"Your ER sucks!" and other pleasantries...how you handle them?

[livingthedream77]

Hello, ladies and gentlemen of the ER.

It's happened to us all, and I would love to hear your experiences.

I work in a TINY 6 bed ER in the middle of corn town USA. There are 2 other hospitals of the same size near us, 5 miles, and 10 miles away.

Middle aged man comes in with his spouse, with c/o low abd pain for 2 mos, worse in last few days. Wife has a stack of test results, CT reads, etc, which is literally 1/2 inch thick, complete with CDs, mostly from nearby hosp.

She will not let him speak for himself, gets very angry when I speak to the pt, not her, concerning sx. He tells me he has trouble urinating, sense of incomplete emptying. Look through docs, US abd yesterday (at closeby hosp), states marked bladder distention consistent with bladder outlet obstruction, suspect prostate hypertrophy. Also seen is cholelithiasis.

Explain we will do UA, standard blood tests, will take approx 1 hr, will go from there. Super duper.

45 mins later, wife snaps on another RN that NOTHING has been done, we've been waiting here OVER AN HOUR, no one had bothered to check on them, he's hungry, hasn't eaten since yesterday.

Other RN talks to doc, he goes in, explains eating bad idea d/t abd pain, he's read US results, suggests bladder scan, and dependent on results, straight cath. Pt says "oh, yeah. They've done that before and I felt better right away." Wife argues with doc that it can't be urine retention, HAS to be his gallbladder.

Meanwhile, I go in with scanner, explain. Pt is cool. Wife starts with "I have to tell you. Your ER SUCKS! Your waiting room sucks! The staff here SUCKS! No one was in here. This should be like the ICU. You should be in here every 5 mins making sure he didn't fall out of bed!" ...etc.

Take the therapeutic high road. "Oh, I'm sure you are sick of hospitals, with your husband's hx of leukemia, etc. I wish it was like the ICU also, where there are only 1 or 2 pts per nurse, but being in the ER, we treat by severity not time of arrival.....blah blah blah."

Her response? "Well in (other hospital) they knwo what's wrong. They would've had an IV in already. What the hell is wrong with you? Why isn't he getting fluids?!"

Explain, "we suspect urinary retention, giving fluids isn't recommended..." etc.

*evil glare*....."are you going to scan or just stand there?"

Deep breaths...do scan... >725ml is result. OK, now please go urinate...nope, can't.Not at all.

OK, I'll tell doc. Insist they are going out for a smoke. Explain no smoking on grounds, you leave grounds, you're AMA, etc. They go anyway.

Should have signed them out AMA....but in the interest of pt care (didn't want his bladder to explode) did not do this.

Guess what?! Now go do a straight cath, doc says. I love my job, I says. Yeah....not happening. Curling up, can't get past prostate. Get OK for coude. That works, eventually. 825ml out, 100% relief of pain.

Wife now silent, her MD from Google University called for gallbladder, it was retention, now she's really ******. Go in to give dc papers, follow up with urologist, etc...."thanks for nothing. ("*****" muttered under her breath).

Wanted to say, if you think we suck it so hard, and X hospital is the place to be, why did you come here? But I didn't.

Thoughts? ****** me off. Solved your problem, but you're more worried that YOUR WebMD dx was wrong, than your husband isn't in pain anymore. I'm sure a complaint is coming, not that concerned, documented everything till Hell wouldn't have it.

Thanks!

[Anna Flaxis, BSN, RN]

She sounds like a thoroughly miserable person. Just be thankful you're not married to her.

[livingthedream77]

Yes, miserable for sure. Understand the control freakishness with her spouse having serious issues, but dang. Who acts like that? Where else would you get away with this?

[MrChicagoRN, RN]

this type of patients can certainly be a challenge. But there's no reason for you to get ***** off. This has nothing to do with you. Sounds like you did a great job, and I'm sure the real patient was grateful for the relief.

[happyinillinois]

When a patient says "this ER sucks or this hospital sucks", I remind them that they don't have to be here. This is America and we can choose to go to whatever hospital we chose to! Usually shuts them up. They can't tell if you are with them or not.

[livingthedream77]

MrChicagoRN and happyinillinois, thanks for your thoughts.

What ticked me off is the complete lack of even minimal social skills. I would have loved to remind her that if she preferred another hospital, it was her right to go there, but as I said, I smelled a complaint coming no matter what. Unfortunately my boss is a coward and would not have backed me up, so I did not. Maybe it was the blue-balled feeling that gave me that made me angry.

Best of luck to both of you, and thanks again.

[valzRN, ASN, RN]

And that reason right there is exactly WHY I do NOT work in a hospital or an ER... OMG how do you put up with people like that? I would have lost my job for sure after that whole incident. Poor guy.. I feel sorry for him!

[Anna Flaxis, BSN, RN]

Sometimes I think people like this have had a really rough time with their/their spouse's illness, and perhaps they've had a really negative experience with the healthcare system in general. It boggles the mind how many hoops sick people have to jump through to get what they need or what they think they need. Some people just have really, really poor coping skills. And as the nurse, you are the face of the institution and so they take all of that anger and frustration out on you. It's not right and it's not okay, and you're a person too and deserve to be treated courteously, but I think that's probably what's at the root of it much of the time.

With a person like this I just remain polite but set limits as far as what I am able to realistically do for them. Sometimes I will just come out and ask "What were you hoping for in coming here tonight/today/whatever?". I've completely turned some people's behavior around just by doing this- by getting them to name what it is exactly they think they need. If I don't think we'll be able to help them with whatever it is they're asking, or if I don't think their expectation is reasonable given the circumstances, I'll say so. But I'll also tell them what we *can* do and what is realistic for them to expect.

....and some people are just rude no matter what. All you can do is try, right?

[meanmaryjean, DNP, RN]

When someone tells me that my hospital sucks, my silent response is "And yet, you're here!"

[nurse2033, MSN, RN]

As miserable as she made you, at least she left your life and you're off the hook. That poor guy has to live with her, and she has to live with herself. What's that like? Could be worse, she could be family!!!!!!

[parascribe]

I'm pretty sure I've had that patient, or their relative, or maybe it was someone who just hatched out of the same pod.

I agree with Stargazer, I've had good results asking simple direct questions, always politely and calmly. I find that often, people are just frustrated, particularly if they happen to lack good coping and communication skills.

On the other hand, some people are just (insert word not allowed by TOS).

[meanmaryjean, DNP, RN]

I'm pretty sure I've had that patient, or their relative, or maybe it was someone who just hatched out of the same pod.

I agree with Stargazer, I've had good results asking simple direct questions, always politely and calmly. I find that often, people are just frustrated, particularly if they happen to lack good coping and communication skills.

On the other hand, some people are just (insert word not allowed by TOS).

I think the word is 'jerks'.......