dealing with difficult patients

[blcp]

Please advise if I acted inappropriately. I recently had a patient who was difficult to deal with. This patient became angry when not put back into bed during shift change. I felt like I was the object of the anger. As soon as possible I spoke to the patient about the behavior. I said," I try to be nice to all of my patients. I would never be nasty to you but when your nasty to me it doesn't make it easy. How about if we work together and be nice to each other? OK? " To which the reply was yes. Now the family sent a letter complaining about my behavior. I have had hundreds of patient since becoming a nurse and this is the first one that I've had to have such a discussion with. Until now as long as I was pleasant and explained delays etc. patients have been understanding. I thought all I was doing was setting limits on patient behavior and telling what the expectaions were as when a patient is using foul language etc.

[lita1857]

I whole heartedly agree!!! Nurses are not doormats/or shouldn't be. As long as it was done in a professional manner, which it sounds like it was....Does your facility have a policy or protocol for this situation? That helps.I never would take verbal abuse, limits get set and then you need to walk away both physically and mentally.Protect thy self, 1st and foremost, what you do for yourself makes you a better nurse for your patients. Take care

[LaurieCRNP2002, MSN, RN, APRN]

Having to deal with difficult patients is just part of what we have to deal with everyday. I think you dealt with the situation very appropriately--but you might want to consider speaking with your manager/supervisor and explain the situation (if you have not already done so). Health care being what it is today, patients have every right to feel frustrated and angry but they have no right to take that frustration and anger out on us! Hang in there and stick to your guns!

We're being hurt by the cost cutting as much as they are because we can't spend the kind of time we'd like to to explain, teach, comfort, etc. The insurance companies and the upper-level hospital administrators just don't get it that putting profits before patients doesn't work!! :-(

Laurie

[goldilocksrn]

I agree. . You must let the patients know you are empathetic to their needs, but that you have feelings too. There are always going to be people who are never satisfied, and at least expressing your feelings will make you feel better.

[bunky, BSN, RN]

You did the right thing, you can't please some people and that's all there is to it. If it hadn't been you they would have found fault with something else. Let it roll off your back and if it'd make you feel better tell your nurse manager you side to it and let it drop. Unfortunately there are jerks in this world and you met one and dealt with it appropriately.

[jkh]

Another approach is to find out the underlaying reason for the behavior. Does the patinet act this way all the time or is it a new behavior. Is he in pain, hungry fear of falling during a transfer or just impatient?

If he is just plain impatient then come up with a behavior modification plan, so all staff is reinforcing the nasty behavior is unacceptable in a way such as you did. Teach the family the reason for the behavior. modification plan too.

[Nancy1]

My facility has been part of a study with the local medical college. We found that most behaviors are related to hunger or pain. The resident is offered something to eat, and some tylenol. The staff was pretty surprised at the results. Another intervention we use a lot is getting quieter as the resident gets louder. I believe that the environmental press (all that is going on, laughter, trays clanging, tvs, and radios) has a lot to do with how a resident behaves.NA