I had something happen today that really bothered me. l lost my voice. I lost it in the name of patient satisfaction.
I listened to a male patient yell at me for something completely out of my control and then demand a new nurse because he didn't like my attitude.
My attitude consisted of explaining to him a certain policy and why it couldn't be broken. I then asked him why he was so mad and not to raise his voice at me. I said it in the most even, professional tone possible.
The bottom line and what bothers me most is he can treat me however he chooses. He can yell at me and if I say one word I am replaced. I am disposable. Who sticks up for me?
In what world is it ok for a grown man to speak to a woman or anyone for that matter in such a way? I feel like I have no voice or rights as a nurse sometimes.
Specializes in Oncology; medical specialty website.
It's in every single customer service profession there is. It's just not inclusive to nursing. It's about how you approach it. Use a little bit of that psychology on them. It is difficult when you think you are going out of your way for someone and they still complain. But this is the real world, and this is how people act. It's not going to change anytime soon, I promise. I have dealt with the customer is always right no matter what for years. And this orientation I sat through the other day called their patients customers, not patients. Labor and Delivery is big money these days, as is elective surgeries such as knee replacements and hips. It's not about the doctor. It's about where they can get the best service while they are admitted. That is how the hospitals make money. Not off your ER visit or a MedSurg patient that is critically ill on Medicare. People will choose to have their surgery or baby where they feel the most comfortable or where the best food is. Believe me, after spending three months in the most absolute awesome hospital years ago, I would go there for anything. My experience there made me have my son there. I had pneumonia and a PE at the time of my first admission. Definitely not my choice to be there, I was close to death, but everyone made me just feel, well, good while I was there. I was not a demanding patient, but the nurses were kind to me and made me feel like they cared. The food was awesome. I think the positive atmosphere helped me to recover. I was never asked to fill out a survey. If I had, I would have given them 5 stars. The hospital was 45 minutes from my house and I chose to have my son there because my first experience was awesome. It was a great experience for me also.
I was admitted to our local hospital a few years later for a bad case of pneumonia. The jello was watery, nobody hardly came to see how I was doing. The hospital was depressing. Again, I never complained but the experience was different. I guess I felt like nobody gave a crap if I was getting better. To top it off because of H1N1, I was not allowed to see my son for over 3 weeks. I still ended up contracting it. I was just not better when I left. I guess I didn't get the caring feeling I did from the other hospital.
It does make a difference. I am not a complainer. I never said a word, and if I had to be admitted seriously again it wouldn't matter which one I was at, I would go, but for the elective things, I will choose the first one every time. And these are two hospitals under the same company just two different towns. It does make a difference. You are not going to make everyone happy. That just has to be expected. It will never happen. But if you can make a small difference so that patient does come back, that helps keep everyone in a job.
I know this is not what many people want to hear, but it's a reality that we all have to deal with. I hope that maybe seeing it from another perspective will help some people understand.
I'm sure this would have been sage advice for that CNA who had her arm broken, or the nurse the other year whose jaw was broken by a pt., etc., etc., etc.
Specializes in Oncology; medical specialty website.
Correct. Take an ICU nurse who's never worked on a surgical floor (because they have spent their time in MICU or cardiac medicine) and see how well they manage those surgical patients. I'd like to be a fly on the wall for that **** show.
When you have all sorts of monitors telling you what's going on with the patient every second, it's a lot easier to forestall a crisis than having to do the same on an unmonitored patient x 6-7 on a med-surg unit.
Valuing one type of nursing care over another does just what administrators would like to see: nurses turning on each other. They can just sit back and laugh.
This type of behaviour used to upset me, too. But I quickly evolved into a COB and now when someone yells at me, uses foul/degrading/overall abusive language... I polite but firmly give them this speech:
"I'm sorry you're upset, but your anger is misdirected and I cannot help you while you are in this state. I don't' appreciate your tone and I don't have to tolerate abuse. I am trained to help you, but not to put myself in threatening situations. When you calm down I will be happy to assist you."
Then I make sure the SOB is safe and promptly leave the room to assist other patients. This usually works to incite a sense of rationality in the patient that this nurse-patient relationship is a two-way street and that they are dependent on me and will only receive my assistance if/when they behave like decent human beings... Just make sure the patient is safe and leave the room, give them a few minutes to collect themselves and while they simmer down CHART EVERYTHING. Then, try to approach them again. BUT sometimes even this isn't enough as conditions at the bedside continue to worsen. That is why I am officially leaving my bedside nursing position. I am so disgusted that we are treated like whipping posts and indentured slaves in the workplace. WE are human beings, too.
We recently received complaints from family members that the patients weren't getting bathed for weeks at a time. Lie. So now our techs are required to do baths on the morning, as if day shift isn't busy enough, and if the patient refuses they have to be asked again in the afternoon or evening. Now I have patients complaining that they are being asked to many times during the day about baths and it offends them. It's hilarious, no matter what you dos someone is not going to be happy. Does anybody else work on a floor that requires to do baths on everybody everyday?? Also I hate when patient say they "need" their lines changed when they are perfectly clean and were changed the day before. I'm like I know you don't change them everyday at home!!!
I work in CCC/LTC and our patients get bathed every morning when they wake up, in the evening before bed, and in-between they're bathed PRN because they are all incontinent of everything. It is exhausting and we do not have PSW's or CNA's to do this for us. We nurses do it all ourselves... and they complain about everything. It's particularly trying on a nurse's patience when you're bathing patient X for the umpteenth time and they berate you the whole time you're washing them, and/or dictate how the process should go. We have one patient who is notoriously so demanding that bathing him takes 1hr each time for all the nurses... it's depressing but we take better care of this man and most of our patients than we probably take care of ourselves. I keep mum and think this to myself:
I work in a rehab/LTC facility, and the rights of employees is far outweighed by the rights of patients and families. We're told to refer to patients as guests, as if we're striving to achieve a 5 star resort rating. Anything they want, whether it's healthy, safe or correct, we're supposed to provide it, or at least try.
Our admin staff emphasizes customer service over everything else. I agree we need to be as tactful as possible, but we're still in healthcare, and sometimes people just need to hear the truth. One of my very aware, continually educated diabetic patients will routinely be mid 300s-400s by lunch, because he has cookies, candy and soda at his bedside. When I check his sugar and he's high, he'll always ask, "Well I don't understand why I'm so high." He'll have 2-3 empty soda cans at bedside between breakfast and lunch. I've educated him on how his habits and lifestyle are the ones effecting his glucose levels more times than I can count. When confronting admin staff about it, I was asked what I could do to minimize his desire to eat and drink between meals, and make healthier choices. They tell us (nursing staff) that the patient is never responsible for what happens - ever. How is this acceptable?
We are currently on semi-lockdown with an outbreak of noro. 15 people one side of the building have been diagnosed, and we're basically shut off from that side. We also ask sick family members not to visit, and it's a policy. We had a family member come in who was symptomatic with an elevated temp, who intended to sit in the dining room at lunch with their family member. Another nurse and I confronted him, stating our policy and making the suggestion not to visit at that time to keep their family member and others from getting sick. The family member had a very short fuse and started yelling and screaming at us, just in time for admin staff to come up and tell the family member that they could stay and eat with their family... in the dining room with 40 other patients. They then turned to us and said, "He gets mad easily, just let him stay. We'll make an exception."
We've also had a mentally ill family member come in drunk with a baseball bat and threaten the staff because their mother wasn't getting any better (80+), and he nearly hit one of the nurses across the face with the bat. It was a big deal, a lot of chaos and drama. In the end we were confronted by admin and asked what we did to provoke them - the facility didn't press charges. For months a topic of the monthly staff meetings addressed what we did wrong in that incident, and how we were to blame for it.
I'm sure this would have been sage advice for that CNA who had her arm broken, or the nurse the other year whose jaw was broken by a pt., etc., etc., etc.
I like to think though that those type of patients are few and not commonplace. Nobody should have to deal with that from another person. If a patient ever attacked me and hurt me, you better believe the police would be called and they would be in jail. And if my employer didn't back me, too bad, out the door I go. No job is worth my health and well-being, just isn't.
The people I am talking about are the ones that say their pillows are not fluffy enough, the grandma who complains about it being too cold, the grump old man who wants his food served to him right now even though dinner doesn't come for another 2 hours. Those kind of things. I'm not talking about extremes.
The person who tries to assault me on the job better think twice, I'm working on my first belt in jujitsu and can do a pretty good rear naked choke!!!
Being a patient is stressful. Being sick brings challenges to people that we usually don't know about: financial, emotional, mental and physical. It can make you depressed, broke, and confused. I have always found patients can be calmed down one way or another, including having someone else. I've been the fill in when others got the boot. Recently, I saw a woman at home who had a wound vac. Within five minutes, she was threatening to call my supervisor. The vac went fine but she insisted someone "who knows what they are doing," check it. Some of us she likes, some she doesn't. I got her on call one night. I told her I would be happy to visit but I identified myself so she knew who I was. She chose to do a wet to dry and wait until morning for another nurse. It's really not about us. Sometimes, there are so many variables that we never really figure out what it is.
It never ceases to amaze me, that the only hospital employees, that patients and family believe it OK to assault, are the nursing staff.
I never hear about a patient, visitor, or family member, assaulting the PT, OT, Pharmacist, dietician, etc. Why is that??
Why are nurse fair game to assault? Could it be, that patients perceive our lesser status in the hospital, and we are just not important enough to be safeguarded from assault. And if by some chance we go get assaulted, well its OK. Patient satisfaction scores are more important than our safety.
Perhaps, if a nurse was assaulted by a patient, or whoever, the nurse went public with it, and they sued the patient.
The nurse then wins a multi-million dollar lawsuit against the patient. It would send the message that nurses are not punching bags. They can take their frustrations out on someone else. They have NO problem venting their frustrations on us. Why is that? Because they know that they will get away with it.
They manage to control themselves with everyone else, why not nursing?
I had something happen today that really bothered me. l lost my voice. I lost it in the name of patient satisfaction.
I listened to a male patient yell at me for something completely out of my control and then demand a new nurse because he didn't like my attitude.
My attitude consisted of explaining to him a certain policy and why it couldn't be broken. I then asked him why he was so mad and not to raise his voice at me. I said it in the most even, professional tone possible.
The bottom line and what bothers me most is he can treat me however he chooses. He can yell at me and if I say one word I am replaced. I am disposable. Who sticks up for me?
In what world is it ok for a grown man to speak to a woman or anyone for that matter in such a way? I feel like I have no voice or rights as a nurse sometimes.
I haven't read much of this thread (although it seems like there was a good amount of bickering back and forth). I still wanted to reply to the OP. I struggle with patient satisfaction because I truly believe in being honest and friendly with patients. When I go to a restaurant I expect courteous treatment (and patients should expect the same) but the difference between me going to a restaurant and going to a hospital is that I should not have a menu of things (food vs. medications and tests) to choose from. A narcotic for a drug seeker is bad medicine. An MRI/CT on a 21 year old obese female with back pain (and no red flags) is bad medicine. I got a patient complaint that I would not CT the former patient.
Listen I know it is hard but don't take a complaint, getting fired by a patient, or someone yelling at you to heart. If you practice even 1 year in this profession and have not had someone upset with you, you are probably practicing bad medicine. Complaints and having a patient upset is essentially background noise in this profession (and is expected). Now I am not saying that if you get a complaint a week that you don't need to change something, but if you never receive a complaint then you are probably not doing the job you are paid to do.
So I am 1 year out of residency: so essentially 3 years of residency and just over 1 year of being an attending. In those just over 4 years I have been "fired" by 7 patients and have had 3 formal complaints lodged to the hospital against me. I can't count how many times I have been yelled at or screamed at by patients or told that I was "incompetent".
With the complaints I had I was still voted (by the nurses, techs, and attendings) as the most compassionate resident in my 3rd year of residency. Still I had a complaint that I was the "most un-compasionate, most unfriendly, and most retardedest (no joke that was in the complaint) doctor "if you could call them a doctor" that I have ever met."
Doing the best for the patient is often pointing out the facts and not giving in to a request that is unreasonable or even dangerous to them. Most patients understand this and with some explanation will realize it. There are still a few that no matter what you do unless you give the X that they are requesting they will be pissed. Your administration should understand this and if they don't get out of that job.
Patient complaints and getting fired SHOULD happen to you. Not every day or even every week but once in a while. It is not a reflection on you or your skills/knowledge. Maybe I am a bit jaded because I work in the ED and we get several difficult patients everyday. Often times I get told how nurse X wouldn't give me a sandwich. They are just as angry when I tell them I won't let them eat a sandwich either until I work up their abdominal pain. If every patient were to say please and thank you and tell you how great you were everyone would do this job.
All in al patient complaints WILL and SHOULD happen. It means you are at least trying to help people from themselves. You are trying to curb narcotic addiction or decrease over testing. Overall remember what yo do MATTERS and you are really trying to help. Sometimes that is helping a patient from themselves and sometimes that will lodge a complaint.
OCNRN63, RN
5,979 Posts
I'm sure this would have been sage advice for that CNA who had her arm broken, or the nurse the other year whose jaw was broken by a pt., etc., etc., etc.