Catching Hell

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I am a Nurse Case Manager fo a major Medicare HMO, and caught the wrath of GOD yesterday afternoon from a Member's son, even though I had nothing to do with our Medical Director's decision to deny placement for her in a skilled facility.I was told to discuss Home Health Care for her with him, and he informed me, among other things, that I was a f----idiot. Every other word was marked with expletives, even though I was trying to help him. It just goes to show that we're blamed for everything..

[sunnybrook83]

And people wonder why nurses are leaving the profession in droves?!

[ruth]

Aw, come on guys. The same thing happens to a Wal-Mart cashier and everyone else that has contact with the general public! Stop the angry pity-party. Yup, I'm an RN that deals with folks like those mentioned above and my fantasy dream job is to be a Greeter at Wal-Mart (Hi!). Do they ever get yelled at? What's your dream job?

[MollyJ]

Hi Pam,

Sorry you got vented on, but that is probably one of the big jobs that comes with case management. It is where we realize that the allocation of resources decisions that we make affect real people's lives. One more statement. It is also your job to help the guy get past the profanity to articulate his concerns so that you can figure out if you need to help him by advocating for him/his mother. Remember, advocacy is part of the nursing role.

And I hope that my last statement doesn't sound too sanctimonious because I, too, have walked away from being verbally whipped when I didn't want to do anything more than NEVER talk to that person again, but sometimes they are really trying to tell us something that we need to listen to.

Good luck.

[Mijourney]

Originally posted by MollyJ:

Hi Pam,

Sorry you got vented on, but that is probably one of the big jobs that comes with case management. It is where we realize that the allocation of resources decisions that we make affect real people's lives. One more statement. It is also your job to help the guy get past the profanity to articulate his concerns so that you can figure out if you need to help him by advocating for him/his mother. Remember, advocacy is part of the nursing role.

And I hope that my last statement doesn't sound too sanctimonious because I, too, have walked away from being verbally whipped when I didn't want to do anything more than NEVER talk to that person again, but sometimes they are really trying to tell us something that we need to listen to.

Good luck.

Hi. I agree with the previous posters. MollyJ, great words of encouragement. I would dare to write that some or maybe many of us can write that we have been verbally beaten by a physician or two, other medical staff, administration, patients, families, and yes, even nurses. That's not to write that you won't feel pangs of hurt when it happens. I've worked in insurance in the past, and have been on the receiving end of screaming physicians or someone else. Once I accepted the fact that these people were venting to me as a representative of the insurance company which they considered the enemy unless their every demand got met, I got over it. I didn't stay in insurance for long, because I wanted to be directly involved with patient care. So I went into home health instead of going back to the hospital. Since being in home health, I've had to break a few hearts because something would not be covered by insurance. Pam, hang in there. I understand that case management is becoming the wave as everyone ages with more complex problems, health/medical technology becomes more advanced, and costs continue to rise. Best wishes.

[ratchit]

Wow.

I'm shocked- more that nurses aren't backing you up than that a frustrated family member thought things would change by screaming at you.

You are in your job as a professional and deserve to be treated as one. Our actions affect people in very sensitive areas of their lives and we will hit some buttons now and then- and should be more forgiving than other fields.

But insulting you, swearing at you, and screaming at you are not acceptable.

When I was in school, I worked at the telephone service center for a bank and took the calls from the people who had tons of money. Even with the billionaires who thought they owned the joint, I was not expected to take that treatment. Policy was to say I understand you're frustrated, I can hear that you're angry and I'm sympathetic. And I hope to be able to resolve this for you. But I won't be spoken to in this manner. Then offer to call them later or let them call you after they've cooled off and can work with you, not scream at you.

Really- what kind of treatment plan are you going to come up with in partnership with a screaming profane monster?

Maybe you should transfer those calls to the voice mail of the medical director or your HR person to get some changes made.

[minurse]

try those words and a few other choice words coming from the patient you are trying to keep alive. What a great day Monday was!!!

[nursejanedough]

OK, call me a Southern redneck, or whatever, but if someone was talking to me and said something like, "allocation of resource decisions", I'd say, "Huh? What in the hel...? I think MollyJ, you must be in management or you should be. Those words were in your response, but it's not you, it's me. I am so tired of all the legal "mumbo jumbo", the psych "mumbo jumbo" and the nursing "mumbo jumbo". All these initials that no one knows. And what is with calling a patient a client now? That's like saying, "The client in room 302 needs an enema now." No offense to MollyJ, and ruth, keep dreaming of that Wal-mart greeter job. Because I don't think you can be sued for saying, "Howdy, instead of Hello." I see lists of RN's being sued weekly. P.S. I was a case manager in Home Health and in some sort of management in LTC. For some reason, if family members don't see their loved ones getting good care, (like being fed their lunch), they get upset. Go figure.

[TracyRN]

Just as an aside: that dream Wal-Mart greeter job? I know a sweet older lady that has that job. Part of their duties include loss prevention and checking reciepts for TVs, stereos, etc. My sweet friend gets cussed out daily by other "sweet" old ladies. Sorry, Ruth, to be the bearer of bad news.

I'll stick with nursing!!

[Julie, RN]

I too am sorry that happened to you...

But what about when other health care professionals behave this way to you?

I am more forgiving of my pt's than my co-workers. I have been a nurse for 6 months and love it! But, I will not tolerate this kind of behavior from my co-workers, so I have actually written up another nurse and a respiratory therapist for truly discustingly unprofessional behavior. I have had several nurses pull me aside and congratulate me on my "assertiveness to step forward and say something". I think it is sad that others just accept this behavior as part of the high stress environment involved with healthcare. What do you all think?

[soundsLikesirens]

I agree. I wouldn't put up with this, from another RN. You can write it up...as far as a patient, I would leave the room and tell them when they could speak to me properly, I'd return but not until then....the people on my unit, most of them, don't accept abuse.

[Mijourney]

Originally posted by Julie,SN:

I too am sorry that happened to you...

But what about when other health care professionals behave this way to you?

I am more forgiving of my pt's than my co-workers. I have been a nurse for 6 months and love it! But, I will not tolerate this kind of behavior from my co-workers, so I have actually written up another nurse and a respiratory therapist for truly discustingly unprofessional behavior. I have had several nurses pull me aside and congratulate me on my "assertiveness to step forward and say something". I think it is sad that others just accept this behavior as part of the high stress environment involved with healthcare. What do you all think?

Julie, you make excellent points about abuse from our coworkers, physicians, and other staff. I think that in many cases, when a family member or patient vents, one has to judge whether the attack is to be taken as a personal affront or not. When you're dealing with the public, in particular, you have to decide whether you want to internalize their remarks. I guess it depends on the type of rapport you've establish with the patient or family.

As indicated by other posters, no, it is not okay for anyone to assault another. And yes, you should be able to either hang up or walk out on someone when under attack or at least get another witness. While they're yelling, calmly announce that you're walking out or disconnecting them, so they won't have any ammo to use if they go over your head.