got shouted at yesterday night

truern · Feb 28, 2009

Anybody remember Erikson?!?

"Adolescence: 12 to 18 Years

Ego Development Outcome: Identity vs. Role Confusion

Basic Strengths: Devotion and Fidelity

Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.

Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.

A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes."

A 15 yo male has just begun being an independent person and suddenly finds himself threatened with the loss of that independence and further a loss of his privacy and dignity by virtue of being hospitalized. He may have even reverted back to the previous stage of development.

While I certainly would not allow him to continue to yell at me or others, I'd try to understand where he's at developmentally and approach him from that understanding.

miko014 · Feb 28, 2009

We have all too many putative adults who are behaving like children, and we continue to make excuses for them. Being sick or stressed does not relieve an adult of the duty to act like one.

Right on! I had a nurse who got ripped apart by a family the other night, and she was so shaken and upset that she had to leave the floor for awhile and I had to change the assignment midshift so that someone else could take over the care - she was afraid to go back into the room. The family member claims to be a nurse (we think she's really a CNA - she doesn't know basic things like how to check NG placement - she yelled at that nurse for "putting all that air in her (pt's) stomach!" and several other things). If she really is in the biz, she should know how things go and that she can't have someone instantly when she wants them - we are not ICU. That's what happened when she snapped - she said she needed to speak to the pt's nurse, and that another nurse couldn't help her. So we told the nurse, who was in with another patient doing a task that takes some time, then told the family she would be in as soon as she could but she was with another pt just then. As soon as she was done, less than 10 minutes later, she came out of that room and headed for the room that had asked for her. She stopped on the way to plug in her computer cart (the battery was dying), and the family saw her in the hall. This one particular one who is the "nurse" and who is causing 95% of the problems and seriously interfering with the care the patient recieves, came out into the hallway and chewed her head off in the station. She threatened to sue, told this nurse that she was sick of her ********, she was going to call everyone under the sun and report her behavior, etc. I wasn't there at the time, I was on one of the other pods on our unit and had no idea any of this had happened until a few minutes later. The nurse came to me in tears, completely shocked. She didn't do a thing wrong - the family is unreasonable. I paged the house sup and stayed with her till she was calmer. Then I changed the assignment and went to talk to the family - the house sup was behind the station reading the patient's chart. The family came out of the room while I was headed that way and demanded that I send the nurse that she had just spit out into the room. I told her that that Nurse A wasn't going to be with them anymore and that Nurse B would be taking over but she was still getting report and would be available shortly. Before I could even offer to do anything, introduce myself, or get any other word out of my mouth, she started screaming at me too. Luckily the sup came around the corner and took over just then so I didn't have to deal with them that time. They behaved for the rest of the night, but I told the sup that if she did that again, I wasn't going to mess around - I would just call security and let them lay down the law. She was being disruptive to all the nurses and the other pts by screaming in the hallway every time she didn't get what she wanted immediately!

Sorry for the long tale - the moral of the story is: I won't tolerate that kind of behavior. Sometimes it just takes a gentle reminder that we are very busy and taking care of many people and we really are doing the best we can. Other times, it takes more than that. Either way, it's not going to happen twice on my unit (at least, not while I am there). Our jobs are hard enough, we should not have to deal with that kind of abuse. Plus, if I screamed at the kid at McDonald's the way that person was screaming at the nurse, they would have called the cops on me so fast I wouldn't know what hit me. Yes, the hospital is a high stress environment for them, but it is for us too, and I'm tired of everyone making excuses for irrational people. If they have a true problem, they should address is correctly and like adults, not by throwing a tantrum and making threats.

RN BSN 2009 · Feb 28, 2009

Sounds like he needs some more home training!!

ChristineN, BSN, RN · Feb 28, 2009

yesterday night I was shouted at by a 15 yr old male patient what happend was he pressed his call light and i didnt get to him quick enough and he snapped at me and said move quicker and then he kept giving me the evils all the rest of the night I was a bit upset because I had looked after him and done things for him for the past three nights so I was a bit angry and sad

I work with teenagers and it is not uncommon to have issues lkike that. The nurses that I work with are not opposed to putting these kids in their place and reminding them, that they can go home, or they can behave. Normally Mom and Dad aren't going to take these kids home, so they'll straighten up. I've found too, that if you have to, tell the kids parents what happened, and then, magically they'll start behaving once the parents have a talk with them (if the parents have any sense).

You should stand up for yourself. Regardless of the age of the patient, nurses deserve to be respected.

survivor08 · Feb 28, 2009

You are an excellent charge, standing behind the nurse and up to the patient's family like that. Too bad there aren't more like you out there, at least not where I work. You nailed it!

Jules A, MSN · Feb 28, 2009

Yes, the hospital is a high stress environment for them, but it is for us too, and I'm tired of everyone making excuses for irrational people. If they have a true problem, they should address is correctly and like adults, not by throwing a tantrum and making threats.

Yes but this is a 15yo not an adult! I'm all for nurses being treated with respect but frankly a child this age yelling at me isn't going to send me away in tears. He absolutely should be more polite but there is so much going on that we don't know about him, his background or present illness. I would address his concerns in a professional empathetic manner. Isn't that what we do?

RN1982 · Feb 28, 2009

I don't know. You got shouted at by a kid, not an adult. Hardly something to be upset over. Just my two cents.

freddiebear · Feb 28, 2009

I think if a child goes from being easy to get along with to getting irritated the first step would be to put your feelings aside and calmly and caringly ask the child if there is something bothering them. Could be seperation anxiety, physical discomfort or a side effect from medications.

Saying something like "I can see you are angry, would you like to talk about it?" would convey that you care.

chicookie, BSN, RN · Feb 28, 2009

eh, his a 15 year old, just forget about it.

You can be the nicest person in the world, you do one bad thing and they won't forgive you. At that age everyone is moody especially when sick, in my opinion.

rngolfer53 · Mar 1, 2009

Yes but this is a 15yo not an adult! I'm all for nurses being treated with respect but frankly a child this age yelling at me isn't going to send me away in tears. He absolutely should be more polite but there is so much going on that we don't know about him, his background or present illness. I would address his concerns in a professional empathetic manner. Isn't that what we do?

So long as the conversation about his concerns also includes some education about how to politely raise concerns and the necessity of doing so from now on, I agree.

miko014 · Mar 1, 2009

Yes but this is a 15yo not an adult! I'm all for nurses being treated with respect but frankly a child this age yelling at me isn't going to send me away in tears. He absolutely should be more polite but there is so much going on that we don't know about him, his background or present illness. I would address his concerns in a professional empathetic manner. Isn't that what we do?

I was referring to the situation I described - you took the part of my post about the adult I was talking about and made it about the kid. I said that a gentle reminder is often all that is necessary.

DeepFriedRN · Mar 1, 2009

Think the only thing you can do is just remind the kid that if he wants to be treated with respect, he needs to show it to others. He's a kid. They act creepy sometimes. My mom told me that when they hit 14-15, aliens take over for about 3-4 years. Having a 14 yr old, I gotta say I think she's right. Geez, at least he's got the kid excuse going for him. It's the adults that behave like this that make me wonder..