Dealing with The Yellers

casi, ASN, RN · Feb 3, 2008

Are they yelling because they know it makes staff come faster or are they yelling because they are confused? Imagine being in a strange place you don't know and not knowing how to get help.

putmetosleep · Feb 3, 2008

I've had this problem over the past month or so and it frustrates me. Patients that are stationed near the nursing stations so they can be watched, but instead of pushing their call bells, they scream "NURSE" over and over again. The current one yells about every 3 minutes. If no one goes to check on her (she's near the nurse's station so the nurses can look in on her) or come fast enough to suit her, she starts screaming all the louder.
Maybe I'm being overly sensitive, but quite frankly, the yelling that these patients keep doing gives me a headache.
How do others deal with patients like this? I'd really love to tell them to shut up, but of course, I can't. I have to be nice.
I'm not assigned to this patient, so I don't know if there are any meds ordered for her.

Find out why these patients are yelling. Maybe they are anxious, maybe they are in pain, maybe they just want nurses to come faster. Who knows. But the only way to deal with it and minimize it is to figure out why they're doing it in the first place. Meds are not always the answer.

strider1500 · Feb 3, 2008

When I worked on a Med-Surg floor most of my patients were full-blown Dementia cases. One lady kept screaming for the police to come and rescue her.

Batman24 · Feb 3, 2008

If they are confused, have demensia, etc. than I would answer their screams as soon I could because they really don't know any better. If they are of sound mind and not in terrible pain/danger I would ask them to use the call button and remind them it's a hospital and many are sleeping, resting, etc. They just might need a friendly reminder and probably mean no harm.

al7139, ASN, RN · Feb 3, 2008

We have the "yellers" constantly on my unit. If I am walking by, and they yell "Nurse!" I will stop and ask them what they need. It is annoying, but lots of times they are confused, or can't find the call bell, and don't realize how disruptive it is. If the pt is A&O, I remind them nicely that they should use the call bell if they need us, so they do not disturb the other patients. It is hard not to get frustrated with these people, but you just have to keep a smile on your face, and deal with them, even though they are difficult.

Amy

Violetucf · Feb 3, 2008

Hello. I work on a PCU floor at night and we predominately elders patients, so I'm no stranger to yellers. If they have dementia, there isn't a whole lot that can be done outside of medication. Sometimes the yelling is a comfort thing for them because they know someone will come in the room if they yell long and loud enough, regardless to the misery they are putting their roommates through. Some of them feel abandoned and helpless in the hospital and yelling for a nurse is a way to gain some control. For the ones that aren't confused, remind them that they can reach the nurse by using the call light, and make sure that someone does go in the room promptly when they do. And make sure they can reach the call light or modify it so they can press the button. Also, sitting with the patient in the room when you're not busy or doing your charting in the room if possible will keep them from feeling abandoned. And make sure they have everything they need in reach (tissue, water, urinal, etc).

I know it can be frustrating, but I think after a while it just becomes part of the background noise, much like the alarms and dings of pumps and monitors. But don't just ignore them, cause bringing the patient comfort is really part of the job.

RNsRWe, ASN, RN · Feb 3, 2008

I'm with the others on this. You just can't get around the yellers, unfortunately. Mostly, the ones that I've had the unpleasant experience of being around are confused. They forget that they have a call bell. They forget how to use it. They worst-off ones forget where they are, of course, and just yell because they are befuddled.

Now, the ones who yell into the hall and ARE of normal mental status, well, they need to be told to use the call bell so that they don't disturb people who will then take you away from ANSWERING their yells After all, if their yells wake the demented ones, who then require your undivided attention for the next hour, how does it help THEM?

And, sometimes, nothing you will ever say will make a danged bit of difference. The confused ones will still yell. The selfish, rude ones will still yell. And at the end of the day, you can either shrug it off or make yourself crazy!

Tait, MSN, RN · Feb 3, 2008

I agree with the previous posters about addressing them based on dimentia or non-compliance or w/e thier particular issue is.

What irks me more is CNA's who proceed to holler from the hallway "What do you need Mrs. Jones?" >.

Tait

GrnHonu99, RN · Feb 3, 2008

I work in neuro. 70% of our pts. are "being kidnapped against their will"....confusion is the only constant thing on my unit...Sedation, restraints, haldol...these are all common practices on my floor. Although, there are some pts who yell for a valid reason, meet their needs and they stop..if not..see above ideas.

oldiebutgoodie, RN · Feb 3, 2008

A nurse I work with who has been nursing for 20 years said that she would tell the elderly demented women who were yelling, "Shhh! You'll wake the baby!" That seemed to turn on some deep internal maternal reflex, and they would settle down. Didn't work for men, though.

Oldiebutgoodie

GrnHonu99, RN · Feb 3, 2008

A nurse I work with who has been nursing for 20 years said that she would tell the elderly demented women who were yelling, "Shhh! You'll wake the baby!" That seemed to turn on some deep internal maternal reflex, and they would settle down. Didn't work for men, though.
Oldiebutgoodie

OMG I LOVE THIS....IM sooo going to use this tonight...im sure there will be some yelling somewhere!