Meth induced abuse? =(

JKL33 · Aug 18, 2020

If wonderful coworkers and a supportive environment and evidence of investment in nurses (good orientation)...I would first focus my energies on developing the ability to maintain inner calm and peace when dealing with difficult patients. There is much to be learned and it makes a world of difference. It is one of those hurdles that, in working to clear it, completely has the ability to make someone into a stronger and happier person in the end. It is such a useful quality to finally understand how not to be provoked and completely tapped out by difficult patients and their problems. It is a skill that is also easily extended into other areas of life once learned.

We're all different, but I would take easy coworkers and a supportive atmosphere over easy patients almost every time. Difficult patients in a supportive atmosphere is doable. Lovely patients in a toxic backstabbing atmosphere where nurses are constantly disparaged is not doable. Also, difficult patients = working hard at doing the work you were hired to do. But a difficult workplace = having to work at something other than what you are primarily there to do; it is the necessary work plus more work that should be unnecessary. No thank you. (Personal opinions, obviously. ?)

LibraNurse27, BSN, RN · Aug 18, 2020

2 hours ago, JKL33 said:
If wonderful coworkers and a supportive environment and evidence of investment in nurses (good orientation)...I would first focus my energies on developing the ability to maintain inner calm and peace when dealing with difficult patients. There is much to be learned and it makes a world of difference. It is one of those hurdles that, in working to clear it, completely has the ability to make someone into a stronger and happier person in the end. It is such a useful quality to finally understand how not to be provoked and completely tapped out by difficult patients and their problems. It is a skill that is also easily extended into other areas of life once learned.
We're all different, but I would take easy coworkers and a supportive atmosphere over easy patients almost every time. Difficult patients in a supportive atmosphere is doable. Lovely patients in a toxic backstabbing atmosphere where nurses are constantly disparaged is not doable. Also, difficult patients = working hard at doing the work you were hired to do. But a difficult workplace = having to work at something other than what you are primarily there to do; it is the necessary work plus more work that should be unnecessary. No thank you. (Personal opinions, obviously. ?)

Excellent advice! Thank you. Difficult coworkers can make an easy job hard... didn't think of it that way...

Sivraj · Aug 18, 2020

Hello and thanks for your post. It resonated with me because I was fortunate to have a fantastic team on my first nursing job, too. After 2 years I left for the ED which had a very different and oftentimes difficult culture. Eventually, I settled in but it took time and I learned that, despite the many opportunities for learning, I really didn’t like the ED. Think of it: nobody is happy to be there. So, I moved on to other things, some were good, others not so much.

The truth is I’ll always miss my first team and I wish I could’ve figured out how to be happy there. The work was kinda boring but the people were great and, to this day, I’ve never found a team that compares. So my advice is, seriously try to figure out what you don’t like and come up with some strategies that may help lessen the blow. Share your concerns with a coworker or two because they may have some great advice. At the very least, it will help to talk about it. If it’s time to move on, then give yourself permission to do so. Good luck with whatever you decide!

CharleeFoxtrot, BSN, RN · Aug 18, 2020

5 hours ago, LibraNurse27 said:
Excellent advice! Thank you. Difficult coworkers can make an easy job hard... didn't think of it that way...

This should be printed on the back of every nurse's diploma. Absolutely true. I once worked an extremely difficult job at an LTAC, and always looked forward to certain days when the "dream team" worked-a group of wonderful coworkers who made the day lighter just by being there.

LibraNurse27, BSN, RN · Aug 18, 2020

thank you @Sivraj and @CharleeFoxtrot ! It's nice to learn from others' experiences, and your comments confirm what I was suspecting, that "dream teams" are rare and should be appreciated, and will likely be missed. thanks!

allnurses Guide · Aug 18, 2020

It sounds like time to get involved in your shared governance councils to start the ball rolling on policies to help nurses deal with these kinds of patients. I work at an inner city county hospital too. We have a team whose entire job is to answer calls for escalating behaviors and take care it, whether that be through medication or other means. If your hospital doesn't have this, it needs to.

If it is a matter of cranky patients there isn't much you can do. But threatening physical violence or actually being violent? Heck no. Start watching how your coworkers deal with it. You can learn from them. Also start letting whoever makes the assignments know that when you have had a certain difficult patient for a shift and you are coming back the next day/night, you want that patient assigned to someone else. You have the right to do that and most hospitals I have worked at understand. Everyone gets a turn with the hard ones rather than one person stuck with them shift after shift.

LibraNurse27, BSN, RN · Aug 18, 2020

Thanks @Nurse SMS! I have mentioned that the cranky/threatening pts are especially hard for me to deal with, especially threatening male pts due to past experiences with assault. I think night shift charge tries to assign these to my wonderful male coworkers who say they don't mind having them (and, because they refuse everything so they aren't a busy assignment).

I let them know I am fine with sick/busy/hospice pts, whatever they want to give me other than the meanies, LOL. I rather drag pts to CT all day and give a thousand IV meds than deal with behaviors. Love pleasantly confused pts too! Some days it's unavoidable to have these pts, so I will ask and observe coworkers who seem to have it down, as suggested ? thanks all for the lovely advice!

twinmommy+2, ADN, BSN, MSN · Aug 19, 2020

Oh meth heads touch my crazy nerve almost every time. And I have a deep crazy nerve too but they make my mom voice come out.

allnurses Guide · Aug 19, 2020

3 hours ago, twinmommy+2 said:
Oh meth heads touch my crazy nerve almost every time. And I have a deep crazy nerve too but they make my mom voice come out.

LOL!! My coworkers used to call me a "Mom Nurse", so I know exactly what you mean here. I was often chosen to get the challenging patients. Straightened them right out.

FolksBtrippin, BSN, RN · Aug 23, 2020

On 8/17/2020 at 10:22 PM, LibraNurse27 said:
Hi all, I work on an ICU Stepdown unit with wonderful coworkers. After reading about nightmare orientations/preceptors/units, I feel even more grateful. My team is wonderful, we help each other and don't let anyone drown. No gossip. My orientation was excellent.
The downside is, it's a county hospital and we deal with many behavior issues. I love caring for most of our patients, working for a vulnerable population, etc, but the abuse is getting to me after 4 years. A huge percentage of pts come in high on meth or withdrawing from it, causing labile behaviors. They don't want to be bothered, scream at us, make verbal threats, sometimes get physical. Also deal w/ etoh withdrawal. My anxiety is so high when I have to go into these pts' rooms, even when they're just irritable but nonviolent.
I am worried if I get a new job I will never find these team dynamics again. Maybe it would be worse to have a less stressful jobs but a bad work culture. Maybe it's worth dealing with the anxiety/fear? I'm looking for honest answers about how rare people think it is to find a good work culture, and any recommendations on what I should do. Thanks so much!!

A good work culture is precious. Probably rare.

I don't know that you will actually find a place that you won't have to deal with drug addicts. They are everywhere. Rich people are also drug addicts sometimes and are often worse to deal with than poor people.

It's very hard to work with sick people, they are at their worst. But that's nursing.

LibraNurse27, BSN, RN · Aug 23, 2020

Precious. I love that word! It is full of gratitude and a great reminder that support, friendship and teamwork are so important. Thanks!