how to handle getting yelled at

[clju9901]

I would really like some advice on how to handle getting yelled at. For the first time in my nursing career, a patient's family member (daughter) yelled at me and basically told me I suck as a nurse.

I had a patient who was S/P DBS placement and was on q2hr vital signs and neuro checks, so needless to say I had spent hours in this patients room throughout the night (I was working 7P-7A), anyway from the time of my last neuro check (~6:15 AM) and 7:40 am when the patients daughter arrived (who of course is a nurse) my patient's IV infiltrated and her hand and wrist were swollen. The daughter proceeded to tell me that she is a nurse and (think very angry almost yelling very condescending tone), "I Look at the patient's whole body, especially their IV site", and things like "you obviously didn't assess her", "this shines very poorly on the hospital", "don't you worry Dr. #$% will hear about this", it went on and on. I made a very sad attempt to stick up for myself saying that the infiltration had to have happened within the last hour or so (since I was in the room around 6:15 and the IV looked and was running fine), which did not help, and stirred her up even more. I ended up apologizing over and over as this woman kept yelling at me, making me feel like a grain of salt and like I was the worst nurse in the world. I now am sitting at home (I got home at about 8:30 am when my shift was supposed to end at 7:30 am) unable to sleep because I keep replaying these words and feeling very inadequate, and not to mention feeling very angry that I let this woman get to me when I know I am a good nurse.

I am wondering if anyone has advice on how to handle "getting yelled at", how to leave it at work and not feel like you never want to go back. Any thoughts are welcome, as are comparable stories!

[nurseangel47]

Perhaps referring them to someone in charge such as the nursing supervisor of the house. That does wonders for those potential trouble makers since nursing supervisors are generally able to cope with more therapeutic communication than a staff nurse in regards to trouble shooting of all kinds. Or, you could let them rant, and respond with something like " I'm sorry that you feel this way. I realize that this must be a very upsetting time for you.

Would you like to speak to a supervisor? Sometimes the mere fact that a loved one is going thru a procedure/surgery and is sick, is enough to make the most polite person go off on whoever is available. I'm sorry that you went thru that unpleasant experience. I, too, have been the scapegoat many times of unpleasant, rattled family members of patients I've cared for.

I documented everything about the case, kept it at home in a safe and private area in case anything legal ever came of it. Scary, but the ideal and only way to CYA sometimes. I also, had to remind myself that nothing I was accused of or yelled at was my fault. Someone actually coded and expired on my watch once and the mother of the pt. accused me of not adequately caring for her son in a timely manner. Had a full blown DT pt. in leather restraints across the hall from him that I was attending to when he arrested. The code team responded adequately. There was nothing that could've been done to save him. It wasn't my fault. I finished my shift pushing that to the back burner to think about when I got off duty so it wouldn't affect the care I gave to my other pts. Nothing ever came of it other than an unsettling feeling like the one you've described. Hang in there. Not everyone is perfect. Ivs will infiltrate, family will go off on you, it's part of the imperfect world of nursing, unfortunately.

[MALE*RN*777]

Usually you won't win verbally with the family member expecially someone who thinks like this woman sounds. You are right in saying that an infiltration could have started as soon as you left on your last check with the pt. moving, etc. I like to use the I'm sorry you feel this way but.... or I'm sorry you miss understood me but.... Then don't go into great detail, seek out the next in charge and explain this issue and let it go from there. Managers will try to save face alot of times just to make the family happy and for their unit not to look bad. I'm the same way you are in that I will go over and over the situation in my head even though I may have done nothing wrong. This is the business we are in. Its easy to say but just go on and do your best.

[suespets]

I really feel for you! maybe the daughter will apologize to you next time she sees you. Hey! It could happen!

[HouTx, BSN, MSN, EdD]

What a terrible experience for you. Unfortunately, unless you are a very rare exception - it won't be the last time. There's nothing you can do to fix what has already happened. But you can use it as a learning experience.

Conflict management 101: "the things that people are yelling about (content) is probably not what they are actually upset about (issue)". In this case, what do you think was the underlying issue? Maybe guilt? After all - she's a nurse too & probably thinks she should have been there at her mother's side to prevent anything from happening. Is she worried about having to take care of her mother after discharge? Worrying that the infiltration will increase the recovery time? Of course it's important to respond to the content of the communication, but as a nurse - you need to try to figure out the underlying issue.

We all respond differently to conflict - My natural tendency is to automatically go into "attack" mode when someone gets in my face. Obviously, this can be a disastrous choice in many circumstances. There's a real art to this - some people are naturals & the rest of us have to learn.

I was fortunate (after one particularly horrendous conflict with a physician) to be "schooled" by a wise nursing director who taught me how to cope. Her advice in you situation would probably have been to respond with something like "I am so sorry I was unable to meet your expectations - I will make very attempt to do so in the future in order to regain your trust".

When you keep it 'other centered' - focusing on her needs rather than yours - you have a chance to turn it into a win-win situation. You are not admitting any fault or shortcomings but simply letting her know that she is important to you; you got off on the wrong foot & want to make it better.