Hola to all and welcome to December. Call it a socioeconomic, or demographics, patient population, or clientele, I am one of those who believes that education and socioenomics are the biggest factors in how patient and family members will behave, which is actually the biggest factor that makes or breaks my day.
After transitioning to the ER I am loving it. The days that I dislike the most, however, are when my patients are consisted of low socieoeconomics and education. I'm sure you have had experienced these folks; demanding, doesn't know how to ask properly, doesn't do anything for grandma or grandpa at home but now suddenly wants everything done and toenails polished, impatient, no acknowledgement of authority, entitled, unappreciative, etc etc. For example, I was getting report the other day and some family member came by nursing station to ask for help. Instead of proper "hello, my dad needs help, may we get an assistance?", she snapped "we need help and yal just sitting there" and I can say I observed these kinds of behavior consistent with low education/socieoeconomics. I mean, a kid doesn't even speak like that.
After numerous encounters with different people of race, socioeconomics, and education, it seems very clear to me that those with higher marks in those two factors are most well behaved, proper people who makes my day smoother and not so much regrettable; family members eager to help their own, always uses proper english such as "please" or "may I", uses full sentences, not demanding, not entitled, patient, etc, and I can speak with my conscience clear that these were people of higher socioeconomics and education consistently.
So those of you who worked from all spectrum of education and socioeconomics in clientele, do those factors ever make a better working place? My goal is to move my way towards the area with higher marks in those two. Tell me your honest experiences. Thank you
. Bottom line is, I haven't encountered bad behaviors that frustrate me from people of high ed, high socio compared to the ones from low ed and low socio (at least enough to remember)
Then you haven't worked with enough of them. They can be rude, condescending and demanding. The condescension is the worst. They feel like you are just a lowly nurse and your whole reason for existence is to serve them. The PP who mentioned the richie riches calling in favors from the people they know in high places is so true!
I think people that are of a lower socioeconomic class get discriminated against (think "white trash") and not always treated well by medical people. This creates a vicious cycle: they act badly (b/c they may have not been raised well or they may not have had anyone TO raise them), the medical system behaves badly back, they get frustrated and act even worse and so on and so on. I have certainly seen poorer, undereducated folks treated like they are less valuable than a middle or upper class person. I'm sure they begin to feel invisible. They have stresses that come w/ a life of under employment, under education and difficulty meeting basic human needs. Add on top of that a hospitalization to upset their precarious paycheck to paycheck existence and they may not be on their best behavior.
I know this sounds like a lot of excuses for people behaving badly but I don't think it's right to go in w/ preconceived ideas about a particular group of people. Until you've walked a mile in their shoes, it is not right to judge. Through no fault of their own, a lot of these people have been born into horrible situations. You don't know what has shaped them and their attitudes.
Staff can be so nasty and judgmental about lower socioeconomic people. Horrific, in fact. One of the nurses I work w/ said to me in report that a pt. was, "A trailer -park- living white trash piece of s--t." It was said w/ so much hatred. However, this man was quite nice. Yes, he asked for his prn pain meds q3hrs. on the dot but he was legitimately in pain. I had chatted w/ him the whole evening prior and found him to be a very nice person. He had so many challenges thrown at him in life to include 2 months in the ICU for Necrotizing Fasciitis requiring removal of about a third of his thigh and buttock. Needless to say, he feared pain and didn't enjoy being in the hospital. He was also very afraid that the current surgical site infection he had (post ACDF) would start spreading and he'd end up in the same situation as before. Also, the prolonged time off from work was going to put him in a bad financial situation. The nurse who made the comment did not know that b/c she never bothered to give him a chance.
Another patient labelled "white trash" and "crazy" turned out not to be once I got her story. She was incredibly stressed b/c her boyfriend (whom she lived w/) had broken up w/ her, she was estranged from her children and she was worried that God did not love her. At 51 years old she was facing LTC b/c she had no one to go home to. She was very restless and tearful and needed a listening ear. Once I took the time and gave her a little TLC (brought her a cup of soup and a sandwich) she behaved perfectly the rest of the night. When I came back in later she exclaimed, "Oh! There's my friend!" That made me very happy.
I am having trouble articulating all this clearly and succinctly and I'm sure it comes off as very Pollyanna but what it boils down to is the Golden Rule: treat others as you yourself would like to be treated. Rich, poor or somewhere in between. Even if they don't treat you that way back.
I've actually thought about this a lot, since I started working as a nurse almost two years ago. A couple of months into my first job, I noticed that I was having thoughts very similar to the OP's...and I became horrified with myself. I didn't want to turn into someone who judged people according to whether or not they had perfect grammar or were on Medicaid.
After some time, I came to the conclusion that a lot of these feelings were caused by a kind of culture shock. I went to a public high school, an ethnically diverse state school for undergrad, but it wasn't until I became a nurse that I started to spend so much time with people who grew up in a culture different from my own. Since I had spent most of my time around people who were pretty similar to me, they were the only people who had really ever gotten upset with me. Now that I'm a nurse, I have to deal with all kinds of people who are unhappy with their situation, and by default, unhappy with me. I think most of us would agree that different cultures express anger and sadness differently, and since I hadn't yet become accustomed to or learned to deal with different kinds of people, these behaviors were much more disruptive and/or more offensive to me.
Judging the tone of the responses, some people may not like my next paragraph, but it seemed relevant and I thought it might be interesting to add:
For decades, people have been researching whether or not the ability to delay gratification as a child is linked to his or her economic success as an adult. The most famous of these experiments is the "marshmallow test," in which a child was given a marshmallow, and given two choices: eat that one marshmallow now, or wait until the adult comes back, and receive a second marshmallow. The researches found that when these children were in high school, those that could wait for the second marshmallow had SAT scores an average of 210 points higher than the other children. They were followed up with decades later, and the "waiting" children were more likely to have a high paying job.
I'd imagine that impatience is a huge cause of dissatisfaction and conflict in the ED, and studies such as this one could indicate that many of these impatient people are more likely have have a lower socioeconomic background.
Of course, everyone (myself included) has had personal experiences that point to the exact opposite of the results of the marshmallow test. I'm definitely not trying to be rude by bringing it up, but I'd like to hear what other people think!
In my experience, it is the lower class "hillbilly" folks, especially in remote parts of my state, that are racist. I have never seen educated individuals behave as that particular family behaved.
In my experience, many well off Southerners are just as racist but the difference is that they keep it behind closed doors.
Maybe its because I come into the room not knowing a danged thing about their "background" and I therefore don't have the chance to pre-judge the pt and give myself a lens in which to view them through.
Oh, definitely, Annie, there are many racist Southerners whom are well off. There are also racist people in other areas of the country, not just the Deep South, I am aware of that because I spent my childhood in the Midwest.... It is indeed derogatory to use the description "white trash", I am aware of that as well... But if you only could have heard these people and the filth they were spewing. The "N" word should NEVER be tossed about, as inflammatory and disrespectful as it is. My patient's aunt said to me "Shame on y'all for keeping this sweet girl in a place with all of these blacks!" It was astonishing. I don't condone using the description "hillbillies" either, but these folks fit every imaginable negative Southern stereotype. I am still angry about the situation!
Over a year ago I posted the question: why are nurses complaining so much about how rude patients and families are. I know it is fun to vent....but I guess one day it just got to me.
Most respondents thought I must live in LaLa land or wanted to know where I worked that all patients and families were so wonderful! In spite of my stating that I worked 21 years in a county hospital treating mostly lower socioeconomic patients.
Ruby Vee came to my rescue....to paraphrase her..."If I encounter one nasty patient in my day, I've encountered a nasty patient. If every patient I encounter is nasty to me then that is on me."
Specializes in Mental Health, Gerontology, Palliative.
.....
Maybe its because I come into the room not knowing a danged thing about their "background" and I therefore don't have the chance to pre-judge the pt and give myself a lens in which to view them through....
Specializes in Mental Health, Gerontology, Palliative.
...... This is what's wrong with our healthcare, you give too much options to those who don't deserve it, then people think a privilege is a right; ...
The problem with 'your health care' is that it takes a basic human right such as healthcare and treats it like a privileged to those who 'deserve it' 'can pay for it' 'come from the right socioeconomic demographic'
It seems acceptable to dump those who cant by the way side, denying them access to the resources which could heal them, help them manage their chronic health conditions etc
Bad manners & a sense of entitlement are free to anyone who wants to have them. the rich and well educated may be using prettier words to say the same things that the poor and downtrodden.
I agree with this. Rich or poor, educated or uneducated; a jackass is a jackass.
The problem with 'your health care' is that it takes a basic human right such as healthcare and treats it like a privileged to those who 'deserve it' 'can pay for it' 'come from the right socioeconomic demographic'
It seems acceptable to dump those who cant by the way side, denying them access to the resources which could heal them, help them manage their chronic health conditions etc
Over a year ago I posted the question: why are nurses complaining so much about how rude patients and families are. I know it is fun to vent....but I guess one day it just got to me.
Most respondents thought I must live in LaLa land or wanted to know where I worked that all patients and families were so wonderful! In spite of my stating that I worked 21 years in a county hospital treating mostly lower socioeconomic patients.
Ruby Vee came to my rescue....to paraphrase her..."If I encounter one nasty patient in my day, I've encountered a nasty patient. If every patient I encounter is nasty to me then that is on me."
I recall that thread...I lurked on it but Ruby Vee was spot on!
Humanity has no bounds to a class or race or culture.
Most people are generally nice, have good manners, etc; there are some who have their head stuck up so far that they can't see their way to the truth, and that includes our own peers...sometimes bias can be so bound that objectivity is lost in out nurse patient encounters.
I can recall one "bad behavior" from someone of the upper echelon of socioeconomic status, all because I suggested that they come in to be evaluated than receive advice over the phone; they told me they will hunt me down and shoot me in the face, and hung up on me. I was 19 at the time, and was NEVER spoken to like that...that day my skin got very thick from that encounter alone. Granted, this individual did come in for evaluation.
I will say I am a reasonable person, but it took me a while to be objective when a person of a privilege background tries to challenge me, I really dig my heels in and throw down the gauntlet in their attempt to try to challenge my education and best practice...I've improved my therapeutic communication skills (utilizing those wonderful skills learned in Mental Health) and it has helped immensely across any background or peer interaction; I approach many by trying to meet them where there at, with reason and rationale and brevity and objectivity.
I can easily think of one very wealthy elderly gentleman that I cared for at home who displayed similar behavior, so it is not confined to the lower socioeconomic class. I found his behavior to be problematic because I feel that when one has an education and a higher station in life, they should display some level of civility. I managed to cut this person some slack because I chose to attribute a good deal of his emotional outbursts to his medical condition. Excuse, yes, but I would make the same excuse for a poor person residing on the other side of wealth, if their health was the same.
annie.rn
546 Posts
Then you haven't worked with enough of them. They can be rude, condescending and demanding. The condescension is the worst. They feel like you are just a lowly nurse and your whole reason for existence is to serve them. The PP who mentioned the richie riches calling in favors from the people they know in high places is so true!
I think people that are of a lower socioeconomic class get discriminated against (think "white trash") and not always treated well by medical people. This creates a vicious cycle: they act badly (b/c they may have not been raised well or they may not have had anyone TO raise them), the medical system behaves badly back, they get frustrated and act even worse and so on and so on. I have certainly seen poorer, undereducated folks treated like they are less valuable than a middle or upper class person. I'm sure they begin to feel invisible. They have stresses that come w/ a life of under employment, under education and difficulty meeting basic human needs. Add on top of that a hospitalization to upset their precarious paycheck to paycheck existence and they may not be on their best behavior.
I know this sounds like a lot of excuses for people behaving badly but I don't think it's right to go in w/ preconceived ideas about a particular group of people. Until you've walked a mile in their shoes, it is not right to judge. Through no fault of their own, a lot of these people have been born into horrible situations. You don't know what has shaped them and their attitudes.
Staff can be so nasty and judgmental about lower socioeconomic people. Horrific, in fact. One of the nurses I work w/ said to me in report that a pt. was, "A trailer -park- living white trash piece of s--t." It was said w/ so much hatred. However, this man was quite nice. Yes, he asked for his prn pain meds q3hrs. on the dot but he was legitimately in pain. I had chatted w/ him the whole evening prior and found him to be a very nice person. He had so many challenges thrown at him in life to include 2 months in the ICU for Necrotizing Fasciitis requiring removal of about a third of his thigh and buttock. Needless to say, he feared pain and didn't enjoy being in the hospital. He was also very afraid that the current surgical site infection he had (post ACDF) would start spreading and he'd end up in the same situation as before. Also, the prolonged time off from work was going to put him in a bad financial situation. The nurse who made the comment did not know that b/c she never bothered to give him a chance.
Another patient labelled "white trash" and "crazy" turned out not to be once I got her story. She was incredibly stressed b/c her boyfriend (whom she lived w/) had broken up w/ her, she was estranged from her children and she was worried that God did not love her. At 51 years old she was facing LTC b/c she had no one to go home to. She was very restless and tearful and needed a listening ear. Once I took the time and gave her a little TLC (brought her a cup of soup and a sandwich) she behaved perfectly the rest of the night. When I came back in later she exclaimed, "Oh! There's my friend!" That made me very happy.
I am having trouble articulating all this clearly and succinctly and I'm sure it comes off as very Pollyanna but what it boils down to is the Golden Rule: treat others as you yourself would like to be treated. Rich, poor or somewhere in between. Even if they don't treat you that way back.