If you didn't have to bite your tongue?

[DesiDani]

What would you say to patients?

[Emergent, RN]

"You are so full of ***t. Your pain is a 1 at worst. You are incredibly pathetic.  Get a job loser!"

 

[macawake, MSN]

5 hours ago, DesiDani said:

What would you say to patients?

I honestly very seldom feel that I have to bite my tongue. I have no problems with the vast majority of my patients. What I think helps me feel quite zen about my patients is that I realized a long time ago that I can only change me. I can’t force other people to change so there is no use getting worked up about it. The second thing that helps me is that I don’t feel contempt for weakness. I feel anger and contempt towards people who are deliberately cruel and selfish, but not weakness. That really helps me because as a result, I seldom get frustrated with people’s behavior. 

It’s a very small percentage that I allow to get on my nerves. And yes, I used the word ”allow” on purpose. It’s a choice. 

Most of the time when I speak my mind to a patient, it’s not because they’ve managed to get under my skin. It’s more that I feel that I have an obligation to let them know that they’re behaving in a less than stellar fashion. I realize that it might sound slightly weird. I feel a bit detached from it all but still think there are certain rules that we should adhere to when it comes to how we interact (in polite society). 

If a patient or loved one is being rude, I will often look them straight in the eye and say something like: ”you know, in life I’ve always found that I catch more flies with honey than vinegar.. I understand that you’re in pain, feel scared and that you’re likely frustrated due to loss of control, but I’m here to help you. Lashing out at me is misdirected. Allow me to spend my time and energy on helping you, instead of engaging in this unproductive back and forth”. Nine times out of ten, the patient will apologize for their behavior. I find most people are actually quite reasonable if you only talk to them. 

If the patient’s behavior is more than rude, and crosses the line to being abusive, threatening and/or violent, I will simply say that ”the behavior you are displaying now, is no more acceptable here than it is in the outside world. If you continue down this path, I will contact the police. You need to stop it right now.” This is of course if I think they are in control of their faculties. I’m obviously not going to threaten my head trauma patient with the police, as I wheel them off to the OR”. 

As I started off by saying, I get along just fine with most of my patients. Many express gratitude and share that I made them feel safe and seen, as we say our goodbyes. I could never have a job where I felt angry a lot of the time and felt that I had to hold stuff in. Since my first career was in law enforcement, I think that I’ve developed some coping skills that help me today. I am not responsible for people’s poor choices and bad behavior. Human beings often make poor choices, it’s part of being human. We as healthcare professionals can offer support and provide information, but we can’t force people to change. It’s liberating to recognize that, because it takes away so much frustration. 

 

[CharleeFoxtrot, BSN, RN]

Decades ago one of my mentors told me this gem, "If it feels really good to say something to (patient, family, boss, civilian), then 100% chance it was the wrong thing to say."

[Jedrnurse, BSN, RN]

Patient: "You work for me, I pay your salary!!"

Me: "Well then, let's talk about my raise..."

[macawake, MSN]

9 minutes ago, Jedrnurse said:

Patient: "You work for me, I pay your salary!!"

Me: "Well then, let's talk about my raise..."

Yes, that ought to shut them up ?

Living and working in a country with universal healthcare is the remedy. Both healthcare staff and patients pay taxes, so very few patients act like entitled brats. 

[guest1163268]

5 hours ago, macawake said:

I honestly very seldom feel that I have to bite my tongue. I have no problems with the vast majority of my patients. What I think helps me feel quite zen about my patients is that I realized a long time ago that I can only change me. I can’t force other people to change so there is no use getting worked up about it. The second thing that helps me is that I don’t feel contempt for weakness. I feel anger and contempt towards people who are deliberately cruel and selfish, but not weakness. That really helps me because as a result, I seldom get frustrated with people’s behavior. 

It’s a very small percentage that I allow to get on my nerves. And yes, I used the word ”allow” on purpose. It’s a choice. 

Most of the time when I speak my mind to a patient, it’s not because they’ve managed to get under my skin. It’s more that I feel that I have an obligation to let them know that they’re behaving in a less than stellar fashion. I realize that it might sound slightly weird. I feel a bit detached from it all but still think there are certain rules that we should adhere to when it comes to how we interact (in polite society). 

If a patient or loved one is being rude, I will often look them straight in the eye and say something like: ”you know, in life I’ve always found that I catch more flies with honey than vinegar.. I understand that you’re in pain, feel scared and that you’re likely frustrated due to loss of control, but I’m here to help you. Lashing out at me is misdirected. Allow me to spend my time and energy on helping you, instead of engaging in this unproductive back and forth”. Nine times out of ten, the patient will apologize for their behavior. I find most people are actually quite reasonable if you only talk to them. 

If the patient’s behavior is more than rude, and crosses the line to being abusive, threatening and/or violent, I will simply say that ”the behavior you are displaying now, is no more acceptable here than it is in the outside world. If you continue down this path, I will contact the police. You need to stop it right now.” This is of course if I think they are in control of their faculties. I’m obviously not going to threaten my head trauma patient with the police, as I wheel them off to the OR”. 

As I started off by saying, I get along just fine with most of my patients. Many express gratitude and share that I made them feel safe and seen, as we say our goodbyes. I could never have a job where I felt angry a lot of the time and felt that I had to hold stuff in. Since my first career was in law enforcement, I think that I’ve developed some coping skills that help me today. I am not responsible for people’s poor choices and bad behavior. Human beings often make poor choices, it’s part of being human. We as healthcare professionals can offer support and provide information, but we can’t force people to change. It’s liberating to recognize that, because it takes away so much frustration. 

 

Ditto, ditto, ditto! 

Well said, Macawake! 

Except you can't appeal to the majority of Americans with logic or common sense, like in Sweden. 

What helps me, is that I honestly don't give a toss because it's a job to me at the end of the day. If their behaviors are going to directly affect my unit or patients well being, I will give them detailed directions to the supervisor's office or administrative offices and goad them to let it all hang out and let them have it! 

I have oodles of passive aggressiveness that needs to be appropriately channeled?????

[JKL33]

7 hours ago, macawake said:

I am not responsible for people’s poor choices and bad behavior.

In addition, patients are not part of my personal support system or part of my subconscious internal calculations of self-esteem/self-worth. They are completely separate from me. For most of my career I have found it odd when nurses react because they have taken patients' random words personally or because they believe that they personally will be in some kind of trouble if patients don't do x, y, z. These are key things that would help a lot of nurses: Don't take things personally, and don't accept  responsibility for others' choices and actions.

[Wuzzie]

"We cannot be more responsible for YOUR health than you are"...oh wait, I have said that.

[macawake, MSN]

2 hours ago, Curious1997 said:

Ditto, ditto, ditto! 

Well said, Macawake! 

Except you can't appeal to the majority of Americans with logic or common sense, like in Sweden.

I’m actually an optimist ? I think you can reach most people using logic and using factual, ”de-escalating” language. But I think that the American way of referring to and treating patients as paying hotel customers, instead of patients, probably results in some people displaying an entitled behavior. 

[NightNerd, MSN, RN]

I have said versions of this (politely!) to individual patients, but as a short-tempered PSA to the masses, I am just dying to yell, "It's 2021. We've all known for a long time that smoking is bad for you. Therefore, I will not be transferring you to a wheelchair to take you outside to smoke. You want a nicotine patch or nah?"

I get it, it's an addiction and I don't wish to make light of how challenging it can be to quit. However, I am sick of having the same argument with people day after day, and I really have to bite my tongue sometimes to keep it therapeutic.

[Guest219794]

I generally don't bite my tongue.  Or hold back much.  I think I am pretty good at saying what should be said in a professional manner.

I think it helps that I don't expect rational behavior from irrational people, or kindness from the unkind.  And, when I see people, they are often having a bad day.  But- none of that makes me a door mat.