New grad dealing with angry/yelling patients

MandyInMS · Jul 12, 2004

I 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 :/

bellehill, RN · Jul 12, 2004

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?

My 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.

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.

geekgolightly, BSN, RN · Jul 13, 2004

Seems 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.

luvbug9956 · Jul 13, 2004

I know that patients and their families can be one of the most difficult parts of nursing. I always feel as if I am making excuses by telling my patients that I was held up by something or someone else. A little trick that I have found works pretty well is when the patient is admitted, let them and their families know where the kitchen, linen room, and other important areas are. Many family members feel a sense of accomplishment just by filling their loved one's water pitcher. This gives the family members and patients a sense of control. If a family member asks me for something such as a blanket or water I try to let them know that it may be a few minutes and direct them to where they can find the items. Use this cautiously....extremely overdemanding patients and families may feel that you are giving them your responsibilities. But I find that many families are more than willing to help out!

I also always try to remember that sick patients and their families are under a lot of stress..many a time a patient will be "difficult" during their stay, and once discharged thank the staff and apologize for their attitudes. I usually see this behavior as a clue to the need for a stress-relieving intervention for patient or family.

teeituptom, BSN, RN · Jul 14, 2004

Welcome to the wonderfull world of nursing

aint it grand

zacsmimi · Jul 16, 2004

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.

Man, do I remember crying all the way to AND from work for the first 6 months!! It wasnt usually patients, but it was sometimes, and often times colleagues that forgot what it was like to be green and scared, and doctors who think they are God (yes there are still some out there....)

Telling you to toughen up isnt going to help. That, unfortunately, will come with time anyway. Remember why you went into nursing. Remember how badly people behave when they are frightened or threatened or helpless to protect their loved ones. Make sure they know you hear them. Dont get defensive. Answer in a soft voice, smile, and walk away. Dont EVER let anyone chew you for 20 minutes. NO ONE. Thats abuse, pure and simple. THere is a difference between abuse and venting, or just blowing up. You are in control here... this is your turf, this is the hospital, the one place everyone else on earth hates and usually fears. Make eye contact. Reach out and touch your patient, so that they know you care. You may be amazed by how fast attitudes change toward you. And yeah, hon - its true... it really isnt about you. ITs about pain and fear and helplessness. Hang in there.

vablueyes · Jul 19, 2004

I work in a busy ER and am probably yelled at at least once a week. I take a deep breath, look the person in the eye, and say "I can understand that you are frustrated (hurt, anxious, concerned...whatever) but we are doing the absolute best we can at this time...you have two choices. You can speak with my nurse manager when she is available, or you can put on your big boy/girl pants and deal with it. I will get to you as quickly as I can." This usually leaves them with a bad taste in their mouths, but leaves me with the upper hand. I refuse to let them get to me. :coollook:

jenruth · Jul 19, 2004

The subject of patients and families lashing out at nurses got me so fired up, I had to register. Personally, I have had very few problems with that kind of behavior from patients and families after my first year of my 17 as an RN, because I simply will not tolerate it. I might also add, I have never been reported or reprimanded for setting down rules when such a situation arises . A persons illness and hospitalization often brings out the worst in family members especially those who are already emotionally troubled, but it does not give license to lash out at staff. This idea that nurses are suppose to silently accept abusive behavior sends a clear message that we are worthless. I might add, that keeping silent has nothing to do with being "professional." It is impossible to work safely and effectively when such people are allowed to act out. It also destroys the morale of the staff, and contributes to staff turnover. Stand up for yourself, your coworkers, and your profession. Learn how to identify troublesome patients or families who are lawsuit prone as soon as possible, and formulate a plan of action. Document all interactions and behaviors, let your supervisor and the patient's physician know what's going on. Many facilities will have social service workers, or risk managers deal with these kinds of patients. The thing is, you have to let them know what's going on. Troubled patients and families create a hostile, uncomfortable environment that prevents nurses from doing their best job. Don't be afraid to speak up; It IS worth it.

chris_at_lucas_RN, RN · Jul 19, 2004

Excellently put! I feel coached and rarin' to get at 'em!

Thanks! (and welcome to the BB!)

passing thru · Jul 19, 2004

Pumpkin: Someone may have already written this, I didn't read all the posts.

But here is my advice and the way I handle it.

I don't stand there for 20 minutes and "Let" someone chew me out.

(I know the 20 minutes is an exaggeration.)

If I were delivering the pillow, and they started to complain, I'd say, "Gotta go, I've got 2 I.V.'s to start and a doctor waiting for me at the desk..." And I skeddaddle outa there.

You must take control.

You do not "Let" the patient be in control.

I've actually been in the position of cleaning an incontinent b.m. patient ...with another nurse or aide and the patient is complaining

like crazy. !!!!

One day I said to the patient, "You think it is bad from your side, you oughta be where we are ! "

I said it with a light tone and a laugh.....

The patient got the point and shut up.

Since then, I have used that line a lot......

like, "Hello !! Do you think WE are enjoying this??"

A little reality reminder goes a long way sometimes.

The reality in this situation is: Two healthworkers assisting and cleaning a patient in a room that smells so bad it is asphyxiating, and we are elbow deep in feces and the patient is COMPLAINING ??

Hello !!

It is time to take control.....when you are assisting and they complain.

NEVER stay in the room and 'TAKE IT'.

Use any excuse and depart ...at once..

LuLu123NY · Jul 19, 2004

:)

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
Pumpkin,
Remember these pts. are in pain ( some are) and many resent being helpless on this kind of floor where they don't move. They have NO idea what YOUR duties are for the shift and only can focus on THEIR needs . It is a hard floor to work on ( I have done it) and they don't mean it personally at all, they merely are venting their frustrations for not having their needs met when they want. Try to remember to have your charge nurse or med nurse medicate them before moving them or getting them OOB. I can't think of a more difficult floor for the pts. in the summer when it comes to comfort, r/t casts and aces galore , not to mention SCD's, as these are hot to wear and positioning is a feat in itself. You will " blow this off" with time and the realization of what they're feeling. Remember, they don't know you as a person, so therefore they don't mean it personally. Try to give them as much comfort as possible and realize that for some, being cleaned up form a bowel movement can be demeaning for some patients. Always try to put yourself in their shoes, as someday YOU will be on the other side of the bed. As for me, I set limits and tell them not to address me in some ways. " My name is not HEY" , My name is... or you can just call me nurse." I also am not a dog and don't respond to whistles. Sometimes we have to teach people how we like to be treated. Hang in there.
LuLu

teeituptom, BSN, RN · Jul 20, 2004

Kust walk away from those people

smiling sweetly and singing

"Hit the road Jack"

dont you come back

no more no more