So TIRED OF IT

Libby1987 · Sep 16, 2018

I'm sure you're right. You're the best nurse that ever graced the profession. All these other nurses are terrible.

I'm considering setting and perception, and the patient experience with dozens of nurses, not myself.

Ms_Interpret · Sep 16, 2018

I'm considering setting and perception, and the patient experience with dozens of nurses, not myself.

Yes...however, what you are failing to consider is that you (in your own words) have been away from bedside hospital nursing for many years and so are drawing conclusions based on a perspective that is far removed from the current challenges of bedside nurses and that is decidedly influenced by just one side of the equation - the patient.

It's harder to throw another nurse into the trench when you're actually in the trenches WITH her/him.

EDIT: And besides, allowing people to vent is what keeps them from acting out in drastic ways to gain support. You're not doing anybody any favors here.

guest52816 · Sep 16, 2018

Rolling your eyes doesn't bother me.
If they are obnoxious just for not getting their pillow fluffed and demanding 6 ice cubes, not 5 or 7, they sure change fast when they get home.

I am sure they do change fast once they are home, and nobody is waiting on them hand and foot.

Few family members will tolerate behavior that nurses are expected to tolerate with a smile.

A dose of reality straightens out many of these patients!

JKL33 · Sep 16, 2018

When I read these threads though, and there are many, about this seemingly epidemic of patients demanding hotel type treatment, I have to wonder then why in their own homes they're usually so damn grateful for our service. I mean these patients are just 24-48 hrs off of your care often still anxious and hurting, and I'm not doing handstands for them, where did the belligerence and sense of entitlement go?

I'll bite. I think there are multiple factors. In no particular order:

1) You have come to them in their own home. They don't have to do anything in particular other than be there and make sure you have a way to get in. Kind of the epitome of "catering" - and I don't mean that in a derogatory way. It's just that the very nature of your services seriously decreases the opportunity for the patient to feel inconvenienced.

2) Depending on capability, they're more likely to mentally be at least a little bit in "host" mode rather than "guest" mode.

3) You are working in a way that would appear to the patient to be independent, having the authority to make good judgments. In the hospital they can see the disrespect and disregard of nurses very clearly. They see us running around like chickens with our heads cut off, they see that our work can and will be interrupted by anyone for any reason. They see that we don't have time to really attend to their needs, even though we may insult ourselves and them saying some stupid canned phrase like, "I have the time!" They know that is disingenuous. They know we we've been told to do and say everything we're doing and saying, and that we generally don't have long amounts of time to dedicate to genuine interactions with them. We certainly aren't sitting down in their living room to hear how things have been going.

4) They can smoke/use tobacco products if they want to

5) They can drink if they want to

6) They can use whatever substances they want to

7) They can eat what they want to

8) Their rest is not being interrupted constantly by your list of things to do

9) Families tend to get pretty excited (either in social/"pull-together" ways or in total angst and chaos ways) when someone has an acute health change and ends up hospitalized. This frequently leads to either "social-get-together" mode or "storm the hospital and find out what the hell's going on" mode - neither of which are great.

10) Breaches of dignity inherent in hospital care are way less likely to come into play. For instance, they'll be wearing their own clothes instead of a ridiculous gown, they aren't disallowed from moving around by themselves as a rule, they don't have to have someone standing near-by while they urinate/defecate/attend to personal care.

**

I think the chances of really having trouble with patients/families go down dramatically when nurses are absolutely determined not to fall into whatever fray may be waiting to ramp up. Steadfastly treating people with respect and, when necessary, setting clear limits while maintaining compassion goes a long way. A super long way. Being perceptive is another skill that is an immense help too.

That said, it is a constant effort. Yes, people are rude. It's pretty much rubbish to insinuate that reports of such represent gross exaggerations. I see firsthand all of the types of situations/complaints that have been mentioned here. I happen to think I'm pretty good at heading off or navigating (potentially) problematic scenarios, but that doesn't change the overall situation that is being reported in threads like this.

jaderook01, BSN, RN · Sep 17, 2018

I'll bite. I think there are multiple factors. In no particular order:
1) You have come to them in their own home. They don't have to do anything in particular other than be there and make sure you have a way to get in. Kind of the epitome of "catering" - and I don't mean that in a derogatory way. It's just that the very nature of your services seriously decreases the opportunity for the patient to feel inconvenienced.
2) Depending on capability, they're more likely to mentally be at least a little bit in "host" mode rather than "guest" mode.
3) You are working in a way that would appear to the patient to be independent, having the authority to make good judgments. In the hospital they can see the disrespect and disregard of nurses very clearly. They see us running around like chickens with our heads cut off, they see that our work can and will be interrupted by anyone for any reason. They see that we don't have time to really attend to their needs, even though we may insult ourselves and them saying some stupid canned phrase like, "I have the time!" They know that is disingenuous. They know we we've been told to do and say everything we're doing and saying, and that we generally don't have long amounts of time to dedicate to genuine interactions with them. We certainly aren't sitting down in their living room to hear how things have been going.
4) They can smoke/use tobacco products if they want to
5) They can drink if they want to
6) They can use whatever substances they want to
7) They can eat what they want to
8) Their rest is not being interrupted constantly by your list of things to do
9) Families tend to get pretty excited (either in social/"pull-together" ways or in total angst and chaos ways) when someone has an acute health change and ends up hospitalized. This frequently leads to either "social-get-together" mode or "storm the hospital and find out what the hell's going on" mode - neither of which are great.
10) Breaches of dignity inherent in hospital care are way less likely to come into play. For instance, they'll be wearing their own clothes instead of a ridiculous gown, they aren't disallowed from moving around by themselves as a rule, they don't have to have someone standing near-by while they urinate/defecate/attend to personal care.
**
I think the chances of really having trouble with patients/families go down dramatically when nurses are absolutely determined not to fall into whatever fray may be waiting to ramp up. Steadfastly treating people with respect and, when necessary, setting clear limits while maintaining compassion goes a long way. A super long way. Being perceptive is another skill that is an immense help too.
That said, it is a constant effort. Yes, people are rude. It's pretty much rubbish to insinuate that reports of such represent gross exaggerations. I see firsthand all of the types of situations/complaints that have been mentioned here. I happen to think I'm pretty good at heading off or navigating (potentially) problematic scenarios, but that doesn't change the overall situation that is being reported in threads like this.

You win the Internet today. Just saying.

Libby1987 · Sep 17, 2018

You win the Internet today. Just saying.

Agree

Libby1987 · Sep 17, 2018

I'll bite. I think there are multiple factors. In no particular order:
1) You have come to them in their own home. They don't have to do anything in particular other than be there and make sure you have a way to get in. Kind of the epitome of "catering" - and I don't mean that in a derogatory way. It's just that the very nature of your services seriously decreases the opportunity for the patient to feel inconvenienced.
2) Depending on capability, they're more likely to mentally be at least a little bit in "host" mode rather than "guest" mode.
3) You are working in a way that would appear to the patient to be independent, having the authority to make good judgments. In the hospital they can see the disrespect and disregard of nurses very clearly. They see us running around like chickens with our heads cut off, they see that our work can and will be interrupted by anyone for any reason. They see that we don't have time to really attend to their needs, even though we may insult ourselves and them saying some stupid canned phrase like, "I have the time!" They know that is disingenuous. They know we we've been told to do and say everything we're doing and saying, and that we generally don't have long amounts of time to dedicate to genuine interactions with them. We certainly aren't sitting down in their living room to hear how things have been going.
4) They can smoke/use tobacco products if they want to
5) They can drink if they want to
6) They can use whatever substances they want to
7) They can eat what they want to
8) Their rest is not being interrupted constantly by your list of things to do
9) Families tend to get pretty excited (either in social/"pull-together" ways or in total angst and chaos ways) when someone has an acute health change and ends up hospitalized. This frequently leads to either "social-get-together" mode or "storm the hospital and find out what the hell's going on" mode - neither of which are great.
10) Breaches of dignity inherent in hospital care are way less likely to come into play. For instance, they'll be wearing their own clothes instead of a ridiculous gown, they aren't disallowed from moving around by themselves as a rule, they don't have to have someone standing near-by while they urinate/defecate/attend to personal care.
**
I think the chances of really having trouble with patients/families go down dramatically when nurses are absolutely determined not to fall into whatever fray may be waiting to ramp up. Steadfastly treating people with respect and, when necessary, setting clear limits while maintaining compassion goes a long way. A super long way. Being perceptive is another skill that is an immense help too.
That said, it is a constant effort. Yes, people are rude. It's pretty much rubbish to insinuate that reports of such represent gross exaggerations. I see firsthand all of the types of situations/complaints that have been mentioned here. I happen to think I'm pretty good at heading off or navigating (potentially) problematic scenarios, but that doesn't change the overall situation that is being reported in threads like this.

I love what you've written here and your mindset is actually similar to mine.

I can see how it appears that I'm insinuating that the scenarios don't occur. Regardless of what I think does or doesn't happen is irrelevant since I not only don't work inpatient but I also don't work with any of these posters.

My point was more about perception. After 30 yrs my mindset and perception have changed. I've gone from taking patient and caregiver behaviors at face value and as a result had more frustration. This not only affected my work experience but no doubt in my case affected the patient/caregiver behavior and experience and round we go.

Once however I started mitigating those behaviors with the issues you've listed above, it changed the experience for both me and the patient/caregiver. How I see and react to those behaviors when I see them coming on (anxiety etc) is entirely different than it used to be and the outcome out of that is a lessening of the inclined behavior. I try to influence my team to have a different perception as well, not to be dismissive but as a way to navigate working in today's healthcare.

To be able to have better job satisfaction after all of these years later in a more challenging environment, with the psychosocial complexities, consumer expectations and trying to navigate CMS VBP, than we've ever had before is a blessing.

I apologize to those I've offended.

Not_A_Hat_Person, RN · Sep 17, 2018

This is part of what I liked about working in corrections. Don't get me wrong, the inmates deserved basic respect as human beings, regardless of what they had done. That said, if you did something an inmate didn't like, and it met the standard of care and didn't violate their human rights, they pretty much had to live with it.

morte, LPN, LVN · Sep 17, 2018

I'm sure you're right. You're the best nurse that ever graced the profession. All these other nurses are terrible.

this the type of post that makes me sad that there is no "dislike" button, just plain rude.

ThePrincessBride, MSN, RN, NP · Sep 17, 2018

Thanks for all the supportive messages!

I do like the suggestion of PACU!

I am working on going back to school. I think bedside nursing isn't a place people stay long-term anymore. Even in the so-called coveted specialities nurses are running to NP /grad school in droves.

guest769224 · Sep 17, 2018

I think bedside nursing isn't a place people stay long-term anymore. Even in the so-called coveted specialities nurses are running to NP /grad school in droves.

Which, one could argue, creates more job security for experienced bedside RN's (higher demand). However...that's if one can put up with all the BS you mentioned in your original post.

Susie2310 · Sep 17, 2018

Patients and family members can certainly be difficult, but under the best of conditions, with timely, appropriate, care given by knowledgeable, caring and competent health care professionals, being a patient/family member and receiving health care is very often a very stressful experience. In reality, medical and nursing care is often not given in a timely manner, from the ED, to primary care, to specialist offices, to just about every medical setting, which results in patients often deteriorating due to delayed diagnosis or being misdiagnosed, or being the recipient of other errors in care. The difficulties in receiving the right care at the right time should not be underestimated. No wonder patients and their family members are often highly stressed and not at their most co-operative and reasonable.

OP; I am puzzled; what did you expect when you became a nurse? Nursing is a customer service role, albeit what we serve is nursing care. Taking care of sick people, who are often not at their most co-operative and reasonable, is what you get paid for. As nurses, the great majority of us are employees; and nurses are not in short supply in general. If you don't want to work face to face with the general public, then for goodness sake find a new avenue of employment. In my experience, all professions/jobs that work directly with the public encounter the same types of problems - a proportion of unreasonable, un-cooperative, demanding clients. You will see it in the higher paid professions also; in CPA offices and law offices, and these clients are usually not acutely ill when they present to these businesses.