New grad dealing with angry/yelling patients - page 3
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... Read More
Jul 12, '04Joined: Aug '03; Posts: 42Thanks 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.
Jul 12, '04Joined: May '04; Posts: 40; Likes: 2Ah 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.
Jul 12, '04Joined: May '04; Posts: 40; Likes: 2Great idea, I too shall try this when the going gets rough. Thanks!
Jul 12, '04Occupation: Pedi RN Joined: Sep '00; Posts: 2,728; Likes: 109you 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.
Jul 12, '04Joined: Jul '04; Posts: 35; Likes: 5I 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.
Jul 12, '04Occupation: RN Joined: Feb '03; Posts: 1,250; Likes: 62Quote from Hellllllo NurseGenerally, 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.
Jul 12, '04Joined: Jan '02; Posts: 5,673; Likes: 159For 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.Last edit by mattsmom81 on Jul 13, '04
Jul 12, '04Joined: Feb '04; Posts: 58; Likes: 4Could 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!
Jul 12, '04Joined: Jan '04; Posts: 9,601; Likes: 3,187as 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
Jul 12, '04Occupation: rn Specialty: 19 year(s) of experience ; Joined: Feb '03; Posts: 230; Likes: 330Unfortunately 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
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
Jul 12, '04Joined: Feb '03; Posts: 900; Likes: 45I think sometimes pts/family members forget the fact that we are HUMAN too..actually some of them could care less..we all realize if they are hospitalized they are not feeling the best in the world and are anxious/stressed to varying degrees. I am a very compasionate person, and always do my best to provide care/understanding to everyone. Some days it's just not so simple, and they just don't have a clueeeeee the stress we as nurses are under. We are human with 2 hands and can only do one thing at a time..prioritizing r/t most critical. The few times I have come across a pt/family member that I couldn't satisfy no matter what I did, I would call the supervisor in to TRY to get their issues resolved. It's not easy, no matter how long you have been nursing, to be 'abused' by pts or family..tough skin?? I've got pretty tough skin but some days it still gets to me....I'm HUMAN...so sue me :/
Jul 12, '04Occupation: Clinical Nurse Educator Specialty: 9 year(s) of experience in Neuro Critical Care ; From: US ; Joined: Apr '02; Posts: 578; Likes: 66Quote from mollyzMy boss cares about the patients (I know that is weird). I give 100% for my patients every shift, if their family has a problem I don't stress over it.What happens if they family complains about you to the higher ups. Like says you have a "bad attitude"? Will your boss support you or side with the patient and family?
One more trick, if they complain about how long it takes to answer the call light...tell them you saw the light on and came to see them as soon as you finished with another patient. Acknowledge their need while letting them know there are many patients on the floor.
Jul 13, '04Occupation: MICU Specialty: 7 year(s) of experience in MICU, neuro, orthotrauma ; Joined: Jun '03; Posts: 972; Likes: 349Quote from chris_at_lucasSeems like any part of life has potential for providing us with unfair treatment. In the case of patients and families, it's doubly hard because we really cannot come back with what we would like to come back with.
My first contact with a patient and their family, I introduce myself (of course), and I'm sure to smile (even if it is a sympathetic one) and I make sure they understand that I'm glad to be helping to take care of them as well as my other patients and their families.
Generally, this has worked to introduce them to the idea that 1) I am friend and B) they have to share me with others, and iii) I'm doing the best I can because I have their collective best interests at heart.
I also make a point of saying something friendly and/or complimentary whenever reasonably possible. (This can be overdone....) (I also do this out in the real world, especially to parents of young children. I view it as prophylactic child abuse prevention.)
I have never had a problem with a patient or family member.
I also arrive at work thrilled to be there and happy to see everybody, which I know makes a difference in how I view my patients and their families, and I'm pretty sure they can sense it.
It works for me. Maybe it will help you. (BTW, I get compliments and gratitude from my "people" so often it is embarassing....)
In the year that i worked as a student nurse with some exceptional nurses, this was the approach that I learned to take, and it really does work. Take the time in the morning to "chat" with pt/family and let them in on some of what you do during the day and how much you want to make sure that they feel safe and well-taken care of. Everyone likes to feel included and liked, and if you project that they are in your fold, they are much more understanding when you can't get to them right away.Last edit by geekgolightly on Jul 13, '04