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?

[Ruby Vee, BSN]

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?

I beg to differ. I'm not going to say over and over that I was wrong for jumping the gun and assuming, but my original post was a genuine question regarding the topic at hand. I would in fact agree that I am one that is "trying to soak in knowledge."

I think most people will also agree with me that students are sometimes naive, blunt, and very curious. This was just me sharing my experience and wanting to gain more information of what I had witnessed.

Call me the cat that was killed by curiosity, but I think we have all been that same cat at least once in our lives.

The very first post, the one that was so innocent because you were "just trying to soak in knowledge" paints a very vivid and very negative picture. See, phrases like "made the already decaying stench of the ICU palpable" may be very good writing, but they are not phrases that say "Help me out -- I'm just looking for some information here." "Just the tone and volume of her voice" and "This is more of an ethical topic than patient safety" are also phrases that imply a negative connotation to the entire experience.

So after calling out ICU nurses for yelling at patients and getting an understandably (to me anyway) outraged response, you back off and say you were only looking for information. I'm not buying that. But on the off chance that I'm wrong, and you were just the victim of overly colorful writing skills and genuinely seeking knowledge, here's some good advice: If you're just trying to soak up knowledge, you're going to encounter more helpful responses and more helpful PEOPLE if you use neutral, non-judgemental language in your quest for information and if you skip making assumptions such as "this is more of an ethical topic than patient safety."

As for saying over and over that you were wrong -- you were. In a thread like this where you've so easily offended dozens of people, the smartest thing you can do to engender future good will is to apologize to every poster you address or quote. Because otherwise you come off arrogant. Which you couldn't possibly be, could you?

[kanzi monkey]

I worked as a volunteer while I was applying to nursing school. Lucky for me, I had very limited knowledge of illness and disease, and how people cared for sick patients in general (because I hadn't needed to learn about it).

What I saw as a volunteer wasn't what Johnson and Johnson depicted.

My impressions were similar to the OPs--I had lots of questions about "nurses tones", "restraints", and "sitters"--not to mention the generally lackadaisical attitude it seemed the staff had toward, well, audible suffering. Had I known about allnurses at the time, I may have posted something similar to the OP as I tried to rationalize my first impressions of hospital patient care.

I don't understand why people think the OPs post is so offensive. What s/he saw represents a reality of some our daily lives NOW--but at some point it was utterly foreign. The smell of burning flesh in a trauma unit will be noticed by the most seasoned health care workers. It doesn't smell better even when it's familiar. The dominating stance a nurse must take to protect a confused patient is quite foreign to the outsider, and very easily can sound belittling and condescending.

When I was volunteering at a very well respected hospital, trying to make my way into an new career and new life--I took all of this contradictory information on "patient care" and stowed it into my brain, tried to make sense of what I could, tried to save the rest for a time when I trusted it would all have a logical explanation. Again, had I known about allnurses, I may have (foolishly, apparently) have come here to try to quietly find some thoughtful answers from seasoned nurses for my "what the heck is going on here?!?" types of questions.

I see that, had I done so, I may have been discouraged.

OP, please keep asking the questions that you do. It is very reasonable to wonder what the heck is going on in a hospital when you don't actually know what the heck is going on.

Mind you, if you are going to be honest and descriptive of your experience and your initial reactions or feeling, you will likely have some people who are utterly incapable of understanding your point of view and will put you down. Humbug to them.

Good luck. And yeah, the hospital can be quite smelly.

[Esme12, ASN, BSN, RN]

I think we all need to remember that the OP is new to all of this. I think they had GUTS to come back and admit they were hasty in their judgement. I think we all need to remember that we were once new and innocent to the inner workings of the hospital environment and that there were times we whispered to our clinical buddy that we were once HORRIFIED!!!!!!! by what we saw!!!!!

I remember the first surgery I saw, now remember in my day they were ALL open incisions.

I was horrified that they all just talked like normal. I was disgusted that they played music and chatted like nothing was going on! Didn't they care about this poor lady buck naked in this freezing room??

I was HORRIFIED as I watched them pile this poor woman's intestines on her abdomen chatting about the night before....dig around...and remove the uterus and ovaries. It took ALL of my self control to keep myself from running and screaming from the room when they took the two sides of her abdomen and shook her intestines back in to her abdomen.

I made a reflex audible gasp. The surgeon looked up at me and said....."What's the matter little girl?":mad: I desperately looked for the nurse in the room who gently nodded her head....so I said...."Isn't there a specific way to put all that back?" he titled his head back and bust out laughing and said.... "What do you think the gas pains are for?" .......at lunch I had quite a bit to share with my nursing friends.

I remember the stench of rotting flesh when a cast was cut off and the wound had maggots....... I never forgot that smell. I was 18 years old.

That is all the OP did....talked to her peers....spoke of her horror....except they reached a larger audience.

Now, because of patient nurses and an understanding instructor...I know better..... I practice nursing differently because of that day.....I don't let new comers suffer alone and in silence. I have prepared my daughter to know that things she may see are not always as they seem.

Thank you OP for coming back to tell us of your growth and having the bravery and tells us of your progress! Nursing isn't for the faint of heart. ((HUGS))

Good for you!

[nurseprnRN, BSN, RN]

Somebody used to have in their siggy line the Maya Angelou quote about how we all do the best we can, and when we know more, we do better. I think the OP knows more now, and I think s/he will do better.

And perhaps lose the flowery language, too. :)

[Here.I.Stand, BSN, RN]

I had a drunk trauma pt (EtOH more than 3x the legal limit an hour earlier) who was on a ventilator, had a ventric, and had NOT had his C-spines cleared. His BP wasn't tolerating sedation yet--we were working on rehydrating him--and he did have restraints on. Well, he was combative and sitting bolt upright in bed...he was putting himself at risk, and beyond reasoning with. I physically had to pin him down, and I didn't say "please, Sir, you need your rest." I raised my voice and used my most serious tone. Protecting his airway, brain, and spinal cord had to trump being sweet.

[calivianya, BSN, RN]

I'm going to have to defend OP a little bit here. I have no idea where she saw the "yelling" in question, but she sure could have been shadowing at my workplace. There is a huge difference between sternly talking in outside voices and actually screaming at the patients. I see the latter happen frequently. There are a lot of dissatisfied nurses who have been working for this company forever who outright yell back offensively when a confused patient starts yelling. I know sometimes you have to raise your voice, I know I've done it myself, but if I'm six rooms down and I can hear the nurse screaming louder than the patient, and the contents of the words are "SHUT THE HELL UP ALREADY!" it's abusive. Maybe some people will disagree with me, but IMO there is no excuse for that kind of behavior from the nursing staff. If you're frustrated, hello, that was a restrained patient - you can walk out of the room for ten seconds to cool off. It's never appropriate to scream at the patient because you're mad at them.

/end soapbox.

[cardiacfreak, ADN]

I agree it is not okay to yell at a patient because you are mad, in most circumstances. I once had a young guy who was coming down off a meth binge, he hit his wife right in the face with his fist and picked up his urinal to throw at me. Heck I wasn't mad I was furious. And yes I did yell at him and yelled for staff to call security.

[ICULINDA]

A lot of good points on here. Since you are now volunteering on the unit I hope your choice of words have changed to ask a question. The one thing I was hoping to see as I read through all the comments was a simply I'm sorry for assuming and the way I worded my statement. Regardless if it was your first time stepping onto a unit or not it just came out wrong. You made all of us nurses sound mean and lack compassion. If you where that nurse how would you have felt hearing a volunteer complain without the full story. Take it as a learning experience instead of becoming defensive. Oh and the stench of death is someone's loved one not the hygiene of a unit. Keep that in mind. Smells are actually an important part of your assessment. So you might want to consider that in nursing school.

[canoehead, BSN, RN]

I remember my first day on a nursing unit, I didn't have two clues to rub together, and I turned out alright. Let's not give up on the OP yet.

I yell at patients 3-4 times a day. I work the ER and get those hard of hearing folk, and I'm certain any education I do sounds bossy. I'll bet any my assessment questions sound like Dr Phil on a bad day. Just FYI, I wouldn't consider any single yelled sentence abusive unless it contained swearing, and even then, there are times...(roll eyes). You've got to know the patient and history.

And stink? Honey, you don't know stink until you've had to get up close and personal to projectile diarrhea. Just wait. You'll lose your nose hairs someday if you stay in nursing. There are smells that you can't wash off, it's on your uniform for the rest of the night so bad that you're asking your coworkers to check for splash marks.

Bad news- the really stinky stuff is childs play when it comes to gross in a nurse's world. Hang around.

[liketheairport]

I'm speaking not as a nurse but as a potential one. What I'm going to say about this is: When a child is about to do something dangerous, I say firmly but loudly, NO. With elderly people, their ears may not hear high frequencies as well as younger people do, thus a lower tone and higher volume may be necessary.

Also, having dealt with psychologically disturbed people before (and having been a psych minor), sometimes a firm voice is the only thing that can get through panic, or whatever else may be cluttering someone's mind. It is absolutely that "Mom" no-nonsense voice that is vital in a situation where chaos happens.

[MiaNursingStudent]

I work on medical telemetry-- also know as the psych hospital overflow, ICU/ER dump, geriatric unit overflow-- you name it, we got it. Most my patients are HOH and don't/refuse to wear their hearing aids. Now imagine that with a dementia patient who is scared and trying to get out of bed head first and pulling at every line attached to him. Yes, I yell. I yell for assistance and also for the patient to look at me- it usually distracts him/her from what they're doing. I remember in nursing school I thought med-surg nurses were the meanest..... Now I know that sometimes we're just misunderstood. I do NOT want my patients hurt in any way due to my lack or ability to communicate what needs to happen in a given situation.

[MomRN0913]

Yes, I have yelled at patients in the ICU. When they were about to pull their ETT, central line or chest tube, I would yell to be that point across if nicely nicely didn't work. I have yelled at my patients who wouldn't keep their bipartisan on which was the only thing keeping them from being intubated.

And when I say " yell". I mean reinforce a louder stern tone.

Because it could save their life.

So, if you don't know what was happening I suggest you get rid of your preconceived notions.

Good luck to you