I am in my second semester of nursing school and was looking for some advise. This semester I am in two clincials (one med surg, and one psych). A couple of weeks ago during my med surg clinical I was assigned a pt who just had back surgery and developed delirium within the past couple of days. When I first went in to introduce myself to the pt she told me to get out and that I was incompetent because I am a student and didn't want to talk to me. I told her I would give her some space and come back later to check in with her. My hopes was that she would cool down but she was even more amped up the second time she saw me. I went a head and performed vitals feed her breakfast (she had tremors and couldn't feed herself), and gave her a bed bath. The whole time she continued to tell me that I was incompetent and that I wouldn't make it in nursing and she would make sure of it and ruin me. Needless to say she made a lot of rude remarks towards me and other nurses/staff memebers that came in through out the day. What really hit me though was her telling me that I don't have what it takes to be a nurse and that I am not a good nursing student.
I had another similar experience in my psych clincial. A pt walked up to myself and one of the other students and he told her that he could tell by looking at her that she was going to be an amazing RN. He then looked at me and said I'm not so sure about you, but then he laughed and said he was kidding but continued to compliment the other student.
I took both of those comments really to heart. I'm looking for advise to see if this has happened to anyone else and how they delt with it/didn't take it to heart.
Here's how I used to deal with that. Walk into room with narcotic in hand. Patient begins hurling insults. I sweetly say "it appears you're having a difficult time at the moment. I'll come back with your pain med when it's over." Mean, nasty person will suddenly become quiet and consequently sneaky boundary has been set. Truly crazy people will keep at it and I shut off my ears and complete whatever task needs done.
Seriously though. You really need to pay no mind to what your patients with some sort of psychopathology say. It isn't personal. It's a symptom. Now your alert patients are a whole other story. I do not agree that being ill or in pain is license to mistreat those who are trying to care for you. Don't smile, don't laugh at my bad joke, no eye contact, one word answers and general grumpiness. Go right ahead but personal attacks, foul language and physical aggression will not be tolerated and I will call them on it in a heartbeat. I'm never unprofessional when I do it and I don't give them an option for another nurse (why do that to my colleagues?) but I make it very clear that I am not to be abused. it generally works and when it does they get the personal care they desire. When it doesn't they still get excellent nursing care but I will minimize my interaction with them and I do not react to their insults. They get really bored with it pretty fast and after awhile don't like the impersonal (yet still good) care. While they might not stop with me I've found they often settle down for the next shift and it gets better from then on.
I've had this happen to me, I usually have the ignoring them part down, but I can't get the part down where you teach them not to treat you that way ; This is something I would like to learn and I truly admire you for this , great advice .
Thank you all for the great advise! I really appreciate it! I'm glad I'm not alone in this experience and that these situations improve with time. Looks like this is just a weakness of mine that I need to work on to improve!
Your first patient sounds like she was withdrawing from alcohol and not delirious. Because of DTs, I have worked with hundreds of alcohol withdrawal patients in critical care and I have only met one who wasn't an jerk during the withdrawal period. So I would take what she said as no authority whatsoever. She was miserable and wanted you to feel that way too. The second patient was in the psych ward for a reason. Leave it at that and move on. I am sure you are a kind person and a thoughtful nurse, because you cared about what they said to you. However, in the future, you will have to decern who can be a good authority to give an opinion about your character and who cannot. I can safely say, those not in their right mind are not.
I have a patient who one day will tell me I'm the best nurse ever and thanks me for my service and then the next day will yell at me and tell me I'm a horrible nurse and that I should consider another profession.
For the psych patient. The pscyh patient probably noted that the comment got to you, and then started to play a game. The psych patient was trying to pit students against each other. By telling you that you are bad and someone else is good, is trying to divide staff. Do not take want a patient with Delirium and a psych patient who are ill have to say.
My psych instructor told us that she keeps a book of all the names patients have called her and likes to look back at it and laugh. Sometimes these types of patients are very creative and it is kind of humorous to see what they come up with! I recently had a patient who was hallucinating and thought aliens were forcing him to drive around and pick strawberries. This guy HATED me and told me I was a terrible person and an even worse nurse. I didn't really give his opinion of me too much weight, since he was the one hallucinating
Wannabenurseneko
259 Posts
I've had this happen to me, I usually have the ignoring them part down, but I can't get the part down where you teach them not to treat you that way ; This is something I would like to learn and I truly admire you for this , great advice .