Saw a nurse yelling at a patient in ICU

Published

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?

Specializes in Med/Surg, Academics.
Then apparently you've never been in a situation in which there was physical danger present now: a patient who was going to yank out his ETT now; a patient or visitor who was physically harming another individual now; nor a patient found to be in immediate life-threatening distress now.

Yes, no, no, and yes. In the first one, I moved quickly, rather than yelling, and in another situation, speaking calmly was better than yelling because yelling would only escalate the situation/danger to the patient. In the last one, why the hell would you yell at the PATIENT?

As I said, I have yet to see yelling at a patient as necessary. I may have only two years under my belt, but I'm not a wide-eyed novice.

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Specializes in Med Surg.

I yell at patients when the situation calls for it...and sometimes it does.

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Specializes in Critical Care; Cardiac; Professional Development.

The observation made in the OP makes my head and heart hurt. It can get wearying being judged out of context from a position of ignorance and found wanting. Walk a mile in my shoes and all that....

You purposefully didn't listen. That's a good thing I suppose. But you also purposefully made some very unflattering judgments, which you now wish to rephrase as inquiries with the goal of learning. This is what is referred to as "back pedaling". Just be honest. It shocked you. Your fantasy of nursing rubbed up hard and close against the reality of nursing and it shocked you. And because you have zero experience and zero knowledge and your fantasy is likely (as was for most who have come to this profession) what fuels you to want to BE a nurse, it disturbed you. If nurses yell and the whole place smells bad, why, where is the glamour/touchy feely/warm fuzzy/sense of contributing to society in that? Why would you want to do it if that is what it is really like?

Well. Some days, yeah. That is what it is really like. Others not so much. And once in a blue moon it resembles what made you do it in the first place.

You stand on the very furthest cusp of what nursing is. You peered into the window and were shocked by what you saw. So instead of admiting you were shocked, you cast out a judgment (because you want the soft kitty version of the dream to be the true one, not the stinky, raised voice, probably rather scary one. One motivates. One repels. We get that.), not even thinly veiled, and then react defensively when those of us so accustomed to assessing situations and, frankly, used to recognizing the dreamland of the newly called, actually call you out. It feels harsh, I know. I was there. It is in truth part of your initiation - learning to see past the fantasy and determine whether the ugly reality (not every day but certainly some days) is something you really do want to be part of.

Your only task at this point is to go back, look again at what shocked you and realize it will be less shocking each time you are exposed and your knowledge will grow each time you are exposed and your ability to judge whether or not you too want to or can be a nurse starts to take shape as you glean the first vestiges of true knowledge.

Nursing is an honor. It isn't pretty, it isn't always kind, it isn't always gentle and it certainly isn't ever easy. It also isn't what people think it is from the outside looking in. When younglings (whether literally or figuratively) look at you and feel you must suck at it because you don't match the idealism in their head... Ouch. That hurts. That feels bad. Because without a doubt that nurse was doing the best she could with what she had in the moment. Every nurse out there deserves that default respect until she proves otherwise. Especially from someone who states they want to be one themselves one day. You can look at how that nurse acted and begin to form in your own head the kind of nurse you would like to be. Or not be. But you are not qualified to determine right or wrong. You saw a small snippet through the window of a difficult nursing situation. You are not qualified to judge it. Not yet.

Best of luck as you explore this journey. Sorry we shocked you.

1
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^^

Well said!

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Specializes in Trauma Surgical ICU.

Can I like that post 1000 times :)

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Wow not.done.yet, very well said.

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Specializes in Pediatrics, Emergency, Trauma.
The observation made in the OP makes my head and heart hurt. It can get wearying being judged out of context from a position of ignorance and found wanting. Walk a mile in my shoes and all that....

You purposefully didn't listen. That's a good thing I suppose. But you also purposefully made some very unflattering judgments, which you now wish to rephrase as inquiries with the goal of learning. This is what is referred to as "back pedaling". Just be honest. It shocked you. Your fantasy of nursing rubbed up hard and close against the reality of nursing and it shocked you. And because you have zero experience and zero knowledge and your fantasy is likely (as was for most who have come to this profession) what fuels you to want to BE a nurse, it disturbed you. If nurses yell and the whole place smells bad, why, where is the glamour/touchy feely/warm fuzzy/sense of contributing to society in that? Why would you want to do it if that is what it is really like?

Well. Some days, yeah. That is what it is really like. Others not so much. And once in a blue moon it resembles what made you do it in the first place.

You stand on the very furthest cusp of what nursing is. You peered into the window and were shocked by what you saw. So instead of admiting you were shocked, you cast out a judgment (because you want the soft kitty version of the dream to be the true one, not the stinky, raised voice, probably rather scary one. One motivates. One repels. We get that.), not even thinly veiled, and then react defensively when those of us so accustomed to assessing situations and, frankly, used to recognizing the dreamland of the newly called, actually call you out. It feels harsh, I know. I was there. It is in truth part of your initiation - learning to see past the fantasy and determine whether the ugly reality (not every day but certainly some days) is something you really do want to be part of.

Your only task at this point is to go back, look again at what shocked you and realize it will be less shocking each time you are exposed and your knowledge will grow each time you are exposed and your ability to judge whether or not you too want to or can be a nurse starts to take shape as you glean the first vestiges of true knowledge.

Nursing is an honor. It isn't pretty, it isn't always kind, it isn't always gentle and it certainly isn't ever easy. It also isn't what people think it is from the outside looking in. When younglings (whether literally or figuratively) look at you and feel you must suck at it because you don't match the idealism in their head... Ouch. That hurts. That feels bad. Because without a doubt that nurse was doing the best she could with what she had in the moment. Every nurse out there deserves that default respect until she proves otherwise. Especially from someone who states they want to be one themselves one day. You can look at how that nurse acted and begin to form in your own head the kind of nurse you would like to be. Or not be. But you are not qualified to determine right or wrong. You saw a small snippet through the window of a difficult nursing situation. You are not qualified to judge it. Not yet.

Best of luck as you explore this journey. Sorry we shocked you.

^^^Whoot Whoot!!!! WELL SAID TRUTH!!!! ^^^

:yes::yes::yes:

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Specializes in ABMT.

OP, yes, sometimes it is completely acceptable and necessary for the patient's safety to yell. It goes kind of like this: Mr. X, Open your eyes sir. Open your eyes. Can you hear me? And then I might yell at my coworkers:I need help in here right now. I do indeed raise my voice when I'm assessing a patient that has suddenly gone unresponsive. That happens in the ICU.

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Specializes in Emergency, Telemetry, Transplant.
OP, yes, sometimes it is completely acceptable and necessary for the patient's safety to yell. It goes kind of like this: Mr. X, Open your eyes sir. Open your eyes. Can you hear me? And then I might yell at my coworkers:I need help in here right now. I do indeed raise my voice when I'm assessing a patient that has suddenly gone unresponsive. That happens in the ICU.

This is a great point. Same thing happens in the ER. 85 year old female sent in unresponsive from the nursing home. Not uncommon to hear "MARY, MARY, OPEN YOUR EYES. DO YOU KNOW WHERE YOU ARE? ETC." Someone walking by may say "hey, why is he screaming at that nice little old lady??"

Another situation, middle aged man brought to the ER, very intoxicated, perhaps with other illicit chemicals in his system. MD and RN where in the room, he took a swing at the RN and then grabbed her. The MD squeeze his wrist and yells "HEY, LET GO OFF AND DON'T EVER LAY A HAND ON MY NURSES" (and yes, he really did say "my," but he more than makes up for it by protecting the nurse). A person walking by might be horrified by such yelling/actions by the MD, but it was more than necessary.

Of course, in the vast majority of circumstances, it is not right or necessary to yell/scream at a pt. However, sometimes it is necessary. I can understand how a volunteer there for their first day might not realize that, but it does happen.

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Specializes in Cardiac Critical Care.

You made a conscious effort NOT to hear the words because you felt that "it wasn't your business at the time." Yet in the interim, you've decided that not only IS it your business, but what was going on was wrong.

If you didn't hear what was said, you don't know what was going on. Enough said.

Just what I was thinking. Also InspiredbyNavy, as a nurse you will have to tune in not ignore. Pay attention to detail and gather all the information you can get before you make a decision. In my opinion had you truly felt that "it wasn't your business" you would have never made a post about it.

There is just not enough information from your account of the story to even comment on it. When you become a nurse, you will learn that a 5 second snapshot of a nurse/patient interaction means nothing. Especially when you purposely didn't hear the situation. I work in a CVICU and I will yell at my all the time if they are doing something to me or to themselves. Safety first.

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Not.done.yet. Very accurate posting, hopefully inspired by navy will "get it"!

It continues to amaze me how people view nurses. To some we will always be dressed in a perfectly spotless white uniform, standing around as if we're holding up the walls.

One thing I wondered about the original post was when the person stated that it was their "first time" there and they were "walking through" the ICU. I do not know what hospital they were in, but I do know this, nobody just "wanders" around the ICU unescorted where I've worked.

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"Decaying stench?" If this ICU had a GI Bleed patient (which more than likely it did) unfortunately there is no way to control that odor. a GI bleed STINKS to high heavens. I work on a CV-Surgery/Telemetry floor, which is down the hall from our ICU. When they have a GI bleed, I can smell it even before I hit the floor.

The fact that the floor stunk, by no means has any direct correlation with they hygiene of the unit. You are a volunteer, it is best you stay out of the business of what is happening before you know the whole story behind it. And yes...there are times I have raised my voice at paitents if the situation calls for it.

What people from the outside do not understand, is how awful staff get treated by patients and visitors. I have been called every name in the book, I've been threatened to be killed, have my throat slashed and to have everyone in this hospital sued for something ridiciulous. Like, one time I had a patient who was on fluid restriction and they were to not have any fluids over 2,000ML a day. My patient had reached his maximum and I refused to walk to get him a pepsi from the vending machine (not to mention he is diabetic). That was when the patient threatened to have my throat slashed.

So yes, there are situations where I will raise my voice to patients and not tolerate such disrespect. You don't know the situation of what was going on. It is not unethical to yell or raise your voice at patients if the situation calls for it.

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