How do you respond to rude patients?

Specialties Emergency

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How do you respond to rude and complaining patients? I took an earache patient back the other night who waited in the waiting room for 12 minutes before being called back. She stormed to the room yelling about how much pain she was in and how long she waited, and that she never comes to the hospital, "especially this one.", etc. (Hello....it says right on the chart when your last ED visit was....ah hem...6 weeks ago.) In the 12 minutes that she waited to be seen after registering, I was seeing a head trauma patient, that I was working on getting back to CT. I'd been yelled at by a patient a few hours before (not even my patient, but she stopped me in the hallway) about how she was still in so much pain, she'd waited forever, and she didn't even know if she had a nurse, etc. so I was not in the mood for this treatment again, especially when I was dealing with a head trauma patient and this earache is yelling about waiting 12 minutes. GRRRRR!!!!! Oh, and I had pneumonia, but still came to work because there was no one else to work night shift. And she's yelling at me because her ear hurts! How do you deal with the rude and grouchy patients?? What do you say to them? You'd think they'd be grateful that someone is there trying to help them. It just infuriates me to be treated this way and feel like I can't say much back to them.

Specializes in ER.

What doesn't work, I've observed, is when the healthcare worker stoops to the level of the uncouth patient.

Some of these people just literally haven't a clue. They've grown up in contentious situations and don't understand the bare basics of polite society. You really get a grasp of this when they come in with their children, and berate and bicker in front of the nurse.

Better to be polite, businesslike, and treat them like anyone else, attempting to educate and explain, reassuring, and trying to be soothing. It really does help keep things from escalating.

Sometimes I remind them how lucky they are to be sitting in the waiting room because no one ever wants to be the person in the hospital that everyone is running to take care of----that's not a good sign. Waiting means you're stable and fine and thank god for that.

LOL. Yeah, patronizing a patient is really going to help since every one of them thinks they are the worst and need to be seen right away.

LOL. Yeah patronizing a patient is really going to help since every one of them thinks they are the worst and need to be seen right away.[/quote']

I'm not patronizing them or trying to be rude. Honestly I usually get a very positive response to this.

Specializes in ICU.

I agree with the above: to them, they don't know or care that you are taking care of a head trauma patient. All they know is how much pain they're in. I try to be short and sweet- kill them with kindness and then get out of there ASAP...being rude or impolite back will only fuel the fire and things will escalate. I could never work in the ER again, so I give you props...the vast majority of the time when my ICU pts are being difficult, they have no idea what they're saying/doing, so I really can't blame them and that helps. Being able to dial up the sedation helps also;). I really feel for you. Also as a PP said, don't go to work when you have pneumonia...that's just dangerous. I hope you feel better soon!

I don't think there is a one size fits all response.

Some patients can be rude at the beginning, but once they see that you are listening and that their needs are being met, they begin to relax and become more trusting, and sometimes they even end up apologizing for their rude behavior.

Some people have learned through their life experiences that they have to be aggressive to get their needs met.

Some people have become accustomed to being treated poorly by people in a position of power/authority/control.

Some people were never taught basic manners or common courtesy, as they were brought up in a dysfunctional environment with a poor example of how to get along in the world.

Some people are so scared for themselves/their spouse/their child and have had to jump through so many hoops to get their needs met that they are angry at the system and exhausted and scared and you are the person they take it all out on.

Whatever the reason is behind their behavior, it is almost never about YOU.

Sometimes my strategy is to just ignore their rude behavior and not feed into it or get into a power struggle with them, and just treat them with as kindly as I am able, and often times they settle down after a while when they don't get a rise out of me.

Other times, I make myself their ally. I agree with them that the system sucks and that no, they shouldn't have to bring their cancer ridden husband to the ER for pain control just because they can't get anywhere with the oncologist, and that is completely messed up, but we're in it together and we will do our best to help them.

Often, I will sit down and look them directly in the eye and use active listening body language so that they feel heard, and then I will politely set limits and/or explain what is a realistic expectation for their visit today.

Sometimes I just grit my teeth and bear it and get them out the door as quickly as I can because no management strategies that I can identify are going to change the trajectory this person is already on.

Specializes in Long term care.

I just say something like "I'm sorry you feel that way". and then I move on to do what needs to be done.

I'm not patronizing them or trying to be rude. Honestly I usually get a very positive response to this.

Not to argue, but what you do is patronize the patient when you tell them what you posted in the other post. As for getting positive results from the patients you say that too, I would be afraid to say anything like that after someone just chastised me for being impatient and rude because I feel like crap and want to feel better.

As a matter of fact that did happen to me once-I wasn't rude but in a lot of pain and crying. I didn't make a scene but just waited in the exam room for several hours. I never complained about the wait yet some snotty nurse told me in a very patronizing way that the doctor was dealing with more serious problems than mine and would be in to see me when he could. Just out of no where she says that. She basically intimidated me so I didn't say anything back. Maybe that's why you get such positive results when you do the same-the patients feel intimidated and don't know how to reply to your comments.

It's people like this that made me go into the healthcare field. I figured that I could try to make up for the rude and patronizing healthcare professionals who feel so "put upon" by their patients by being a caring and sensitive professional who can see beyond a patient who is not feeling well who is being "rude".

Specializes in ER.

That's true, a person can be grouchy when they feel bad. You don't know what else might be going on in their life. They might have just been laid off, going through bankruptcy, their mother just died, their water pipes froze and their car is broken down. Then they have to deal with a bunch of annoying questions, it might just send them over the edge.

Specializes in Emergency/Cath Lab.

Get on one knee and start kissing ass. We need that press gainey score to be high!!!!!

Specializes in ER.

You don't have to kiss ass. But you do need to develop people skills to handle difficult people.

Some people let rude people push their buttons. I like to stay more detached. It makes people more cooperative. My function isn't to teach manners but to get through the patient/nurse interaction with the least problems, and perhaps effect healing on some level.

Specializes in ER, progressive care.

I agree, kill them with kindness. I feel like I could say some really mean and nasty things back, but I bite my tongue. I like my job.

Sometimes you have to be honest, though, but not necessarily rude. I had a patient who was c/o pelvic pain, labs and tests were unremarkable...anyway, I mentioned something to the doc who decided he wasn't going to order anything else. We then get another patient who came in CRITICALLY ill (tension pneumo among other things) and this doc was taking care of this patient. My pelvic pain pt demanded that she speak with the doctor and I simply told her that he was in an emergency situation literally trying to save someone's life. I told her it may be awhile before he can come in, told her I had already spoke with the doctor earlier and he decided he wasn't going to order anything else. She seemed to somewhat understand what I just told her, but she told me "well can you have him come in when he gets a chance?"

We've had less-acute patients complain about it taking so long for the doc to come in, blah blah blah...we had a pedi code one night and they were complaining...our charge nurse walked by and heard the complaints. She stopped and said to them, "I'm sorry, as soon as the doctor is done trying to save a baby's life, he'll be RIGHT IN." They just stopped complaining after that.

Specializes in ER.

I agree. I think if you explain that you have a critical pt, most people totally understand. I do that all the time, with good results. It's part of the education process to explain to pts how the system works, what to expect from their visit to the ER, when to expect the doctor, test results, etc.

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