Frustrated with myself...advice plz

[RheatherN, ASN, RN, EMT-P]

so, i had a pt today that was just kinda crabby. i did all the thought processes in my head to help this person as much as i could, calling the md many times because i didnt feel what he did to help the pt was totally correct, but who i am to say right? i spoke with the md and stated my concerns, but he still did what he wanted. i explained many things to the pt and tried to help as much as i could with pain relieve. took away pca, gave fent patch x2 for a high dose, ended up calling for more meds if i could, i suggested pca again, and was told no. i got po oxy, and then ended up calling again and got iv fentanyl. but get this, q1hr prn for pain! hello!!! i called how many times, do you think that is really going to do it? so anyhow, i am being patient with the md, and trying like heck for the pt- i gave one dose of the q1hr fent and the pt calls one hour after the first dose, (yes i explained and he understood that he needs to ask for the med, besides the fact that i was going to check on him anyhow but was interrupted) and he proceeds to yell at me and swear and be sooooo rude. i said please dont speak to me that way, i will bring your meds in right now. i did such, and then i tried to explain to him professionally that you dont speak to anyone like this, its not appropriate (ect, ect). you get my point. i was so upset with him when i went off shift right after that. i called our pt advocate to get her involved to see what else we can do. i got case mgt involved other md's other dpts. but he just didnt care. so i am upset i guess that i am upset with him. i know i will have him tomo and be fine with that and all, but i have never let someone i guess really get to me.

thanks! so how can i better distance myself from this? i am totally not a person that lets things get to me ever, until this when i was spoken to and tried to calm him down and he just started again.

thanks!!

-h-rn

[LaceyRN]

Sounds like you did everything you could to advocate for this patient and get him adequate pain relief. Good for you! He's probably crabby b/c he was in pain. Fresh post-ops can often be "crabby" due to pain, anesthesia, etc. I bet he's in better spirits tomorrow. :)

Try not to let it get to you too much. You were probably just worn down from dealing with the doc and patient all day! :)

[Ayvah, RN]

Being crabby because one is in pain is NOT an excuse to swear at someone and treat them badly. OP, it sounds like you took the right steps to advocate for him, and sometimes no matter what you do people will find something, anything to be mad at. This reminds me of a patient who I spent the most time on one night, doing a bunch of extra things for, going out of my way numerous times for. Come the morning he exploded at me because I asked if I could bring him some food since he was diabetic. Yes, it upset me a lot, but sometimes some people won't ever be happy. I spoke with the wife who said he was always like that. I also spoke with the charge nurse about the issue.

Easier said than done, but just be secure in the thought that you did all you could, and he was not right to swear at you and disrespect you like that. You don't deserve to be treated so poorly.

Only other thing I'd suggest is to get your charge nurse involved. Sometimes when the rationale comes from another person, it clicks better for the patient, and the charge is also on your side and can help you keep your cool.

[WalkieTalkie, RN]

It sounds like you did everything appropriately.

Just realize that you are not in control of the situation and it is not your fault. You've followed all the appropriate pathways and hopefully the patient advocate can help get all parties on the same page.

Do yourself a favor and pat yourself on the back, take a deep breath, and realize that things will eventually get better. We want to fix everything, but so often we can't, and we get too caught up in it. Frustrating, huh?

[HouTx, BSN, MSN, EdD]

OMG - you poor thing. Nurses have rights also, including the right not suffer abuse from people they are attempting to care for.

Question - where was your manager during all this? One of the most important functions of a nurse manager is to advocate for their staff. They are supposed to act as a buffer and intervene whenever their nurses are getting 'beat up'. Unless they do this, they're pretty much useless.

[LadyK,RN]

While I am still a nsg student, I used to be a pt advocate for an HMO (outpt clinic setting). I've had more people yell at me than I can count, when I was there soley to listen and problem solve. Anyway, the main thing that I have found that helps is to remember that 99% of the time it is not personal. If you know you've done everything you can then know that the pt is angry at the situation (illness, loss of control, etc.) not you, but unfortunately you are the target.

Hang in there, not every day will be like this.

[RheatherN, ASN, RN, EMT-P]

well update.. i totallly had the pt the next day, i knew i would and was expecting it and wasnt worried or anything about it. he asked if he offended me!! i told him well yeah, but you know what, that is exaclty why i spoke up and expalined again how it was in appropriate. ect..he aplogized many times and then did the same exact thing in the afternoon.

tx for support everyone!

-H-RN

[locolorenzo22, BSN, RN]

Sometimes, we forget that our patients are upset and human. I've had people swear at me, try to blame me for things that I have no control over....and I am the only one who could allow them to make me feel that way. So I choose not to allow them to make me feel inadequate. It's not my problem that happens.