Dealing with Difficult

mscsrjhm · Jul 4, 2008

I'm just too old and tired. As soon as any conflict starts- I ask the patient if they would like another nurse. Tell them that you know they are sick, and perhaps miscommunication has lead to a bad start, so another nurse might be able to understand their needs better.

No sense in either you or the patient having a bad shift.

The patient is usually very happy to get another nurse- they can talk about what a terrible job you did, and they will treat their new nurse wonderfully- just so everyone knows that it is your fault.

leslie :-D · Jul 4, 2008

i haven't a clue as to what you are asking.

a pt has a code brown.

ok.

who is upset and why?

what is the dilemma?

who cleans it up or how to deal w/irate pt/family?

leslie

slaterd · Jul 4, 2008

I think you might have missed the metaphor.

I wasn't being literal

Virgo_RN, BSN, RN · Jul 4, 2008

Kill em with kindness. Pretend that I really do care about their petty little issues, and explain what I can and cannot do, all with a smile on my face. Then go about my business and roll my eyes and mutter under my breath about them while I'm pulling meds in the med room.

leslie :-D · Jul 4, 2008

I think you might have missed the metaphor.
I wasn't being literal

ah...

my apologies.:)

you always keep your cool.

that is the only way one maintains control of any given situation.

you (calmly) listen to their complaints and respond w/proposed interventions/solutions.

if the ranting continues, you remind them of how you intend to handle it, AND, that yelling and carrying on, will not produce faster results.

i believe most of these pts/family respond to polite and firm limit setting.

and as i always advise, write darned good notes.

leslie

nursej22, MSN, RN · Jul 4, 2008

It depends on the situation--sometimes a direct approach works: "I feel that there is tension, disagreement, conflict, whatever between us. How do we resolve this?" Patients and families may not realize the expectations that your employer, the law or doc places on you does not allow to fulfill their expectations. And sometimes they are pi**ed about something completely unrelated to you and they just dump on you.

I am getting really tired for being blamed about the wait in ED, being npo all day because an emergency bumped you down the schedule, that your doctor is rude, I don't have time to explain your entire hospital course to 20 different relatives, not my fault the room is too hot, cold, small, stuffy, not enough chairs, toilet is too low, smoking is not allowed, or we are out of cots. You don't like it here? There are at least 4 people in ED who would like your bed. And if I were you I would be a lot nicer to the person who brings your pain meds!

I have offered to have another nurse assigned to them but we are so busy that changing assignments is sometimes worse because it sets you and your co-worker so far behind.

I don't hesitate to call security when people are too aggressive. I don't get paid enough to put up with abuse.Some people are just a-holes and you only have to deal with them for one shift, while they are stuck like that for a lifetime.

Natkat, BSN, MSN, RN · Jul 5, 2008

Ha.

We have a saying. "I'm going to go home and leave him right here."

I deal with it by letting them rant while I'm mentally planning my grocery list in my head. Meanwhile their mouths are moving but all I hear is the Charlie Brown teacher voice....."wah wah..wah wah wha wha wha....wha wha wha...."

Just last night someone said to me "did you dialyze that patient last time?" I said "no" and the nurse said "good, because he said he doesn't want that nurse touching him again." I laughed and said "they say that about all of us. I just ignore it."

Don't take it personally. A person who has been a jerk his whole life isn't going to change while he's in the hospital. He treats everyone like that. Stay calm. Let them vent. Count to 10 then ask them what they would like you to do for them. If you can't do what they ask, offer some alternatives. Meanwhile just do your job and visualize your paycheck.

Daytonite, BSN, RN · Jul 5, 2008

well, my training came from being raised by a mother who was the incarnation of judge judy and dr. laura with a belt in one hand and a wooden spoon in the other. both her parents were alcoholics and she learned all the dysfunctional behaviors from them including unfairness in discipline. if she was wailing on one kid she would look at another and yell, "what are you looking at?" and proceed to start wailing on him because, "i'm sure you deserve it".

what i learned from being treated like that [and you are going to have patients who just pop off suddenly, without warning, or accuse you of something you know you didn't do] is to just stand there with a blank look. you never respond in protest face to face with the complainer because that only fans the fire [and we got an even worse spanking from our mom]. if complaints rise to the level of the manager, then you present your defense and hope the manager is smart enough to realize that there are passive-aggressive nincompoops in the world who use strangers [you and i] to take their frustrations out on. you try your best to assuage them. you try to meet their needs, as stupid or demanding as they might be, before they voice them, if you can, since some of these people are testing you to see how fast you are going to respond to their beck and call. sometimes prompt service [yes, i did say "service"] shuts them down and gets them out of your hair which is all i wanted in the first place.

i treat everyone with respect. i've worked in places where we had drug addicts, prisoners, homeless people, wealth beyond your dreams, movie stars, gypsies and people you might call scum. bottom line is that they are all people and if you treat them nicely, they, in general, do the same right back at you. those that don't--well, they've got their own thing going and i refuse to be sucked into their personal dramas.

i took a seminar years ago where i asked about people who were always on their call light with one little request after another. your instructors from school will tell you that these patients are in need of something and it is up to you to figure it out. that's what the seminar leader said too, but he did tell us how to go about figuring it out. you have to spend time with these people, talk to them and be very observant. they may not tell you right away because that little issue of trust and bonding has to happen. but i have generally found that when i have paid attention to many of these squeaky wheels there was a hidden bombshell that was eventually revealed. some of these people ended up being our code blues! don't get me wrong, a few are just nasty sobs. i'd rather be nice to all in order to catch the ones that are coding instead of turning a deaf ear and losing someone because i missed the s/s of an impending code. i just am respectful to everyone. i can badmouth them when i get home and safely out of their earshot.

i learned how to do transcendental meditation in my 20's and practiced it pretty regularly. i also was a student of metaphysics and studied a number of different religions. i think that my spiritual beliefs play a big role in how i see other people's behavior. i believe that everyone is traveling their own path of discovery. we cross paths with others along the way and [now here is where the meditation and metaphysics helps] rather than see the encounter as something negative, i try to figure out what i can learn from my interaction with that person. if you look at things that way then there is something positive to learn from encounters not only with patients--even the sobs--but with everyone. as nurses we are also in the unique position to role model the correct behavior with patients. some nurses forget that. what meditation, metaphysics and spiritualism has taught me is that nursing gave me many more opportunities to grow spiritually than i would have had in any other profession.