Do patients/families that are hostile, rude affect your morale?

missy2b · Feb 21, 2006

Do patients and families affect your morale? Have you encountered situations which left you feeling demoralized, insecure or denigrated? For example, how many of you have had family members write down everything you do, from the moment you come in to the room? Do you feel harassed? Are there resources available to you such as debriefing programs, one on one counseling, unit meetings or managerial back up? Does the nursing staff provide support for one another? Or do you just "suck it up", being that the "customer is always right" ? Have you left a facility due to these type of experiences? Do you think this is a problem in the nursing profession?

Of course they affect my morale. I am one of those pitiful souls who wears her feelings on her sleeve. I don't often feel insecure--I know my stuff. I can feel like a doormat, however, because I can take a lot of crap without blowing up. Last week I did one of my "can I get you anything?" queries. I was told "a cup of hot tea would be nice." After the fourth attempt and being griped at, I had to tell her that I never would have offered had I known it would be such an ordeal. (Did I mention she was on droplet isolation?) She had already screamed at me because there was poo on her collection hat and because her outpt testing schedule was not being followed. It gave me great comfort to call her the "Antichrist" outside the room. I earned it--I had her for three straight shifts when everyone else had a one shift limit.

I don't care if the caregivers write down everything. At least they care.

As for the other question, I am a noc nurse, so I have seen my mgr maybe half a dozen times in 3 years. We are supposed to have staff mtgs, but the mgr forgets about them most of the time, so they happen 3-4x/yr. And the counseling? I have never known anyone to go--it has an extensive wait. We have a lot of alcohol use on our unit. The RNs tend to use in the off hours. The techs, well, several have been caught under the influence of spirits. We have wonderful staff. I know several who have facilities for lack of support, but no one is so optimistic as to expect a workplace free of "those people."

libbylaroux · Feb 22, 2006

well, when I decided to go into nursing there were a few people who couldn't believe I would make it because my social skills were decidedly weak. I am a hard worker and try my best to do things completely and correctly and always get A+ on my science courses and passed the NCLEX like it was nothin' but socially I was (am, maybe) retarded. I cared and still do about people, but could get very defensive and radiate hostility, esp when overwhelmed and too busy and too underappreciated and especially especially when people would insinuate that I wasn't running as hard as I could when I was.

After 5 years in nursing, I am starting to develop the ability to go into a room and radiate calm friendliness. It's kind've a laid back body language combined with quick yet deliberate movements that makes them think everything is okay, that I have it under control and that all is going as well as can be expected. I don't get very personal, I hardly ever tell the patients anything about myself. If they are freaking out, sometimes I will actually tell them to calm down but have learned how to do it in in such a smiley, competent way that they don't take offense. 4 years ago I would have snipped back at them. Now I just loosen all my muscles, look them in the eyes and nod my head as they talk to me. When they start asking prognosis and too complicated "whys" I tell them those are questions for the doctor, which they can ask when the doctor comes around. Simple questions I will answer (why is she getting blood and FFP? Why haven't I had the CT scan yet?) etc. But Why Is My Mother In Renal Failure? is a question I defer to the doctor. Sometimes I will indicate that I am prioritizing care for a group of patients, phrased just so, with a smile and a quick apology.

Instead of screaming "Jeez Louis, the patient in the room next to yours is getting ready to choke to death on his own phlegm and you want me here so you can complain that the @#%$ eggs on your stupid breakfast tray are cold??!! You iiiiiidiot!" like the baser part of me wants to do.

All in all, nursing has been very good for my personal growth.

Having said that, tomorrow at work someone is going to find my button and push me over the edge arrrrrrrrrrrrrg.

You Know It. Keep on keepin on, your day off is coming soon :-D

smartynurse · Feb 22, 2006

This is what I am curious about, that dealing with these types of situations, over and over again, without proper support or acknowledgement, is going to hurt the nursing profession- I do not think that the newer generation of nursing is going to put up with this type of work environment. Does it come from short staffing? I'd say yes. I'd also say that people in general are vigilant about their health, I'd also say that people still have misconceptions of nursing's professionalism and feel that it is a low class job that doesn't require much education or advanced skills (especially on the floors, not necessarily in the ICU), and that can be blamed on the news media, tv shows, hospitals, and ultimately, nurses themselves....what do you think?

UM Review RN, ASN, RN · Feb 22, 2006

well, when I decided to go into nursing there were a few people who couldn't believe I would make it because my social skills were decidedly weak. I am a hard worker and try my best to do things completely and correctly and always get A+ on my science courses and passed the NCLEX like it was nothin' but socially I was (am, maybe) retarded. I cared and still do about people, but could get very defensive and radiate hostility, esp when overwhelmed and too busy and too underappreciated and especially especially when people would insinuate that I wasn't running as hard as I could when I was.
After 5 years in nursing, I am starting to develop the ability to go into a room and radiate calm friendliness. It's kind've a laid back body language combined with quick yet deliberate movements that makes them think everything is okay, that I have it under control and that all is going as well as can be expected. I don't get very personal, I hardly ever tell the patients anything about myself. If they are freaking out, sometimes I will actually tell them to calm down but have learned how to do it in in such a smiley, competent way that they don't take offense. 4 years ago I would have snipped back at them. Now I just loosen all my muscles, look them in the eyes and nod my head as they talk to me. When they start asking prognosis and too complicated "whys" I tell them those are questions for the doctor, which they can ask when the doctor comes around. Simple questions I will answer (why is she getting blood and FFP? Why haven't I had the CT scan yet?) etc. But Why Is My Mother In Renal Failure? is a question I defer to the doctor. Sometimes I will indicate that I am prioritizing care for a group of patients, phrased just so, with a smile and a quick apology.
Instead of screaming "Jeez Louis, the patient in the room next to yours is getting ready to choke to death on his own phlegm and you want me here so you can complain that the @#%$ eggs on your stupid breakfast tray are cold??!! You iiiiiidiot!" like the baser part of me wants to do.
All in all, nursing has been very good for my personal growth.
Having said that, tomorrow at work someone is going to find my button and push me over the edge arrrrrrrrrrrrrg.
You Know It. Keep on keepin on, your day off is coming soon :-D

:roll :roll :roll

Thanks Libby, I needed that post!

jefflaine · Feb 23, 2006

sometimes nurses feel like being degraded because of some words from the family of the patient or from the patient as well.At the government hospital where we affiliate,as a student nurse,i frequently have this observation with some of the staff nurses and with the patients and their relatives.But i have realized that,that's just a part of our job.Before we give our patients the right care they're needing,i think we should first be ready with those instances that sometimes make us feel bad.We cannot blame them,as i always keep in mind,that WE HAVE OUR INDIVIDUAL DIFFERENCES.!!

God bless you all!!

simbawicz · Feb 24, 2006

Yes, they can. Like many of you, I try all the things we are taught, have picked up on my own, come in as divine intervention. There are a few patients/families though, who have an agenda coming in: they are going to get as much out of us as they can before they leave. We often do service recovery on our unit, and frankly, it can be a problem. Service recovery can simply be because the patient didn't like, well, nothing that can be put into words. But they have learned that they call the patient rep, get moved into a large private room, and have staff that will fetch anything and everything they want whenever they want, because the patients and families are told in front of the nurses that they can have whatever they want. I have had a hospital administrator do that in front of me--tell me we are suspending hospital protocols pertaining to PCA pumps and going off the floor to smoke for 2 hours unaccompanied. (But, yes, dear, you as the RN are still liable for whatever occurs when you cannot find the patient.) Movie tickets, free meals for the whole family, whatever they want. Too bad they are not the only patient in our care when this happens. It effects morale, efficiency, and safety. I hate when that happens, and fortunately, it isn't that bad all the time. Most of our patients are very kind and considerate, and are greatful for the care we give. That's what makes it worth putting up with the others. The truly difficult ones are that way without regard to their current physical condition. I hate reinforcing their behavior

boulergirl, CNA · Feb 24, 2006

I recently got sucker-punched by one of my dementia residents, and guess what? The family tried to put the blame on me. They said I don't speak his language (I'm a "white American", what do I know, right?) Never mind that I cued him in Spanish as I always have. He hit me when I least expect it. Granted, maybe he "doesn't know what he's doing", but someone mentioned to me that he was abusive in the past.

Anyway, I went to the ER for this...at least I didn't need stitches, didn't lose any teeth, and that resident is living in another facility.

goody1shoe · Mar 5, 2006

I never said that you claimed that ALL were nitwits.
Sorry for the offensive "unusual" reply. I was being sarcastic, but intended no harm or offense toward you.

I understand exactly what she meant and I agree the vast majority of patients, whether or not they have a formal education, have common sense.

rnthom · Mar 5, 2006

Often, though not always, families need to be educated on both the patient's condition as well as hospital routines. I have found that by spending a little extra time with them at the start of the shift, the rest of the day goes well. With families, as well as with all patients, be honest, respond to their questions and concerns, let them know you are available and when you are not, and if you don't have the answers, you will attempt to get them. Sometimes, especially with patients who are at the end of life, I download information from the internet and give it to them, so that they know what to expect. On those occasions, the families have thanked me and have even requested me to be "their"nurse when I am on duty. Sometimes though, there is just a clash of personalities between nurses and patients/families. At those times, ask for a different assignment but offer the idea that every nurse take a turn with that family. It will give every nurse the opportunity to work with that family and, depending on the number of nurses assigned to that unity, you may only need to attend to this family once a week.

islandnurse55 · Mar 5, 2006

I have been working as an RN in psych for 15 years and if I had a dime for all the hostile and rude behaviors I have been faced with, I could have retired 10 years ago. But in all honesty for me, that one moment when a patient or even their family member tells me thank you for caring, or when they say how they miss me when I am not there makes it all worth it.

mctina_20 · Mar 5, 2006

yes.. but considering their situation its understandable

RN34TX · Mar 5, 2006

I understand exactly what she meant and I agree the vast majority of patients, whether or not they have a formal education, have common sense.

Those comments were made several weeks ago and it's over and done.

There is no need to dig them back up just to stir the pot.

No one has even posted on this topic since 02/24 before you decided to dig that up and comment on it when you knew that it was offensive to someone.

Normally I wouldn't have even thought twice about it, but I just watched you throw in your comments on another thread you participated in just to egg people on and to keep them bickering and flaming at each other.

Please don't quote me just to get people started in writing angry/offensive posts at each other.

You had your fun on another thread.