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)
I disn't declare that I needed to find a way to put him in his place. I just asked what others would do in that situation. But thanks for your reply. I did ask another nurse to take over the iv, I didn't even try to stick him again. Ultimately, he refused a second iv, I documented that, and moved on.
"Have a clever response that puts him in his place ". Nurses do not put patient's in their place. This patient sounds pretty sick, and is sick of being sick.
I would have not taken his response personally, apologized for the missed stick, and used anything and everything to diffuse the situation. ( without running to mother charge nurse)
Wow, ok let me clarify. Maybe I did not word that first post quite right. I am not a mean nurse. I am a rather new nurse. Of course my skin needs some thickening and that will come with time. I treated this man with utmost respect. What I meant by "put him in his place" is that I did not deserve to be spoken to like he did. I understand that he was sick and I am very compassionate toward that, but no matter the circumstances, there is a way to speak to people. THAT is the advice I am asking for. How can I speak to him that will help him understand that I do know what I am doing and I am here to help. For anonymous reasons, I did not post his diagnosis or the names of this pt but I can assure you, he was stable. Please do not think that I am a little "snowflake" that can't take a harsh word. I can and I did. I just want to know the best thing to say to a patient when they clearly don't want me near them
Wow, ok let me clarify. Maybe I did not word that first post quite right. I am not a mean nurse. I am a rather new nurse. Of course my skin needs some thickening and that will come with time. I treated this man with utmost respect. What I meant by "put him in his place" is that I did not deserve to be spoken to like he did. I understand that he was sick and I am very compassionate toward that, but no matter the circumstances, there is a way to speak to people. THAT is the advice I am asking for. How can I speak to him that will help him understand that I do know what I am doing and I am here to help. For anonymous reasons, I did not post his diagnosis or the names of this pt but I can assure you, he was stable. Please do not think that I am a little "snowflake" that can't take a harsh word. I can and I did. I just want to know the best thing to say to a patient when they clearly don't want me near them
There are no specific words to say in this situation. It depends on the nurse-patient relationship you had so far developed. You are correct that it comes with time. I found that sitting down, listening to the complaint, acknowledging the complaint, and apologizing never failed.
Several posters here, myself included ,felt you presented the wrong demeanor.
Best of luck with this type of encounter in the future, they are difficult and nursing is a dance you learn as you go:up:
I'll just say sorry and move along. If he has that much IV check for compatibility and see if you can run a few at the same time. Some people are just big babies when it comes to needles. Welcome to nursing. People are always in a pissy mood. If he is getting that much IV meds and for a long time, maybe he should get a PICC line.
First, before anything explain to the pt. what is going on. I have seen nurses say to pts. "You need another IV." Then not communicate anything else before they stick them. The pt. will they say to someone later "I don't even know why they gave this to me."
Instead tell him that "your doctor ordered 8 IV meds to be given right now. I can see that you are frustrated with everything that is going on, but it is important that we get a second IV."
When the pt. unleashed on you, remember, it is not personal. Putting him "in his place" will not make either of you feel any better at the situation. The pt. is angry at the situation, angry that he is ill (either chronically and/or actually), he is angry that he has to get stuck again, he angry he is in the hospital, he is angry that the food stinks--or that he is NPO perhaps--etc. Do you deserve to have him talk to you like that? Of course not--no one should be treated like that. However, it is not about you. I am not suggesting he can continuously belittle you every time you walk in the room. He certainly can't be violent--if there is any suggestion that he would become violent, escalate to security, etc. Otherwise, he needs to get his frustrations off his chest--let him. It is unfortunate that it was (sorta) directed at you, but this is about the pt., not about how you feel about the situation. When in doubt, reread the 1st sentence of this paragraph--it's not personal!
If you miss, and he goes off, apologize (hey, misses happen...he may not realize this, but we all know it does). Explain again why the second IV is necessary, and offer to get someone else to try. If he refuses to have you as his nurse any more, talk to charge and offer to take a "hard" pt. from another nurse and hand him off.
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.
They don't scream at their doctors, only their nurses. And that has to stop. Nurses deserve even more respect than doctors do because we are with patients a whole lot more. And have to deal more with their families, too, which is often a real source of misery.
I'll just say sorry and move along. If he has that much IV check for compatibility and see if you can run a few at the same time. Some people are just big babies when it comes to needles. Welcome to nursing. People are always in a pissy mood. If he is getting that much IV meds and for a long time, maybe he should get a PICC line.
Needles hurt. You might be a big baby, too, if you had to deal with what some patients deal with.
Been there,done that, ASN, RN
7,241 Posts
"Have a clever response that puts him in his place ". Nurses do not put patient's in their place. This patient sounds pretty sick, and is sick of being sick.
I would have not taken his response personally, apologized for the missed stick, and used anything and everything to diffuse the situation. ( without running to mother charge nurse)