Nurses who talk snarky to patients

[OnlybyHisgraceRN, ASN, RN]

Disclaimer. Before I get flamed ( and I know I will) here is a little background: I've been in nursing for six years... not long but not new either. I don't have my head in the sand and now I realize that nurses are not the fluffy, bubbly, angels I thought they were when I was little. I've have had my share of rude and obnoxious patients, however for the most part I'm excellent at modulating my emotions and do not react to their behavior. When patients have taken me there I found myself walking away, counting to ten , and deep breathing.

I have seen health care professionals talk snarky to patients, but for some reason I hold nurses more accountable, I thought we were taught to utilize therapeutic communication even when it is very hard not to. Some of the comments I've heard toward patients were probably well deserved however it is still not excusable.

I have reported several staff for the way they talk to patients in the past however it feels like a loosing battle. If I was to report every snarky comment I'd be reporting people often. I even reported physical and verbal abuse of a nursing assistant, yet she still has a job after complaints from patients and other staff members . I've had seasoned nurses tell me to" go ahead and report them... who will they believe me or you".

I'm not talking about setting limits and using a firm tone. I'm talking about nurses who are down right nasty to patients. No patience whatsoever.

My questions is how do some of you nurses tolerate this kind of behavior or do you not tolerate it and report every single time you hear snarky comments toward patients.

Thanks for reading.

[Been there,done that, ASN, RN]

Your efforts , and the results...will depend on the facility you work at.

I've been a nurse for 30 years. The last 6 have been traveling and agency.

I have an internal agency position in a large metropolitan facility ... I was SHOCKED at the "snarky" behavior of nurses and assistants.

I started writing up the most blatant examples. The issues were addressed. It didn't take long for the offenders to realize where the "write-ups" were coming from.

I received such animosity... I was getting concerned about my safety during the looong walk back to my car.

Management verbally told me they appreciated my insight,,, things slightly improved. I don't think it was worth it.

You can't change... evil, wicked, mean and nasty.

[dudette10, MSN, RN]

I've heard nurses and NAs talking too gruffly/snarky/etc. to patients. If I hear it, and I'm working directly with the person, I help handle the issue with the patient a bit more tactfully or gently. Nine times out of 10, the other person has backed off a little. A couple of times, when we've left the room, the other person has provided unsolicited excuses as to why he/she has talked that way. I just smile and nod because that tells me that my response got through to them.

In the course of learning patient relations from my co-workers, I've said stuff like, "I liked how you handled that. I'll have to use that some time!" I'm sincere when I've said that because I genuinely learned a new approach to difficult situations--not just blowing sunshine up someone's butt for the sake of boosting someone's ego--but I do usually say it at the end of shift at the nurse's station, where others can hear.

ETA: I've never witnessed physical or verbal abuse. I would handle that completely differently. I would have to be in the situation at the time to know exactly how I would handle it.

[canesdukegirl, BSN, RN]

What kind of reporting system do you have? Is it anonymous?

At my facility, we have an intranet "incident reporting" system. You can send it with your name or not. When I see something blatant, I don't hesitate to report it via intranet. These reports go straight to Risk Management, get filtered down to the NM and believe you me, the NMs are expected to act on them.

I had to file a report on a verbally abusive exchange I overheard, and I signed my name to it. I was called into my NM's office and was told that she had received several reports of disruptive behavior from this staff member. She asked me if I was afraid of retaliation from this person. Quite frankly, I knew that he was a loose cannon and I was afraid that my tires would be slashed, false accusations would ensue and that he would try to get back at me if he could. He was fired shortly after I filed the report, but I found out later that it took several YEARS of documentation to get to that point.

File a report. Every document describing disruptive/abusive behavior matters. Even if you don't see the end result, know that your efforts will pay off eventually.

[vintage_RN, BSN, RN]

I am not a nurse yet but I have witnessed rude and snarky behaviour from nurses as a patient or when my friends/family were patients. I went to visit my friend after she had a baby and I went into the ward and stood at the nurses desk to ask what room she was in. Two nurses were sitting there charting and they just looked up at me and ignored me. When I said "excuse me" they snapped "what??? you cant just stand there you know"..and were honestly so rude. I dont understand it. My friend was in tears when I saw her because her nurse was so snarky and rude to her. I really dont understand it.

[PennyWise]

It goes on in every healthcare facility, regardless of whether they respect the "write ups" and handle them well or not. Its an unfortunate occurrence that takes place for varied reasons: the person is naturally nasty, burn out, its been an unusually difficult day, problems at home etc ect.

I believe write ups fail to curb the problem due to one major flaw: they too frequently come from one who is themselves a major offender. Not saying I believe this to be the case with you, but in many instances where an individual stands accused of using improper communication techniques..... the judge and jury are guilty too hence the one being accused automatically shuns any advice they receive from them and believes any punishment they receive to be politically motivated, "They only suspended me because one of their favorites wrote me up, and she didn't like me." Nothing gets through to them.

I've seen only one facility handle things in a way in which this phenomenon was accounted for. This facility, in an attempt to improve PG scores, taught "coaching up" co-workers. It placed heavy emphasis on improving patient perspectives of the workforce. For example, if a patient complains to you that their dinner is cold or not what they ordered, instead of saying "OMG this is the third time I've had to do their job for them, let me fix that for you" (like many of us do), reply with "Gee, they are usually so good with this, let me find out what went wrong and get this fixed for you." Not only have we avoided giving someone a poor impression of the facility, but we open up the door for solving the problem without causing bad feelings.

With regards to dealing with nurses who are "snarky", the same approach can work. First, attempt to repair the damage with the patient in a non-accusational way. Next, let the staff member know how they are coming off the way they are and hope they correct things (if it is a case of just having a bad day, this will be enough). If you are met with resistance, then you get management involved.

If management got involved, they did things in a supportive manner rather than taking a judicial approach. That way, resentment towards whomever may have reported them was reduced.

At first this may seem too soft to be effective, but its not as if doing things the other way has helped so far. The advantage to this approach is, once someone is exposed as having this problem.......the facility can act accordingly without fear of being "too harsh".

The other advantage is, someone who may just be having a bad time can be given the opportunity to correct their approach to talking to patients. Let's be honest here........the number of nurses who have never said something to a patient that they wish they could take back equals the number of nurses not answering the question honestly. Think back to one of those moments you've had and imagine someone taking a snapshot of the incident and using that moment in time to judge you. Much better to use a supportive approach with regards to matters such as this. This helps relieve the issue concerning the fact that no one is free of guilt regarding this problem too.

We all float down here.

[OnlybyHisgraceRN, ASN, RN]

Thanks for everyone's perspective.

[Esme12, ASN, BSN, RN]

Depending in the situation.....there will be times that you will be beating your head against the wall. At times you will make yourself subjected to lateral abuse. In some instances.....slaughtering the sacred cow/favourite can cost you your job.

I guess the question is.....are they just one of those miserable people or having a bad day. Are they abusive or just sarcastic. Is it worth the consequences and energy? Is the boss one of those proactive fair endangered speicies?

Pennywise says it well....