I feel like I am working at Walmart...The customer is always right!

studentnurse2175 · Dec 29, 2009

I dont what to say to you but " The customer is alway right" philosophy has happened to a friend of mine. I worked in the psysh field and a patient complained called to get some information about her son. The nurse spent half an hour during our most buisiest time to talk to the mother. The mother called our DON and said all her questions where not answered and we did not who the right amount of compassion.

I left that facility. I think you should leave too. Health care is a very litigeous field and you need people to back you up. You should also report your reason for leaving in your exit interview. I was too chicken to do that.

ROLO · Dec 29, 2009

There are a couple of things that I try to remember in this difficult situation:

Be the best that I can be. If I am already in a bad mood, or I have responded in an obviously bad way, then I have to suck it up and take responsibility for it. I need to apologize and go on. We're all human and we make mistakes.

Be CONSISTENTLY the best I can be. When my peers and boss have seen me working with some difficult patients, and they know that I can do it & do it well, they are less likely to believe that I responded poorly. Think of that staff member who is often frazzled & lets the inappropriate language flow from his/her mouth...while taking care of the patient. Is it surprising that a patient might complain? No. But if you have learned some great communication skills, and shown that you know how to use them, then you are less likely to be accused of behaving badly.

Share the love! Do what you can, the best that you can, but get your charge nurse, and/or nurse manager, and/or house supervisor involved ASAP. This takes some of the responsibility off of you. Let them see the patient first-hand.

You can't please everyone. No matter how hard you try, you will NOT be able to please everyone. You might have a patient leave, and not even know that there was a problem, and then you hear that you behaved badly. You can't please everyone all the time...this goes with the job.

Count to 10. Sometimes the first thing that is poised to come out of our mouths is not the best. Literally, count to 10, rephrase what you want to say, ask yourself how it sounds, and if it sounds OK, then say it. A lot of times it is all in how we say it.

Try a little humor. Try to find some humor in the situation. Don't make the patient the joke or make them look bad, but many times we are only as bad as WE make ourselves feel. If you have treated the patient well, don't beat yourself up...or talk yourself down!

I am sorry about your situation. This is not the first or last time it will happen. You don't really have control over your patients or anyone else, but you do have control of yourself, how YOU respond, and how YOU THINK ABOUT YOURSELF AND SITUATION.

Lacie, BSN, RN · Dec 29, 2009

I am in agreement with the original poster that there are situations in which management should step in and take control letting pts/family members know thier behaviour/actions are inappropriate and will not be tolerated! I think Rolo's post is good advice but lets not turn this around as the nurses' fault. There are somethings just unacceptable in relation to pt behaviour. I recently left a job as the DON in which administration did not stand behind my staff when abuse from pts accured. Example: Dialysis pt who because she didnt think the pct was getting her on the machine "fast" enough jumped out of the chair and physically shoved my pct into the wall, then went on to tell my LPN who is african american/latino "to go back to the ghetto where she belongs". My pct was 64 year old woman whom was shoved into the wall and a tiny woman who could have been seriously injuried by this pts action. I backed my staff to the hilt on this one as I did witness the entire episode. The administrators response was the staff anticipated a problem from this pt (furtherest from the truth) and it was thier faults!!! Problem is if administration doesnt protect it's staff who will? This lady continued after this to abuse staff, make demands of who and what to do in regards to her care even to the degree of actions we knew were contrary to what was needed. In turn every dialysis treatment became and argument of which I had to pull staff from her care and do it myself. In the long run this was what she wanted - me to do her care every treatment. In time she pulled the same behaviour with me then every other staff that treated her. Never did admin step in no matter how many times we complained. Yes we can control our behaviour but in some cases no matter what you do you cant control the pts but we should still be protected from abuse. I have since left this job for numerous reasons but this was a primary in my decision. This was the first job in 28 years I have worked that allowed pts to abuse staff without intervention. If this pt assaulted you and was in her right mind when she did it - its a crime.

PeachPie · Dec 29, 2009

The customer is always right AND NEVER RESPONSIBLE. This is why I'm leaving nursing to go into IT.

ScoopsPerson · Dec 29, 2009

IMHO--this philosophy of "the customer is always right" breeds lack of responsibility and this problem is endemic is our society. No one has to have respect, common courtesy and just plain manners any more. One can say,do, act anyway they please and not be held accountable. Everyone feels entitled. I had a pt's SO the other night demand to stay in the room with her boyfriend in a semi-private room. We told her she had to stay in the waiting area over night. She screamed, yelled, and she lived 2 miles from the hospital. Her boyfriend, the pt was not critical (he was released the next morning actually) she was just a control freak and had to be at his side. We had to get our police (we are a federal hospital) to escort her off the premises...after she called all of us every name in the book. This was a woman who was well into her 60's and not a young kid. There was another male pt in the room and does she not think he is entitled to his privacy?

imaRN08 · Dec 29, 2009

we recently had a similar pt experience as the OP.... came in with CHF, on dopamine gtt, could hardly breathe or maintain sats on cannula with massive generalized edema. well guess what... was refusing assessments, new meds, lasix, foley, xrays, labs... u name it, the pt refused it. treated us like sh*t, becoming verbaly, emotionally and in some cases physically abusive. they would put on the call light CONSTANTLY, staff would enter and be screamed at for "bothering" them... the pt complained to the CEO that every nurse, tech, lab person was incompetent and no one was doing anything to help them get better... even contacted the BON on some nurses--- of course the claims were unfounded, as every nurse charted everything (thank GOD). the pt was argumentative with every doctor who was on the case, "fired" them all, but then wondered what the problem was when it was said by the attending that if they were going to refuse everything and "fire" every Dr on the case, including him then he could go home since the pt was pretty much not allowing anyone to do anything. one day the IV, which they refused anyone to assess, let alone change, infiltrated. the pt would NOT allow me to intervene with Regitine, stating it was MY fault the IV went bad. the pt would not even allow me to try to explain why this was important, the fact that the skin would become necrotic, etc... the pt didnt want to hear it from the attending when he came up to explain it. all of us documented EVERYTHING!!! pt was also refusing to leave until they were "all better"... stating they would be here as long as they needed to be. well our NM got involved along with administration and social work with no solution. eventually, they left; almost a month after this nightmare started. im sure they are sitting at home OD'ing on sodium, since you know, we about killed the pt by witholding it from them (how DARE us!!) i guess all the Dr's notes state "will not admit, or will not consult, will not treat", etc.

also had an incident happen where a pt tried to sue us over altering their Rx upon discharge. usually our docs all do electronic Rx's, but it was busy one days so he wrote on a Rx pad instead. we copied it like with every script and come to find out that obviously the pt altered their scrpit for Vicodin on the way to the pharmacy and blamed us. yeah.... rrrrright... obviously they didnt even have a case. but the facility APPOLOGIZED for the 'inconvienence'... WTH???!!!

i love the fact that we can be treated like less than dirt and people can get away with it, and we all just have to 'deal with it.' its sad to say, but it literally makes my day when i get one thank you or a compliment from one patient.

ROLO · Dec 29, 2009

The purpose of my post was to give tools to empower the nurse, not to find fault with the nurse. Two weeks ago, I had a bipolar patient, in manic phase, who called me everything but my name; but, some of the things that I mentioned DID help me feel better in dealing with that patient. I am also frequently asked (and commended) on how I can take care of some of the "difficult" patients that I sometimes find myself with --I shared some of those things. With that being said, had I been pushed (and it is difficult trying to relive situations or hypothesize hypotheticals...), I probably would have filed charges. Yes, as you said, it is a crime, and I would hope that that would help set some limits...not only for the patient, but for those who do not support & protect us. I've done that before (filed charages)...I was assaulted by an adolescent patient with a board that had a nail in the end of it. I can set limits, but I have also processed some of those situations and why they are uncomfortable to manage (difficult patients and uncaring administration). I choose to be proactive and try to understand those situations, rather than feel like a victim.

StNeotser, ASN, RN · Dec 29, 2009

The thing is, people do need limits, standards and rules. What if general society had the same lack of rules as the hospital?

What if you were in a queue at Starbucks six deep and one customer was allowed to barge to the front of the line and then complain if he didn't get served immediately? What if that customer were allowed to assault the Starbucks employee, not get arrested but then receive free coffee for a week because his needs were not met?

Up2nogood RN, RN · Dec 29, 2009

To the OP, I would kindly ask your NM to come with you to the room and show her expertise when you need to do something you know the pt is going to refuse. What would be better yet is if the family members are there. How is she going to make a pt agree to care that she's previously been refusing to apease the family but not infringe on patient rights? Does this pt have psych issues (family too?)?

southernbeegirl, BSN, RN · Dec 29, 2009

i was suspended once because i told the daughter of a dying patient that her mother was dying and there was nothing more we could do. she had been demanding that we basically "cure" her mother. her mother did die a few hours later. afterwards she sent a letter to administration about how she couldnt believe they had a supervisor as rude and intimidating as me. i had over 6 witnesses that were present when i talked with her AND it was on camera. the administration did not speak with ONE staff member about the incident. they simply suspended me and told me i was lucky i didnt get fired.

mamamerlee, LPN · Dec 29, 2009

At the first hint of trouble with a patient or family, get your manager involved. The FIRST refusal, the FIRST instance of truly inappropriate behaviour. Then, WRITE IT UP. Yes, I know that it is time-consuming, but those reports are your documentation that there is a problem.

And what happened to you after the patient drew blood? Was a report done? Were you seen by employee health or the ED? Just where was your manager???