How do you get thicker skin?

[Loves2Lurk]

So, I am a relatively newer ED nurse, started in Feb 2010. I generally don't have problems when psych pts or older pts with demetia are mean and hateful because, obviously, they have issues. But yesterday, an older man (who was totally alert and oriented) was not satisfied with his care (I wasn't even his nurse, I answered his call light) called me a "fat ***** and when I stood there stunned he said "Yeah you, the ugly one". Why do people think that when they walk through the doors of the ED, all of the rules of general society and common decency, morals, manners, etc go flying out the window? I mean, it really hurt my feelings and I don't know how to grow that thick skin to make it possible to deal with these people. I am embarrassed to say I shed a few tears (I have had 2 babies in the past 3 years and my body image sucks right now). It also just irks me that afterwards the man just gets coddled by the charge nurse to make HIM feel better.

So, my question is, how do you all deal?

[mindlor]

sorry this happened to you....

now, I find that the best way to deal with this type is to do your best to ignore the remark. And then kill them with kindness. Offer to fill his water, you know what I mean....

Also please remember, that although he may seem alert and whatnot, hospitalization is very stressful and pts will sometimes behave inappropriately secondary to stress/anxiety....

So, they do need a little more leeway. Another approach is to simply state "What you just said was very hurtful to me, I would appreciate it if you would not make comments like that in the future."

If they continue, then its time to see the charge nurse and get the census juggled around and get you out of that situation.....

[DixieRedHead, ASN, RN]

You are a mother and a nurse. If your hips are a little wide right now from child bearing, so what. When you lose the baby fat that old guys will still be a mean, rude, old man.

My mama said "Trash is something you walk around, not something you wade through." Just walk away and ignore it.

[whereslilly]

Sick people are Angry people. He wanted that reaction from you! Its not so much as a "thick skin" as a basic understanding that as a nurse, its never about you. Unless you were negligent with your care, and obviously you were not, its purely projected Anger. A good response would be, "I see you need assistance, how can I help you sir?" Deflect and try to deescalate the anger. Never stand over the Pt. Stand slightly away, as not to intimidate him. Continue to speak in a soft tone. I see that this is something you are sensitive about (your weight). The Pt doesn't know this. He isn't out to hurt you personally. Never internalize what a Pt has said to you, either Good or Bad. (slippery slope). As you gain experience you will see and hear alot of ugly things in the ED. Some very sad. This is a good lesson: Never take it home with you. Most importantly, never let an Angry Pt get to you!

[shoegalRN, RN]

I had a frequent flyer pt curse me out and call me a "crazy *****". She did this in the waiting room full of people. I looked her in the eye and told her "Now you will NOT use that language and speak to me that way!". She instantly started apologizing. I didn't get upset, but it kinda got to me because we always had a good rapport. After that, I saw her the next day and she spoke to me and said "how you doing today baby".

I know it's hard not to take things personal because you are human. However, when I have someone being disrepectful, I call them on it. If things escalate, I call security.

[surferbettycrocker]

i understand that sick people are often angry people but what that old guy said was really direct and very hurtful not just raising his voice and exploding to whomever will listen. i have no words other than im really sorry that you had that experience.

i get that as nurses, one has to understand or try to--where the anger is coming from HOWEVER i also think it is a slippery slope to accept behaviour like that because people are 'sick or hurt. it needs to be addressed.

i think its deplorable that as nurses we have to hear things like that and deflect or ignore., and to be honest the real sickly patients are the ones who barely even talk let alone insult people.

[WineCountryRN]

As an ED educator, all I can say other than sorry for having to deal with someone mean spirited people and yes they are out there. One of most beneficial presenters that we had in our ED was a former cop/head of our security who teaches on de-escalation in the ED. If you plan to stay in the ED keep in mind that ALL of the patients in the ED are under stress just by virtue of being in the ED and second, there are stages when a patient is 'escalating' and one of those is to strike out both physically and verbally to the nurses. The ED can be very hostile and ED nurses are often assaulted by patients, family and their colleagues. May I suggest that you look up Crisis Development Model and learn the stages and how you should respond as a provider. It sounds like this person was being defensive and acting out (verbally) and you were in the line of fire. Being a working mother in a new role is very stressful. You don't have to apologize for your feeilngs or your weigh. If nothing more, seek out your Employee Assistance Program to help you through some of the stress and find healthy ways to cope.

[casper1]

This man might had appeared to have no psych issues.I'd bet Based on his hurtful comments he has major ones. Hospitals are full of bullies , Patients, families even co-workers and managers. You are a kind and thoughtful person who was trying to help, you did not desearve his treatment.

Kind, and thoughtful people are drawn to Nursing. We would never in a million years treat others like this. Know in your heart that you are a better person, that you have the grace to turn the other cheek. I feel anger is a sign of weakness, its unproductive and inhibits your ability to examine a difficult problem and find solutions

[ProgressiveActivist, BSN, RN]

If this loser spoke to an employee that way in an airport, a bank, a post office or pretty much any other place of business, he would be charged and arrested for assault.

Treat and street.

[mindlor]

If this loser spoke to an employee that way in an airport, a bank, a post office or pretty much any other place of business, he would be charged and arrested for assault.

Treat and street.

Libby, that sounded rather conservative as I read it :) you may need to change your name soon :)

[Altra, BSN, RN]

OP, I'm sorry you had that experience, and I'm sorry that your department thinks so little of its staff.

If that had occurred where I work, that patient would receive a *consultation* from Security, and if that did not immediately rectify the problem, any one of the physicians I work with would have immediately discharged the patient.

Unacceptable.

And that's where the "thick skin" comes in ... knowing, truly, that you did nothing to provoke such outlandish behavior, and that the behavior has nothing to do with you.

[TheDreamJourney]

I also believe that disrespectful behavior needs to be addressed in it's own appropriate manner. I have grown thicker skin because I have worked in retail for years and believe me it's amazing how rude people can be. I think with time you will learn how deal with angry patients in your own way. My advice to you is to talk this out with a loved one and get it out of your system that way. Everytime I have a hard day at work I tell my older sister about it. It's amazing how talking things out releases stress. Sorry for your experience and hope you feel better soon.