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 PCU.

I usually look at them with a blank face, let them know we are sorry they are being inconvenienced, and advise them we have a patient representative that they can speak with if they are having issues. Then, I keep doing what I have to do. Most of the complainers have issues that have nothing to do with us and we are just the lucky scapegoats. We have excellent patient reps who usually will try and alleviate the patients' frustration. By and large, it is nothing we have done and dealing with a patient rep will allow them to feel as if they are being taken seriously.

However, at the end of the day, we do the best we can to prioritize, stabilize, and take care of our patients. Some people were miserable before they ever met us and will continue to be miserable way after they have left us...yelling will not change that, nor will I allow it to ruin me for more than a few hours.

BTW, the above is for those seriously rude, entitled patients that are just not going to be happy with anything...

There are those patients who have had a rough time, either through issues going on or being neglected while we stabilize the more unstable ones...to those, once I can (even if not my own patients), I attempt to address the issue myself, find what needs to be done, or just listen once I get a moment to breathe. I let them know I have a list of needs to be met and if I am late getting back to them I have not forgotten, but will be there as soon as I can.

In answer to the original question...

Rude patients try everyone’s patience but people react to emergencies in as many different ways as they grieve. No two are exactly alike but as a nurse, it is my job to cut people extra slack when they come to my ED. Part of my skill set is handling whatever comes in the door.

I try to remember that today (although it is just another day at work for me) is a horrible day for them, so bad that they feel they have an emergency! I try to show them I care even if they have to wait for 6 hours to be seen by a doctor, I am seeing them right now. I try to reassure them that their needs are important and explain that patients are not seen by doctors on a first come first served basis in the ED but are seen by how critical they are.

I try to make eye contact because they can see in my eyes that I care and I am sincere. I try to remember that I am an advocate for every one of my patients.... not saying that I’m always perfect and never have a bad day, but I never feel that what I’m expressing is phony as in the post below. I put my hand on their arm if appropriate and ask them if they would like a blanket. I let them know I care. If they are rude to me - I am not rude back.

Hopefully I misunderstood the post below, but not making eye contact and expressing phony sympathy only acknowledges to me that the writer might be happier with a different job.

I tend to avoid eye contact, not take it personally, try to do a little routine TLC, express a little phony sympathy, get them settled, and show them the remote control to the TV. I encourage them to try to relax, explaining that the doctor will be in shortly, once we get the triage process finished.

I think avoiding eye contact, while staying calm, really helps, plus acknowledging, briefly, that they are frustrated.

Specializes in Emergency.

Agree w/horsebytes. Eye contact is important with ****** off patients. It establishes a level of seriousness and sincerity.

Specializes in ER.

Hmmm, that's funny you think I should leave the profession because of the way I handle difficult patients. I actually have a reputation in my unit for always getting on the good side of pts, and I've received several letters of thanks from them. This led to a commendation award last year which included $150.

So, be careful before advising people to leave the profession. Yes, sometimes phony sympathy is in order, rather than react to a pt's rudeness in kind. If you don't really feel the sympathy, you do need to fake it...

Specializes in Emergency Nurse.
Hmmm that's funny you think I should leave the profession because of the way I handle difficult patients. I actually have a reputation in my unit for always getting on the good side of pts, and I've received several letters of thanks from them. This led to a commendation award last year which included $150. So, be careful before advising people to leave the profession. Yes, sometimes phony sympathy is in order, rather than react to a pt's rudeness in kind. If you don't really feel the sympathy, you do need to fake it...[/quote']

I agree. The art of handling a rude patient is part of the job. Everyone differs on how they manage the situation, its part of the learning process. The important thing is that our focus should always be in the patients wellbeing, even though theyre bs sometimes.

Always turn the conversation to them. Ask them "What would you like me to do"?

Specializes in Emergency Nurse.
Always turn the conversation to them. Ask them "What would you like me to do"?

Here in the middle east if say that, discrimination takes place. They will say i am blah blah blah, i live in this country do this do that, im paying for you to work, etc (specially if im in triage) my best weapon against them is the blank stare with matching if you have a problem u can go to administration tom morning hehe

Specializes in ED.

My favorite response to a rude patient complaining of pain is, "Pain is no excuse for poor behavior."

I can tolerate a lot and will not be rude back to a patient but sometimes you have to let them know it is still "my" room and rudeness is not acceptable.

I had a 80-something YO patient the other day and we were doing great together...before the daughter arrived that it. Pt needed two IVs and was a difficult stick. Got the first 16ga w/o the pt even flinching. Daughter arrived just in time for the second. Stuck the pt, she didn't flinch but the daughter kept telling the pt to say "ouch." "Say 'ouch' mom. It is ok." Daughter kept egging her on. Then she told the patient, "You have my permission to kick her." I gave the d a look and asked her what she just said. She repeated herself and I told the patient that she doesn't have my permission to kick me.

Missed that blood draw and was going for another try. Daughter starts that same crap. "You can kick her really hard now."

I looked at the daughter and told her that assaulting a healthcare provided was a felony and we take that pretty seriously around here.

The daughter stammered and was trying to back pedal saying she wasn't threatening us. Yeah, right.

I charted the **** outta that. That is sooooo not cool.

Specializes in PCU.

I hope, eventually, that all states will support healthcare enough to make it a felony to assault a healthcare provider. People come to us to help them. It is not right that they feel like it is ok to assault us when all we are doing is attempting to help, either stabilize, comfort, or sometimes even save their lives. I have been blessed thus far, but have colleagues who have been assaulted.

Specializes in Trauma, Teaching.
I hope, eventually, that all states will support healthcare enough to make it a felony to assault a healthcare provider. People come to us to help them. It is not right that they feel like it is ok to assault us when all we are doing is attempting to help, either stabilize, comfort, or sometimes even save their lives. I have been blessed thus far, but have colleagues who have been assaulted.

I still have a scar from being bitten. Pt convicted of several felony counts of battery on a health care worker.

For the ones just being rude and/or bossy, especially if they are 20-30 years younger, I put on my best stern Mom-to-Toddler face and voice. We get along much better after that.

....

I had a 80-something YO patient the other day and we were doing great together...before the daughter arrived that it. Pt needed two IVs and was a difficult stick. Got the first 16ga w/o the pt even flinching. ....

16 guage really in an 80 year old!!! Hard stick???

I want to kick you!

Speaking of sooooo not cool.

Sigh!

Once had a code blue on the floor and another patients family came out into the hall asking a nurse for a cup of tea for their mom. The nurse told her it would be a minute as there was an emergency on the floor. Patients family said yes I heard the code blue, now go make that tea. That really made me see some people really have no respect for others, even in times of life and death. Very sad to see what our society is coming to.

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