Nasty/aggressive patients

Nurses General Nursing

Published

Hi nurses,

so, I recently graduated from my rn program and have accepted a job in the emergency department at my local hospital. Seeing as how I always had wonderful and interesting patients in nursing school, I've been very excited to start my new job. (Less than 10 days! Woohoo!) however, tonight while at a convenient store obtaining a powerball ticket I encountered the most unpleasant person I've ever come in contact with. I was getting off the phone with my husband when she started going off on me for bothering her while trying to fill out her ticket. Insulted me up and down called me names the whole nine yards, over nothing! And it got me thinking, if this person can attack me like this for no reason at all I can only imagine how it will be in the ED. So now, I'm doubting my ability to deal with those patients who are super mean and aggressive. My approach in school was to be as nice and understanding as possible to all the patients and for the most part, it worked, but now I'm doubting that approach and that I may be too sensitive. How have your experiences been? Are these people the majority or the few? Do you ever get used to it? TIA

Specializes in Med/Surg/Infection Control/Geriatrics.

Perhaps part of the anxiety too, is from the fact that this woman caught you off guard out of the E.D. element. That can be a bit unsettling when one is caught unaware.

You have a wonderful attitude though, trying to understand behavior. Well done!

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That's very true. The more I think about it, the more I think she's probably just really hard up for money and was probably trying to concentrate. It just kind of got into my head because she was super mean. Lol and it really got me thinking, wow, if she's being like this to a complete stranger over something this dumb I can only imagine how people are going to be when I cant give them any more pain relief or whatever else they were hoping for. Not to mention the mental health patients. I got into nursing because I really do want to help people but I really can't imagine dealing with people like that every day. Thank you though!

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Specializes in Cardiac Telemetry, ICU.

I don't think the solution to this person's irate behavior is to attempt to increase the OP's empathy for her. I've had people do this before. I don't recall the details but it was outside a gas station. Maybe he wanted at our pump or something, boohoo. He's absolutely flipping out so I told him it "hmmmm, sounds like a you problem" and went about my business. He looked shocked. People like that want a specific reaction and being unfazed isn't one of them. Sometimes you just have to care less. I think the advice to more closely examine your own behavior would only make you feel as if you're having to walk on eggshells to people-please. Forget that.

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Specializes in NICU.

I am glad I had the meanest raunchiest patients in nursing school,and waking up someone who is handcuffed to the bed , to do a bp was unnerving but you learn.You have gotten some good advice here from very experienced nurses.I can only add ..never turn your back to someone who is out of control,..ever.There were times I went to work with pepper spray in my pocket because I had a lonely ride to a dark half empty parking lot and we had gotten threats.

But good luck to you,i'm sure you will win them over with your sweet attitude and smile.

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I can only add ..never turn your back to someone who is out of control,..ever.

+1

Also always have an exit out of the room. Don't let them corner you or close off your exit.

Kindness doesn't always work with pt's with mental health problems or chemical dependency issues but don't let it make you unkind. Sometimes they'll keep experimenting with what buttons to push over an entire shift to get to you, or instead they'll butter you up and try splitting you with other staff. Then, surprise, later you're the enemy. Always have a universal front with your fellow coworkers.

Address how rude comments are unacceptable, use verbal jujitsu to return conversations back to them and let rudeness roll like water off the proverbial ducks back. It may take some time to thicken your skin.

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Handling patients like this at first is difficult. I used to take it personally and get really upset. You do learn how to cope with it and realize there are so many disorders that cause people to act this way. Of course there is the person who has nothing wrong with them mentally, they're just rude! Luckily, my hospital takes this seriously. One time my patient was so mean and was threatening me, my supervisor wanted me to have the police called to press charges. The thankful and nice patients definitely outweigh the mean and nasty. Good luck!

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You should not have to 'get used to it' but I guarantee the hospital will expect you to and not back you up. I realize people in the ER do not feel good but they never have, we have become a much more rude society and now that patient satisfaction is tied to reimbursement it will become worse. Strangely enough my expectation in ER was that people behave with some semblance of adult-like behavior; rarely do they and please don't get me started on food complaints. The few times I have been in an ER I went out of my way to be courteous to my nurses and the last thing I felt like doing was eat, current climate nurses are verbally and physically abused and this is just accepted by management, I have worked in corrections for several years and my only regret was not doing it sooner, I treat everyone with respect and if they cannot do same, get obnoxious etc...back to cell they go escorted by a deputy.

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I went to a store after work as a new grad. I was already stressed beyond capacity, exhausted all of the time and being eaten as a 'young'. A woman thought I took her parking spot and said "I am going to kill you 'racial epithet' b#tch." I just said the 1st thing that popped into my head which was "go ahead, you will be putting me out of my misery."

She just stood there with jaw dropped as I walked away...apparently it took the wind out of sails

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Thank you all! That's great advice. And to the commenter who mentioned corrections nursing, I almost went that route, so good to know. I'm lucky in that my hospital has a Bert team in the er at all times for patients who become physically aggressive. I'll still be certain to always stay aware though. It's just such a crazy world we live and in.

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Maybe her husband just died or her boyfriend is cheating on her. Your little conversation with your loving husband pushed her over the edge and made her lash out.

I have a coworker, with whom I normally get along. She is really judgmental about patients, dwelling on their faults too long. Some patient came in, it was some dysfunctional family situation. My coworker launched into a self righteous speech about her perfect husband, how they do everything right, yadda yadda... She's is very happily married to a great guy.

I finally turned to her and said that my husband is dead and I'm getting tired of hearing this. She nicely shut up and we are still work friends.

My point being, sometimes less fortunate people get annoyed by those with what they perceive as better luck.

I am so sorry to hear of your husband's passing, Emergent.

I am praying for you to receive courage and comfort.

Peace and blessings to you.

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Thank you all! That's great advice. And to the commenter who mentioned corrections nursing, I almost went that route, so good to know. I'm lucky in that my hospital has a Bert team in the er at all times for patients who become physically aggressive. I'll still be certain to always stay aware though. It's just such a crazy world we live and in.

Be as courteous to people as you can without letting them use you.

THE LESS YOU SAY TO PEOPLE, THE BETTER. Often this is true. SILENCE IS GOLDEN.

In other words, you don't always have to verbally respond, certainly not with some wisecrack or sarcastic remark.

I think you will do fine. Congrats on getting this job.

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Specializes in ICU/community health/school nursing.
She sounds nuts.

Just put her out of your mind, enjoy your new job, congrats on graduating.

What did you say or do in response to her?

I'd advise something like, "I'm terribly sorry, Ma'am".

Love that!

Mr. Ruby Jane started his career as an ED nurse. His motto: "Kill 'em with kindness." So far he's been successful.

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