Saw a nurse yelling at a patient in ICU

[inspiredbynavy]

So today was my first day volunteering at the hospital and I was walking in the ICU when I hear a nurse yelling at a patient. Just the tone and volume of her voice made the already decaying stench in the ICU palpable. This is more of an ethical topic rather than patient safety but I think it could play in the patient's stress levels.

I'm a pre-nursing student and I'm not aware of the whereabouts on ethics for nurses and hospitals yet. Do nurses have ANY rights to EVER yell at a patient, especially one in the ICU?

[MunoRN, RN]

In general Nurses should be expected to take the high road, and they don't always manage to do that. Although I wouldn't say it's never appropriate to yell at a patient. Patient's who are verbally or physically abusive, and have no altered mental status or psych excuse for doing so, may need to be yelled at times, albeit rare.

[Laurie52]

The already decaying stench in the ICU?!? What exactly does that mean?

[SaoirseRN]

Without knowing the context it is hard to give an opinion on the matter.

[Altra, BSN, RN]

Did you listen to anything being said, or just conclude that the raised voice was out of order, no matter what the context?

And, just a question ... have you ever cared for anyone who was extremely hard of hearing?

[meanmaryjean, DNP, RN]

Please define 'yelling'. We oftentimes MUST raise our voices to be heard by certain patients. This is accommodating a patient's hearing deficit, not yelling.

[inspiredbynavy]

I realize some patients may be hard of hearing, but you could just tell by the TONE of her voice that it wasn't just her trying to talk to a patient that was hard of hearing. I did not hear the exact words she had said. I felt like it wasn't my business at the time. Like I said, I'm fairly new to being in a hospital. This is a completely new environment to me. And what I meant by my metaphor of a "decaying stench in the ICU" was that it kind of smelled different than other parts of the hospital (definitely not in a good way either), and then I realized that there were patients dying there as well. Probably not the prettiest choice of words, but that was what depicted my mood at the time.

[meanmaryjean, DNP, RN]

I would say that if you didn't hear the words, you REALLY do not know the situation.

[Sun0408, ASN, RN]

Ditto to above.. I have had to "yell" several times to get my HOH pt to hear me. Mix HOH with dementia and you have a hell of a shift...OP, try to say "lay down", or "lets get back in bed", or "don't pull on that" in a loud voice and tell me how that sounds to you..

[applewhitern, BSN, RN]

Wow. "Decaying stench?!?" Maybe the smell was stool, or a GI bleed, or mucomyst. And I agree, the patient was probably extremely hard of hearing, with dementia, and maybe even combative. Was the patient constantly pulling out his/her IV, foley, or other medical equipment? It bothers me that you are a "pre-nursing student" and already are posting here about something a real nurse did, especially since you don't even know the situation.

[Esme12, ASN, BSN, RN]

I realize some patients may be hard of hearing, but you could just tell by the TONE of her voice that it wasn't just her trying to talk to a patient that was hard of hearing. I did not hear the exact words she had said. I felt like it wasn't my business at the time. Like I said, I'm fairly new to being in a hospital. This is a completely new environment to me. And what I meant by my metaphor of a "decaying stench in the ICU" was that it kind of smelled different than other parts of the hospital (definitely not in a good way either), and then I realized that there were patients dying there as well. Probably not the prettiest choice of words, but that was what depicted my mood at the time.

Nurses will commonly use their....what I call their Mommy no nonsense, I mean business, KNOCK IT OFF....SHAME ON YOU tone.

Unfortunately...some of the patients bodily functions and disease processes that have a certain....shall we say..... stench....:poop: that are common with certain disease processes like C-diff ( a horrible smelling loose stool), or GI bleeding (another smell unique to that disease), gangrene, alcoholic latculose stools (unto itself a stench of ammonia and rotting flesh) that are not easily dissipated and covered up with air freshers.

A confused alcoholic detoxting patient isn't always receptive to please and thank you and can resort to throwing urinals and poop at the staff, shouting obscenities at the top of their lungs, and calling a nurse everything impolite that they can think of....because they want/need a drink/drugs. They feel the uglier they are the more likely you will give in to their demands.

A stern KNOCK IT OFF, LAY DOWN RIGHT NOW.....ENOUGH!!!! can seem to the casual bystander as inappropriate when in actuality it is therapeutic communication to avoid the use of restraints.....or bodily harm (I'm kidding....)

Someday you will understand.....((HUGS))

[mikimoto]

Yelling or loud voice speaking with a hearing-impaired patient? You need to define the situation further.