never been screamed at like this before :(

[mmc51264]

I have been working in Rehab unit at LTC facility since June (grad ADN in may). I really love it (other than the 1 hour drive). Until last night. I am a very attentive, on the ball nurse. I am very good at being efficient, proactive; learning what people like (leave me alone, I'll call you, or I want pain meds q 4, wake me up, etc.) I have a pt now that I cannot please!!! For the last 3 nights, I have gone to the room to start 1600 med pass and they have found something wrong. 2nd night it took me too long to get a sleeping pill: I was at room by 1615, but had to go to Pyxis to get the med b/c pharmacy hadn't come yet with narcs-explained the situation exactly and thought there was understanding "I'll be back in a few min, I have to go up front and get med". This person complained that they couldn't believe it was 1625 and hadn't gotten meds yet??????

Last night, at 1830, while I was taking 15 min to scarf down some food and text my husband, I am told that they want a diff pain med that night and sleeping pill later. Okee dokee, got it. Start med pass at the right time. I walk into room and get SCREAMED at for 10 minutes about how I didn't bring pain med @ 1830. I was too busy goofing off, fiddling with my phone. Mind you, CNA had been in room twice and nothing was said about pain. To top it off, I cannot apologize for misunderstanding, etc b/c hearing aide has been taken out and I am just waved off to get out of the room.

Of course it is the weekend and there is no admin or reg supervisor there to help me. I have emailed my DON explaining the situation, but I am so worried that I am going to get in trouble because of how weighty the satisfaction-survey-reimbursement issue is.

I am so demoralized right now. Again, I have never been yelled at like that. I know I am in bad situation (13-17 pts on avg, usually with one CNA) I was hoping to get that magic one year of experience so I could move on. I have been there six months.

Thanks for listening.

[Anna Flaxis, BSN, RN]

OK - am I the only one who picked up this "red flag"? Why did the patient say the OP was 'fiddling with my phone' if s/he couldn't possibly have seen this since the OP was obviously not in the patient's room at the time??? The CNA probably relayed this information on one of those trips to the patient's room, right? Looks like another round of "make the nurse look bad" game to me. Maybe it's time for a heart-to-heart talk with that CNA - about teamwork and appropriate communication with patients.

No, you're not the only one. I noticed that, too. It's quite possible that the CNA went to report the patient's request to the nurse, saw that the nurse was on break/using her phone, and went back and reported to the patient that the nurse was "on the phone" or something to that effect. It may not have been intentional on the CNA's part to make the nurse look bad. It could simply have been an incidence of poor communication.

To the patient in the room, that room is their world. They have no concept of what else the nurse is juggling; what else is going on in the building around them. They are only aware of their own little world. Even though the nurse has every right to take a break, when a patient like this has a request that they want attended to immediately, hearing "the nurse is on her break/on the phone/busy with another patient" is not something that fits in with their idea of how things should go. Some people have very poor coping skills, and react very poorly to this sort of thing.

Now, I am not excusing their poor behavior. I agree with the others who say you should not stand there for ten minutes letting them berate you. Listen for a couple of sentences, tell them you hear their frustration, but you are here now and do they want their med now, and if they do not calm down, tell them you'll come back when they are calm, then walk out the door.

Also, it is appropriate to address communication issues like this at the next staff meeting in a nonjudgmental, non-accusatory manner. This is a topic appropriate for all staff, not just the CNAs. You can tell anybody almost anything if you just say it right. Saying something like "I'll tell the nurse as soon as she's done fiddling with her phone" or whatever the CNA might have said to the patient, could be said in so many different ways that would NOT elicit this kind of reaction from the patient.

[GLORIAmunchkin72]

Be careful...what you say may be construed as 'punishment'.

Gotta set limits....

My nasty patients get seen last, get their pain meds last and get their call lights answered last....

They quickly learn the result of being a jerk....

I dont tolerate it.....

That being said, 99.9 percent of my peeps are wonderful people....very rare to get a rude one.....

[imintrouble, BSN, RN]

Have had those pts before. It boils down to an attempt by the pt, in their anger/rage, to break down the nearest available human being.

Who know what pleasure that brings them. I don't.

It becomes a war of attrition.

You let them win when you attempt to reason with them. They are unreasonable. I just stand there and let them rant, while I plan my menus for the week. Or balance my checkbook in my head. Or chart my course through the grocery store, starting with produce and ending with bread. When they're quiet, they're done, and that cues me to say "I'm sorry".

There are some days in nursing that are simply to be endured, until you can go home to your family.

[tewdles, RN]

Like water off a ducks back...

[BostonTerrierLover, BSN, RN]

I'm sooooo sorry, we are fresh out of Demerol, how bout' some Tylenol and a back rub- and you can practice imagery that your on a tropical island basking in the sun drinking from a pineapple with the little umbrella:)

[mmc51264, BSN, MSN, RN]

Quote from HouTx

OK - am I the only one who picked up this "red flag"? Why did the patient say the OP was '

fiddling with my phone

' if s/he couldn't possibly have seen this since the OP was obviously not in the patient's room at the time??? The CNA probably relayed this information on one of those trips to the patient's room, right? Looks like another round of "make the nurse look bad" game to me. Maybe it's time for a heart-to-heart talk with that CNA - about teamwork and appropriate communication with patients.

No, you're not the only one. I noticed that, too. It's quite possible that the CNA went to report the patient's request to the nurse, saw that the nurse was on break/using her phone, and went back and reported to the patient that the nurse was "on the phone" or something to that effect. It may not have been intentional on the CNA's part to make the nurse look bad. It could simply have been an incidence of poor communication.

I was at the nurse's station when she first came to me. The CNA was fine, I just mentioned the fact that she had been in the room and the pt never said anything about waiting for meds. The only reason I stood there was that I was like a deer in headlights! I was in shock!

Admin must have said something to pt b/c when I went back to work, it was all smiles and "please? and "thank yous" :)

[nursel56]

Admin must have said something to pt b/c when I went back to work, it was all smiles and "please? and "thank yous" :)

You mean they didn't throw you under the bus? It gives me a little hope for the future because most of the time when I read accounts of incidents like this lately admin takes the side of the patient. Glad it got worked out!