Nasty/aggressive patients

JKL33 · Oct 20, 2018

Yep, you learn to separate yourself from it since it has absolutely nothing to do with you personally and is solely about the person who acts that way.

That doesn't at all mean that you can't/won't have empathy and compassion in situations that call for it, or that you can't get far by treating people with respect and kindness - - because you absolutely can get far by doing that. But when something is just uncalled for you have to be objective; you have to remain separate from it.

Professionalism and a staunch refusal to melt down and respond in kind may or may not stop the behavior, but it will certainly protect your outlook and positive sense of self.

You mentioned being "nice." Nice is what other people might agree to call you as long as they don't happen to feel upset about anything right then. It's totally meaningless. Kindness is active; it's genuinely caring and flows from a secure self-esteem. This article is a little flowery for my taste, but I think it explains the distinction well enough - and I think a new ED nurse should consider it. :)

Best of luck!

Come back and let us know how it's going, here or over on the ED Nursing subforum.

allnurses Guide · Oct 20, 2018

What JK said pretty much sums it up. Many patient's barring mental health issues can be calmed by kindness and a supportive attitude. In the case of the mental health issue when all else fails there is always Haldol/Ativan/Benadryl works like a charm almost every time.

Hppy

Penelope_Pitstop, BSN, RN · Oct 20, 2018

Excellent comments above mine.

I would like to add that you are human and that is it okay to not be capable of understanding everyone. Should you always be professional and polite? Absolutely. Even in non-working matters, being polite costs you nothing.

However - everyone has "soft spots" or breaking points. I can tolerate a great deal, including being cursed at, snapped at, yelled at, etc., but once a demented elderly patient called me "so fat" again and again that I felt my kindness and patience wane over the course of a shift. Now, had she called me stupid, or evil, or a bad dresser or whatever, I would have laughed it off. But this actually HURT my feelings. So please, remember that you are human and we all have sensitive spots and that sort of thing.

And...some people are jerks. Does everyone who is a jerk have a reason for being that way? Probably. But you're not going to get to the bottom of that during the course of an ED visit. So keep that in mind, that they're just "passing through" and won't be your problem after your shift (or even before the conclusion of your shift, being in the ED!)

But, at the end of the day, you should not be a punching bag, either. You can absolutely keep someone "in check," so to speak but be courteous while doing it. Picking your battles is a part of nursing judgement. And you'll get there.

Oh, last thing! Congratulations!!!

cleback · Oct 20, 2018

It helps that we see patients when they're not well, so part of rude/aggressive behavior can be attributed to that. Otherwise, just remember it's not you, it's them.

HelloWish, ADN, BSN · Oct 20, 2018

In my 2.5 years as a nurse, I can only think of one patient who could not be wooed by kindness. I have had exactly one patient who was flat out rude and nasty despite my extraordinary efforts to be respectful and kind! However all my other 100's of patient's respond in kind to compassion and kindness including the ones with mental illness. I do know when to set a patient straight if needed and will do it. However, I go right back to being respectful.

Emergent, RN · Oct 20, 2018

I'm trying to conjure up the scenario you described. A Powerball is a lottery ticket, correct? The person in question was irritated because you were on the phone? How loud were you talking?

It sounds like she overreacted. But, what is your part in this? It is a phone etiquette rule to not talk on the phone while waiting in line at a store. Remember, for every person who gives you negative feedback, there's 9 others who quietly fume.

We don't know what's going on with this gal, but your phone conversation apparently got on her last nerve. She probably has a lot of stress in her life and wasting money on a lottery ticket is her little escape. She's fed up with modern life, and rude people on their phones. So she lashed out at you.

Kugrad2018 · Oct 20, 2018

JKL33 thank you, great advice and I'm on my way to read the article!

Kugrad2018 · Oct 20, 2018

Emergent,RN. Yes, that was the situation. In my defense I was not in line, I had just walked into the store and was saying my goodbyes because I know that it is rude to be on the phone in line. But I can assure my "alright honey, love you. See you soon" was not all that loud and clearly almost over. I was just appalled that something so small could set someone off like that.

Emergent, RN · Oct 20, 2018

Emergent,RN. Yes, that was the situation. In my defense I was not in line, I had just walked into the store and was saying my goodbyes because I know that it is rude to be on the phone in line. But I can assure my "alright honey, love you. See you soon" was not all that loud and clearly almost over. I was just appalled that something so small could set someone off like that.

Maybe her husband just died or her boyfriend is cheating on her. Your little conversation with your loving husband pushed her over the edge and made her lash out.

I have a coworker, with whom I normally get along. She is really judgmental about patients, dwelling on their faults too long. Some patient came in, it was some dysfunctional family situation. My coworker launched into a self righteous speech about her perfect husband, how they do everything right, yadda yadda... She's is very happily married to a great guy.

I finally turned to her and said that my husband is dead and I'm getting tired of hearing this. She nicely shut up and we are still work friends.

My point being, sometimes less fortunate people get annoyed by those with what they perceive as better luck.

Kooky Korky, BSN, RN · Oct 20, 2018

Hi nurses,
so, I recently graduated from my rn program and have accepted a job in the emergency department at my local hospital. Seeing as how I always had wonderful and interesting patients in nursing school, I've been very excited to start my new job. (Less than 10 days! Woohoo!) however, tonight while at a convenient store obtaining a powerball ticket I encountered the most unpleasant person I've ever come in contact with. I was getting off the phone with my husband when she started going off on me for bothering her while trying to fill out her ticket. Insulted me up and down called me names the whole nine yards, over nothing! And it got me thinking, if this person can attack me like this for no reason at all I can only imagine how it will be in the ED. So now, I'm doubting my ability to deal with those patients who are super mean and aggressive. My approach in school was to be as nice and understanding as possible to all the patients and for the most part, it worked, but now I'm doubting that approach and that I may be too sensitive. How have your experiences been? Are these people the majority or the few? Do you ever get used to it? TIA

She sounds nuts.

Just put her out of your mind, enjoy your new job, congrats on graduating.

What did you say or do in response to her?

I'd advise something like, "I'm terribly sorry, Ma'am".

BAY AREA RN, BSN · Oct 21, 2018

yes i get those patients now in nursing school and i learned that we just get the job done and deal with it. try to cluster your duties with those pts. and just bother them when its time to give meds. of course you do your checks to make sure they are ok but just try to give them space to keep your stress down