Disrespectful patients

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Hello everyone,

I am both asking for advice and getting this off of my chest. I am an rn on a med surg floor. First, let me start off by saying I am a pretty good stick when it comes to iv's. I would say 90% of the time, I get an iv within 2 sticks- typically one though. That being said, no one is perfect.

Long story short, I had a patient getting 8 iv meds back to back. So I explained to the patient that he would benefit from having two iv's. Unfortunately, I did not get it on the first stick. This man went crazy.

He told me that I would not stick him again because I was clear that I havn't found a good vein. That, I just did not know what I was doing. He said "I don't know what kind of game you are trying to play but you have no idea how to do this and I want a nurse that does." .........I was literally speechless. I simply left the room.

Of course, I have replayed the situation over and over and each time I have a clever response that puts him in his place without getting me fired. But what would you have said/ done?

He then questioned my credentials each time I reentered the room which is just down right disrespectful. Any advice for next time? (Other than get the dang iv on the first sticky lol)

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"I will get my charge nurse to come and see you immediately". And do so.

Being stuck 8 times is wearing even with the most mild mannered person. And yes, it would be very frustrating to most people, Unfortuntely, you were the brunt of that anxiety/anger. I will tell you not to take any of it personally. It seems to me it was the situation, and not you as a person or a nurse. Going forward, just simply say you will get your charge. Let her/him smooth feathers and perhaps come up with a plan "b".

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Specializes in Flight Nursing, Emergency, Forensics, SANE, Trauma.
jadelpn said:
"I will get my charge nurse to come and see you immediately". And do so.

Being stuck 8 times is wearing even with the most mild mannered person. And yes, it would be very frustrating to most people, Unfortuntely, you were the brunt of that anxiety/anger. I will tell you not to take any of it personally. It seems to me it was the situation, and not you as a person or a nurse. Going forward, just simply say you will get your charge. Let her/him smooth feathers and perhaps come up with a plan "b".

I think OP meant the patient was scheduled 8 iv MEDICATIONS... Not that he was stuck 8 times.

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Tried to quote but my phone would not let me. She never said the patient was stuck 8 times only that he had 8 IV meds back to back.

I think another point of frustration for the patient is that he already had a working IV so the extra stick for the second IV might not have made sense to him. Most patients are pretty understanding about being stuck when their IV goes bad because they know they need one but even if he said I understand before you stuck him he might not have truly understood the rationale being the second IV. A lot of people will say they understand what you are teaching them because they do not want to look dumb. That's why some form of teach back is so important.

Now will 8 IV meds back to back i can see where the thought of having a second might be helpful but I'd only stick a second time if I had multiple IVs that were not compatible. Other a 250ml bag and piggy backs or secondary's would be a lot more convenient for everyone. (The IVs you were hanging could have been incompatible I'm not assuming they could have been hung together or that you didn't check I'm just over explaining I suppose )

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Specializes in Medical-Surgical/Float Pool/Stepdown.

I don't think the OP said the Pt got stuck 8 times but that the OP only stuck once and missed...correct OP?

I've had Pt's degrade me before and the longer I've been a nurse the more I've learned to (or just lost patience with) deal with it. I would have told the Pt that his behavior was inappropriate and that I was well qualified in my job and with IV sticks but there are many variables to IV sticks and we don't always get it on the first try.

I would not have tried to stick him again regardless as the Pt already had an unrealistic view of IV starts in general and it would be hard to just relax and do my thing.

It's a different kind of pressure when someone's coding and you're working against time to get an IV placed. It's a whole other issue when someone's stable and just being an a-hole!

For what it's worth, I find that I ruminate over frustrating situations more that seem to me are unnecessary and that catch me off guard. Luckily and unluckily I've been in more and more of these situations so I ruminate less and less.

One of my favorites (I work night shift) is when a Pt gets ballistic because we woke them up throughout the night for needed assessments/meds/etc and we did try to cluster care. Why do people think they're going to get a full nights sleep in the hospital and that we'll just not bother them for 8+ hours at night...yeah right dude, go home then! :sarcastic:

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AJJKRN said:
I don't think the OP said the Pt got stuck 8 times but that the OP only stuck once and missed...correct OP?

I've had Pt's degrade me before and the longer I've been a nurse the more I've learned to (or just lost patience with) deal with it. I would have told the Pt that his behavior was inappropriate and that I was well qualified in my job and with IV sticks but there are many variables to IV sticks and we don't always get it on the first try.

I would not have tried to stick him again regardless as the Pt already had an unrealistic view of IV starts in general and it would be hard to just relax and do my thing.

It's a different kind of pressure when someone's coding and you're working against time to get an IV placed. It's a whole other issue when someone's stable and just being an a-hole!

For what it's worth, I find that I ruminate over frustrating situations more that seem to me are unnecessary and that catch me off guard. Luckily and unluckily I've been in more and more of these situations so I ruminate less and less.

One of my favorites (I work night shift) is when a Pt gets ballistic because we woke them up throughout the night for needed assessments/meds/etc and we did try to cluster care. Why do people think they're going to get a full nights sleep in the hospital and that we'll just not bother them for 8+ hours at night...yeah right dude, go home then! :sarcastic:

I agree I worked nights for over a year and we re in the rooms a lot at night. I also hate waking that sleeping dementia patient to do something. I perfected my ninja nursing skills in those rooms.

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Right. I only stuck once, his meds were all incompatible and we're all ordered stat. I explained to him that he needed quickly, they could not be given through the same iv at once and a second iv would help him receive them quicker. One stick and he was furious. Thanks for the replies tho! Charge nurse it is! ?

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Specializes in Oncology, critical care.

I get flustered when patients speak to me that way and I often need to take a deep breath before I speak or continue. I used to get really upset and leave the room but after working in critical care/trauma my perspective on these things changed. I would have families literally screaming in my face for no real reason. I came to realize that people/patients are usually not angry about whatever it is that they are yelling about (like your need to poke him a 2nd time, which isn't a big deal and the patient usually doesn't care). They are scared about being sick/hurt/in pain, do not like feeling vulnerable, and are taking it out on you because... well... you're right there. After letting them get it out of their system I would take a breath, put my stuff aside and ask them what's going on. Nine times out of ten they will unload a boatload of anxiety on you, but then will relax and allow you to continue (and then you become their favourite nurse). I've even gotten apologies after the fact. It's all good, it's a scary situation for a lot of people -- regardless of why they are there.

And good on you for having such amazing IV skills! Not everyone has the accuracy you do. ?

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Specializes in SICU, trauma, neuro.

I usually stick to "it is not okay to speak to me that way," end the conversation, and get my charge if they seem like they want to complain to somebody. Our charge RNs back us up, while carrying a bit more authority than the bedside nurse seems to. Once my charge told a patient that he would have the unit manager speak to them in the morning, when pt was still complaining to him (pt was mad that I wouldn't give her sister toiletries and a hospital gown to sleep in.)

As for the IV access/stat meds issue, i'd call the MD and say "hey, pt only has one PIV and is refusing a 2nd stick. Do you have a preferred order of administration for these 8 stat meds, or do you want to discuss placing a 2/3 lumen PICC? Or do you have any other thoughts?" (I know that's not the advice you were asking for, but included it because I'm sure it will come up again, for you or someone else reading)

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Specializes in Cardiovascular recovery unit/ICU.
Mrs.in2015 said:
Right. I only stuck once, his meds were all incompatible and we're all ordered stat. I explained to him that he needed quickly, they could not be given through the same iv at once and a second iv would help him receive them quicker. One stick and he was furious. Thanks for the replies tho! Charge nurse it is! ?

Had a deteriorating pt on the floor that had to be moved to ICU. The doctor was great at explaining the reasons and the pt condition to the family in the room. One doctor in particular hadn't rounded in a couple of days and the family, granted was furious. But.....they said that they were going to call the nursing board. They looked us nurses right in the face and repeatedly stated they were calling the nursing board. Made NO sense. We immediately got the supervisor and made her aware of the situation. Nurses get dumped on all of the time. I know they were scared for their loved one but the nurses had been exceptional to them. We sometimes have to bear the brunt because we are always with the pt and family 24/7. We make good sounding boards when a family gets scared and upset. I didn't take it personally because I've been doing this a long time.

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Specializes in MDS/ UR.

You have a bigger fish to fry with publically declaring needing to find a way to put a patient in his place. He may have been out of line but I think you are too- more so because you are the professional and care giver.

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Specializes in MDS/ UR.

Maybe next time you should just have another nurse assume the IV care.

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