is this okay for psych patients? I cant stand it. One of the off-going nurses got in the patients face demanding that he go to his room. The patient back talked, but really he is very psychotic. He went to the doorway and stood in the doorway. That wasn't good enough for the nurse. The nurse got right up in his face, I mean nose to nose, and screamed you better get in that room right now, Im not playing with you... it was just so unnecessary and demeaning to the patient. The nurses posturing was a scary. Granted these patients can be trying, but again that's why there are in the hospital. If your burnt out please allow another nurse to take over, and stop personalizing their behaviors. I really want to report this to the NM, but its such a difficult situation being the new one, complaining about the seasoned one.. ughgh... its just sickening sometimes... very un-therapeutic and sad

[Sadala, ADN, RN]

I have also seen this before in psych. I never could figure out what glory there was in winning a power struggle with a mentally ill patient. Just doesn't make a lot of sense to me.

[VivaLasViejas, ASN, RN]

I don't know much about what it must be like to work with psych patients, but I do know what it's like to be one, and if I were in the middle of a manic/psychotic episode and a nurse (or anyone else) were to treat me that way, I'd probably punch his/her lights out.....and I'm not a violent person. There is NO excuse for antagonizing, degrading, belittling, cursing at, or treating adult patients like unruly three-year-olds. Not even when they're acting like unruly three-year-olds.

While dementia is undoubtedly different from mental illness in some ways, I've worked with patients who had both conditions, and believe me, you can't argue or reason with either. Nor do such tactics work with someone who's flat-out psychotic (I know, it's been tried, and it didn't work with me either). Please advocate for your vulnerable, mentally ill patients and report the unnecessary roughness to your supervisor.

[Hygiene Queen]

I work psych and what you are describing is not acceptable.

Call him on it.

Report it.

[Isitpossible, LPN, LVN]

hygiene ---I really contemplated reporting it... but I feel sure that management is aware of their nurses behaviors. these nurses have been there years upon years... I don't believe that management doesn't know their staff after so many years. Rather-- I thought about suggesting some type of sensitivity retraining for all nurses... I think that may fly better..

[Marshall1]

Do something - these patients are in vulnerable positions and either the nurses you work with are cruel and abusive or they truly don't understand psych patients. Either way, they are abusive to the patients, based on your description, and make nurses look like @$$-----

[LoveNeverDies]

Completely unacceptable in any unit. I'm an aide in an ALF and this has been done to dementia patients. I report every single harmful interaction. You know your unit best, but suggest something soon because that needs to change. Pretty soon she will do that to the wrong patient, and she will either end up airborne or stomped 2 feet through the floor.

[Hygiene Queen]

It's not cool to escalate a psych pt... and that is exactly what's going to happen if this nurse keeps getting in people's faces.

So, a pt gets angry and lashes out... so what then?

Is anyone going to step up and say that a nurse incited them?

Our job is to keep things cool and set limits in a firm but professional manner.

Yes, recommending more training is a good idea, but don't let it slide because you "think they know about it already".

Advocate.

[Orca, ADN, ASN, RN]

I have worked with mental health nurses who are heavily into the control aspect. On a geropsych unit where I once worked, I could sense my patients beginning to tense up in the last hour of my shift - in anticipation of my relief nurse coming in. She was critical of my crew for "letting the patients do whatever they want." She came in to "restore order". She was very abrupt and negative with the patients, and she was interested only in them staying in their rooms and not bothering her. What she did was not even remotely therapeutic, and she had no tolerance whatsoever for any patient who was the least bit difficult - which was a pretty sizeable chunk of them. Most situations were handled through direct confrontation.

Impatient, high-strung people should not work in mental health.

[Orca, ADN, ASN, RN]

hygiene ---I really contemplated reporting it... but I feel sure that management is aware of their nurses behaviors. these nurses have been there years upon years... I don't believe that management doesn't know their staff after so many years.

Even if they are aware, report it. The more reports they get, the more likely they are to do something. If they do just dismiss your complaint, then you are in a truly dysfunctional work environment. In any event, once you have reported, management cannot claim that they were unaware of any issues should this blow up in the future - and it will. Sooner or later, nurses like this will confront the wrong patient and there will be a physical altercation - one that could have been avoided with a little kindness and patience.

I had rather spend 30 minutes talking a patient down than five minutes restraining him.

[JeanettePNP, MSN, RN, NP]

When I was doing my psych rotation in school, there was one pt with bipolar disorder who was put in 4 pt restraints every.single.day. Obviously it was only making her nuttier. Finally the attending said nobody has permission to put her in restraints unless he comes personally to the floor.

ALL of us will fly off the handle given enough provocation and disrespect. The purpose of a psych ward is ostensibly to provide a safe, therapeutic environment for healing. Unfortunately I haven't seen that in real life.

[AZ_LPN_8_26_13]

Impatient, high-strung people should not work in mental health.

I think that sums it up quite well. Type A people who are control freaks shouldn't even dream of working in this field. I am considered by my peers to be a kind, compassionate, empathetic listening type of person who cuts sick people slack for being in a hospital, and even I wouldn't consider trying to be a psych nurse.