Sometimes you just can't bite your tongue..... - page 2

Not too long ago, I had an assignment in our fast track area, working with a notoriously slow provider. Folks were waiting longer than usual for their non-emergent and often not-even-urgent... Read More

  1. by   EmergencyNrse
    As good as it feels to "inform" patients and their families of their rudeness and inconsideration of everyone around them I caution you to refrain from doing so.
    It never helps the situation and can only open you up for scrutiny.
    Administration doesn't care how slow things are. They only see you being unprofessional to the "clients".
    One of the 1st stages to ER burnout...
  2. by   hiddencatRN
    Quote from EmergencyNrse
    As good as it feels to "inform" patients and their families of their rudeness and inconsideration of everyone around them I caution you to refrain from doing so.
    It never helps the situation and can only open you up for scrutiny.
    Administration doesn't care how slow things are. They only see you being unprofessional to the "clients".
    One of the 1st stages to ER burnout...
    Yeah, I know. I think I'm definitely feeling a little burnt out. I've cut down on overtime completely, but we've been routinely running short-staffed and busy, and it's an inner city emergency department so it's a particularly challenging ER population. I'm usually pretty good about dealing with patient and family frustration and complaints and remaining therapeutic in my communication, but fast track plus notoriously slow provider plus fake concern about sick patients just proved to be a little too much for me that night.
  3. by   thelema13
    Sometimes blunt truth is the best thing for a patient.

    Like the 400+ lb lady who has come into the ED x3 in the past week, all by EMS for knee pain. I got her the last time. I added morbid obesity on her health history and gave her education on diet, exercise and weight loss. She throws her arms up and excaims "OH! YEAH! I'm really obese!"

    To which I calmly replied "Miss ______, you are more than 200 lbs overweight and by definition, you are morbidly obese. Your knees would stop hurting so much if your body weight wasn't compressing your joints to oblivion. Every pound you lose take 4 pounds of pressure off your knees, this would be a good place to start in your pain management."

    For some reason, she complained to the charge nurse and the nursing supervisor. Everyone gave me a pat on the back for being so brutally honest.
  4. by   travkitty
    *standing ovation*


    Quote from thelema13
    Sometimes blunt truth is the best thing for a patient.

    Like the 400+ lb lady who has come into the ED x3 in the past week, all by EMS for knee pain. I got her the last time. I added morbid obesity on her health history and gave her education on diet, exercise and weight loss. She throws her arms up and excaims "OH! YEAH! I'm really obese!"

    To which I calmly replied "Miss ______, you are more than 200 lbs overweight and by definition, you are morbidly obese. Your knees would stop hurting so much if your body weight wasn't compressing your joints to oblivion. Every pound you lose take 4 pounds of pressure off your knees, this would be a good place to start in your pain management."

    For some reason, she complained to the charge nurse and the nursing supervisor. Everyone gave me a pat on the back for being so brutally honest.
  5. by   nceakins
    I was working with the charge nurse on an unresponsive patient while waiting for the rapid response team to arrive. The wife of the patient in the other bed came over and asked me to fill his water pitcher. I bit my tongue but the charge nurse told the wife "I would hope that if your husband needed urgent care that no one would interrupt the nurses trying to care for him."
  6. by   SMARN
    I find being passive aggressive is way more satisfying than any other responses. It's something I use all the time, though, so it's pretty common practice anyway, lol.

    I can make someone think I'm totally agreeing with them while I'm actually making fun of them. Happy patient, happy me.
  7. by   cbreuklander
    Happens on Med-Surg, too. I had a patient with an unstable heart rhythm. I will admit it took me some time to settle it down, get the Dr. on the phone, IVP meds and calming the patient and family. However, amazingly, I had no other patient call lights come on during this time.

    Well, I walked into my next patient's room to do a routine assessment. She had orders for discharge and was just waiting for a ride home. She looked at me and said "I don't want you. I want a nurse who has time to see me. I have been waiting more than an hour since you came on duty."

    I told her that wasn't a problem, I would get her a different nurse and walked out of the room. I called the charge nurse and she re-assigned the patient. The charge nurse came to talk to me later about it. She said that she went in to talk to the patient (cause we're all about Press Gainey scores now) and the patient assured her that she hadn't needed anything. She just expected that her nurse would be in to see her in the first few minutes of the change of shift and if this hospital couldn't provide that she wouldn't be back.

    Her loss. We are an awesome hospital with awesome nurses who take care of unstable heart rhythms
  8. by   BelgianRN
    According to my co-workers I'm blessed with the ability to say things that would certainly get them fired if they tried it but somehow I get away with it.

    I remember I was transferring an elderly lady (85ish) from a wheelchair to a bed in the ER when I said to her "well just hop on girl". Girl is a very common term in Dutch when dealing with elderly patients. The son in the room tells me "girl... girl... she is not a girl". So before he can say anything I ask the woman if she has a penis and she answers me that she hasn't seen one for 20 years but no she doesn't have one last time she checked and she winks at me. So I tell the son well since she has no penis she's a girl for sure. Just left him standing there as he was searching for a comeback. FYI the son didn't have my sympathy as he was an I'm gonna drop my elderly mom off at he hospital because it's a 4-day weekend so now she has complaint A - Z on a friday afternoon and he made sure to bring all her stuff already.

    Another one of my favorites is the woman that was visiting her husband in the ICU. He had a neurotrauma and had some very nice frontal behaviour. So he gets tied down. And as I approach the woman I can see she is a complainer. So before I can say anything she starts yelling that it is unheard of that her husband is tied down and that we are incapable and he should be transferred to another hospital. So at this point the poor husband tried to see the room upside down, so I tell him "John can you move to the center of the bed please". Then she starts complaining I should call him mr X instead of John because well it is disrespectful to use his first name. So I tell her that I'm on first name basis with all the men that masturbate themselves in a 2 m radius around me and John is no exception. She just glared at me and I glared back and then she goes "so anything changed with my husband mr X". So I answer "no John is doing really well apart from him trying to see the world upside down". She just looked at me and she goes "you're not giving up with the John thing right?" So I tell her "no". And she says "very well but just you you cheeky person". When he was discharged she gave chocolates to the department and a little one that read "for the cheeky nurse".

    I'm telling you it's all looking innocent and glaring at the right times and you can just get away with speaking your mind.

    Just the other week I was sitting at the desk in the ER (not the info desk) talking to one of the MDs about orders for a patient and this woman walks up to the desk, taps the desk because I'm not making eye contact and goes "you tell me where my sister is, NOW". So I look at her and go "No, and you will take two steps back stop listening in on this conversation stand there, be silent and practice somethin called patience". She was like a cameleon turning red to purple and red again. So after the MD is done in my pleasant voice I go "so with what can I help you". Turns out I couldn't help her and she had to go to the info desk. But I just can't stand people that interrupt conversations, reminds me of children that need attention. Makes you wonder why so many colmmunication errors occur.
    Last edit by BelgianRN on May 12, '12
  9. by   Ruby Vee
    my cardiology patient stopped peeing, and the cardiologist ordered a renal consult. the nephrologist had a reputation for being surly, and that morning was no exception. he called the unit at 0710 -- about 5 minutes after the cardiologist called him for the consult -- and gave me a telephone order for several things, including to clamp the foley and get a urine specimen for him to look at. he showed up at 0720 wanting to know where his urine speciment was. since the guy was producing less than 5 cc of urine/hour, i didn't have one. so he started his rant about stupid nursing staff who couldn't get anything right and went on from there.

    "i'm sure dr. smith ordered this consult just to ruin both our days," i blurted out before i could stop myself. to my great surprise, he shut up, looked thoughtful and then said, "i'm sorry. i guess i've been rather rude, haven't i."

    i never had any problems with that particular nephrologist again -- he was always pleasant to me!
  10. by   NO50FRANNY
    I got a round of applause for this one, but it wasn't a patients' family it was an intensive care paramedic who is known to be an arrogant and nurse despising jerk. He is one of those ambos who will phone through critical patients only because he has to, then refuse to tell you the patients' vital signs, preferring to only speak directly with the senior doc. He also thinks he knows a little bit more than he does. Most of us have little love for this man. The patient was an 18 year old with a new (undiagnosed) AML- pancytopaenic, febrile, and peri-arrest en-route, had atropine etc. He had treated him as a suspected meningococcal infection (moron). It was one of those days in resus, all our senior physicians including our director, that's 5 ED ninjas (attendings? FACEM or consultant in OZ) were in different bays doing the following, 2 were intubating, one was doing a chest drain on a tension ptx, one was running a multi trauma with a massive transfusion in progress and the other was running a PEA arrest. I had sourced these guys from the back offices when everything turned to rubbish, usually we only have 1! Yes this was the worst resus shift I was ever in charge of in case you were wondering. Anyway, in rolls this poor kid. They transfer him across and 3 nurses and an intern are onto him straight away doing what we do and this guy is just looking at us refusing to handover until a senior doctor arrives. I couldn't find one straight away but one was coming, as soon as he finished intubating-This ambo says this in front of the patient "Um, what the F is going on here? Where is the Facem?". My response, probably a little too loud "Every senior physician in this department at this very moment is performing a life saving procedure, YOU are going to have to wait, or you can tell me and my colleagues so we can start treating him properly, I will pass on your OPINIONS as soon as they arrive if I think they are relevant and if you could keep your profanities to a minimum we would all appreciate it". He was speechless, and everyone else was smiling, including his partner.
  11. by   Hygiene Queen
    I have had my share of times where I have had enough and all professionalism was tossed out the window.
    I guess I can get rather stern and to-the-point when I absolutely have to (and that is so rare, thank goodness!).

    What I have actually said:

    "You will not laugh at my patients!"
    "You will not talk to the staff that way!"
    "I'm kicking you out! This is an emergency -- not a show for your entertainment!"
    "I do believe you are playing games with me... but the window of opportunity has now closed and you have now been bumped on the priority list."

    And my favorite exchange (and the nadir of my professional behavior):
    Bald Narcissistic Antisocial Patient: "I oughta just rip every last bit of that red hair right outta your head!"
    Me: (clapping hands and smiling)"Yay! Then we can be twins!"

    I, too, have an ability to say things and get away with it and it amused one of my clinical instructors very much... which was a good thing!
  12. by   LPNtoRN2014
    Quote from NO50FRANNY
    I got a round of applause for this one, but it wasn't a patients' family it was an intensive care paramedic who is known to be an arrogant and nurse despising jerk. He is one of those ambos who will phone through critical patients only because he has to, then refuse to tell you the patients' vital signs, preferring to only speak directly with the senior doc. He also thinks he knows a little bit more than he does. Most of us have little love for this man. The patient was an 18 year old with a new (undiagnosed) AML- pancytopaenic, febrile, and peri-arrest en-route, had atropine etc. He had treated him as a suspected meningococcal infection (moron). It was one of those days in resus, all our senior physicians including our director, that's 5 ED ninjas (attendings? FACEM or consultant in OZ) were in different bays doing the following, 2 were intubating, one was doing a chest drain on a tension ptx, one was running a multi trauma with a massive transfusion in progress and the other was running a PEA arrest. I had sourced these guys from the back offices when everything turned to rubbish, usually we only have 1! Yes this was the worst resus shift I was ever in charge of in case you were wondering. Anyway, in rolls this poor kid. They transfer him across and 3 nurses and an intern are onto him straight away doing what we do and this guy is just looking at us refusing to handover until a senior doctor arrives. I couldn't find one straight away but one was coming, as soon as he finished intubating-This ambo says this in front of the patient "Um, what the F is going on here? Where is the Facem?". My response, probably a little too loud "Every senior physician in this department at this very moment is performing a life saving procedure, YOU are going to have to wait, or you can tell me and my colleagues so we can start treating him properly, I will pass on your OPINIONS as soon as they arrive if I think they are relevant and if you could keep your profanities to a minimum we would all appreciate it". He was speechless, and everyone else was smiling, including his partner.
    To quote Alias on clerks 2 " ooooo sick burn!!" you ninja, you!
  13. by   mc3
    Quote from VICEDRN
    Sorry. Had to laugh. Been there done that. Drama queens are the same everywhere you go I guess. Just to remain mysterious... I would have added, "our provider in this area is very methodical and thorough." and let them chew on a response to that.
    And they start the behavior in elementary school............
    mc3 (a worn out school nurse)

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