New grad dealing with angry/yelling patients

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Hi all,

I am a new grad of 4 months working on a busy Ortho/Trauma floor. It has gotten to be an almost daily occurence that I come home crying because a patient/family has decided to take out their frustration on me. When I was in school, I always had the idealized dream that I would get out and help people, and they would be appreciative. At least once in a while, I would get a "thank you". That has yet to happen. The patients/families who I've had problems with are patients who all the nurses have problems with - so I know it's not me. However, this doesn't help me from taking criticism personally. I hate just gritting my teeth and standing there while someone chews me out because it took me 20 minutes to bring in an extra pillow. Sometimes I can understand where they're are coming from - it's a teaching hospital and it can be frustrating trying to deal with the many different interns. But most of the time, these patients are just generally rude, or crazy, people to begin with. If the floor wasn't so busy, I would be able to talk to my colleagues to find out how they're able to deal with these patients. But we rarely get to eat lunch as it is.

Can anyone give me some advice on how to handle them? How can I not take this so personally? Is there some mental trick I can play in my mind so I'm not thinking "I don't get paid enough for you to yell at me, you crazy old bastard"? Any advice at all would be greatly appreciated.

:crying2:

The first thing you need to do is "walk away" when this kind of thing starts. You do not have to tolerate that kind of abuse. Simply STATE "I know this is a difficult situation for you but I will not tolerate your abuse". Where I work things are much different but when I worked the floors that was what I did, it worked.

Specializes in LTC,Hospice/palliative care,acute care.
Hi all,

I am a new grad of 4 months working on a busy Ortho/Trauma floor. It has gotten to be an almost daily occurence that I come home crying because a patient/family has decided to take out their frustration on me. When I was in school, I always had the idealized dream that I would get out and help people, and they would be appreciative. At least once in a while, I would get a "thank you". That has yet to happen. The patients/families who I've had problems with are patients who all the nurses have problems with - so I know it's not me. However, this doesn't help me from taking criticism personally. I hate just gritting my teeth and standing there while someone chews me out because it took me 20 minutes to bring in an extra pillow. Sometimes I can understand where they're are coming from - it's a teaching hospital and it can be frustrating trying to deal with the many different interns. But most of the time, these patients are just generally rude, or crazy, people to begin with. If the floor wasn't so busy, I would be able to talk to my colleagues to find out how they're able to deal with these patients. But we rarely get to eat lunch as it is.

Can anyone give me some advice on how to handle them? How can I not take this so personally? Is there some mental trick I can play in my mind so I'm not thinking "I don't get paid enough for you to yell at me, you crazy old bastard"? Any advice at all would be greatly appreciated.

:crying2:[/quote...I know EXACTLY what you mean....Those feelings of " I suck" get worse for me when my depression kicks in....I KNOW I am a competent nurse but sometimes I'll lie awake at night-completly exhausted but my mind keeps racing and I can't sleep-I'll fret about a pt and take complete responsibility for stuff that really is in no way my responsibility.....If I am tired or not feeling well this happens more often....The first year of your nursing career is so hard.....you have had alot of life changes and it is easy to get overwhelmed.....My best advice to you is to first do a personal inventory and determine if you do have symptoms of depression..If you do then it's an easy fix...If you don't believe depression is a factor then follow other's advice and don't stand there getting abused (that just takes your time away from everyone else) Deliver the care to the pt and address the pt directly and then scoot. You are a professional and you don't have to take that ****...bottom line-if the complaint is of a medical nature you pass the buck and encourage the complaintant to call the MD themselves..If it is a complaint regarding you not answering their call fast enough because you are swamped then refer them to your supervisor or nurse manager right away...Let them deal with that crap.......Whatever you do DO NOT stand there and let someone yell at you...no one should..If it is happening to you and your co-workers frequently then something is very wrong and it needs to be addressed by your management before someone gets hurt....Maybe staff needs some ducation regarding violence in the workplace...It's no joke...maybe your facility has let the situation get out of hand....Good Luck-it will get better---but we all have good days and horrid ones.That never changes......

Thanks everyone,

It sounds as if thicker skin is just something that will come with time. In the meantime, it makes me feel better to realize I'm not the only one dealing with this. I'll try to hang in there.

Thanks!

Ah yes, the ortho unit....have been on one for the last 20 years. Some patients nice, some not. Yes, it is true that abusive patients and family members get less of MY attention as a nurse. The secret is to learn all about pain and medications because 99 percent of the time they are hurting. Vistaril and po narcotics are good. A good nap or sleep is helpful. If they are on a PCA and you can bolus them do so. Of couse in ortho patients positioning of the patient is VERY important but take care of that pain first. That is all there is to it. And do not hurt yourself taking care of these patients. Don't take things too personally either. It takes years to learn that but start early and you will toughen....like I say...Don't take any guff! Even old nurses get their share of nastiness from patients. Hang in there.

Great idea, I too shall try this when the going gets rough. Thanks!

you should not be subjected to verbal abuse, regardless of how much you earn. I would make an appt. with the manager and ask for help, an inservice, etc. There may be training films in the education dept. you can borrow. I would make it a MANAGEMENT issue, not a personal one. Don't let people corner you. Just say, I am sorry you feel this way, do you want me to get your nurse? a complaint form? then LEAVE the room. Don't make excuses because that gives people something to argue about. This is getting to be a problem, but it is a workplace advocacy issue and should be handled by management.

I have to agree with an earlier writer, When I start out my shift. I am on top of pain control, this is my number one agenda. I dont wait around on getting those painmeds started. I find my patients are happier and rest better than those of my co workers. I also smile a lot when I am at work (why not,my kids are not there) and when someone does have a problem, I aske them what can be done to solve it, let them come up with a plan. Or I will ask them to list there top 3 complaints and when I get a chance I will come back and discuss it with them. If all else fails, I refer them to the charge nurse, thats why they get the big buckies. :rotfl:

Generally, when a pt or family member gets verbally abusive, I immediately drop whatever I'm doing and leave the room, without saying a word. I just walk out on them in the middle of their tirade. I'll come back a few minutes later, and they are usually quiet. If they do start yelling again, I again stop whatever I'm doing and leave without saying a word. Most of them figure out that they're not going to get anywhere. They usually shut up after they figure out that I will leave the room every time they start. And..what are they going to tell my boss? "That nurses won't stay in the room and let me finish yelling at her!" ?

This strategy has worked pretty well for me.

I will try this next time- I have always stayed for the tirades and asked "What can I do to make you feel better about this?. Very exhausting mentally for me. This sounds like a better idea. Thanks. :)

For someone yelling and abusive, I leave the situation immediately and then plan how I will proceed...if it was abusive I won't go back alone but with security, a supervisor...depending on the severity and specific situation.

For unpleasantness without abuse, and demanding behavior: What has worked for me is to say to grouchy patients and families "What is the most important thing I can do for you this shift." Then rather than give me a litany of complaints, they find that one thing that is #1...and I do my best to provide it.

When someone first suggested I try this, I was unsure if it would help...but it seems to. Some are never happy; I just do my best, realize I will never 'make everything better' no matter what I do for them. Try not to take it personally, as mentioned.

This is an area of nursing that has been difficult for me too..as I too am very sensitive, and try so very hard and it really hurts to not have this acknowledged. Sadly, most of our positives in this field must come from within ourselves.

And its tough when our supervisors won't back us up. :o

Could you 'deputize' some family members for different things? Like make one in charge of getting more ice water, another in charge of pillow arrangement. Then give them a written list of events that would be 'true' emergencies which they'd need to call you for. A lot of families consider EVERYTHING to be an emergency, so if they had a list to look at they could debate each other instead of you! :)

as has been suggested thick skin is acquired...many times you cannot simply walk out in the middle of a procedure but you can take control of the situation...find out if they have a legitimate complaint..if they do tell them whom they can speak to to have it corrected...many times it is a lack of understanding//they think if you are sitting at station charting that you are "doing" nothing...they have no idea how much time and work or how many other pts you are caring for...sometimes it is nothing you can do anything about...they are angry that the accident has changed their life sometimes forever, or they see their career going the toidy, sometimes people are just loudvulgar and controling...thank your lucky stars that you don't have to go home to them,. life can always get worse

Unfortunately in nursing you are going to encounter all types of people. I agree most family members are stressed out and frustrated. We are first in line to vent those frustrations on. There are also more than a few just outright jerks in the world. Just look around your local Wal-mart sometime :p

The one thing that has always helped me when someone is bing ugly is this little phrase I heard onetime :always be gracious, no one knows what you are actually thinking :chuckle

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