So TIRED OF IT

Even factoring out the whole moral issue of being a jerk to someone who is just doing their job... I would, from a completely selfish standpoint, never mess with anyone handing my food/drinks/meds. I would never mess with anyone I depended on to bathe/evaluate/ resuscitate me etc. I just don't get it.

Emotions run high with stress, and I try to remember how stressed patients are...but threats and assaults should never be tolerated. Behaviors that impede the care of of other patients should not be tolerated. There needs to be protocols to address these things swiftly....the fact that we are not backed up on this is insane.

To those who feel that the OP and supporters are "bad nurses"... I always think of Maslow's hierarchy of needs: on many floors and fields, we have to provide basic physiological care and safety before we can address inadequate coping mechanisms and psychosocial needs.

Some patients need our attention for immediate safety needs. These come first, and sometimes because of the roll of the dice, we deal with several at a time, and they are not resolved quickly - resources (time, staff, emotional energy, caloric intake) run thin. And yes, some patients need their pillows adjusted because they can't raise their arms: we need the time to do this....not adjust pillows for the patient who just wants attention. Some patients are acting out for attention because they have underlying stressors and inadequate coping mechanisms: we need the time to assess and deal with this...and so on.

A violent patient who is dead-set on finding a punching bag, a patient who wants a personal assistant and is disrupting critical care on another patient, a demanding family member who is coping with loss of control by trying to forcibly take it back....all of these things further complicate our job. Do they have valid needs too? Sure, but it's not always what they're asking for. It's OK to express frustration with that.

To dismiss it with "get out of nursing" or "simply re-read my response X number of pages ago where I told you to make better eye contact".... well. I question y'alls cool heads in difficult, high-stress situations if you can't even read these responses without belittling the HUMANS behind the posts.

I was never good at searching on this site, but I do believe this is not Susie's first rodeo on this subject here.

Too true. We are meant to be angels of mercy, dispensing sprinkles of love and joy to sick and infirm in her eyes.

We are serfs to be ground into the dirt as long as she and her family is looked after by the perkiest, happiest, positivist nurse around.

I recently had to deal with a Susie after getting a phone call about a death in the family. I couldn't leave the unit right away due to a staffing issue. My Susie told me to four letter word starting with F cheer up, nobody had died!. I burst into tears and walked away. I guess in her perfect scenario world I should have maintained eye contact and agreed with the patient.

I teach a bit now, and I always explain to my students that there is no such thing as a "problem patient". There are only patient problems that nurses must address.....

Now whenever I have an upset patient, the first thing I ask is this: Does the patient have a legitimate reason to be angry at us? Did we fail to treat the patient with respect and caring? Has the patient been in severe pain and we didn't manage it properly? If we have done (or not done) something that would anger most reasonable people, then we need to evaluate our own nursing behavior and ensure that in future, we provide care that meets the highest standards.

If we have done nothing to bring about this kind of behavior, then we need to recognize that the patient has a problem, and as a professional nurse, I have been trained to deal with behavioral problems! I--and YOU--have that power to initiate my nursing expertise to deal with the problem.

Try that approach, and good luck to you.

Are you serious with this? You must be in management/administration, because in your system, the patient is never wrong and nothing they do is ever their fault. Your "approach" is a recipe for nurses feeling unsupported, like everything is their fault, and burned out. It's a dream come true for people who want to blame the nurse for everything. Disgusting.

To those who feel that the OP and supporters are "bad nurses"... I always think of Maslow's hierarchy of needs: on many floors and fields, we have to provide basic physiological care and safety before we can address inadequate coping mechanisms and psychosocial needs.

Some patients need our attention for immediate safety needs. These come first, and sometimes because of the roll of the dice, we deal with several at a time, and they are not resolved quickly - resources (time, staff, emotional energy, caloric intake) run thin. And yes, some patients need their pillows adjusted because they can't raise their arms: we need the time to do this....not adjust pillows for the patient who just wants attention. Some patients are acting out for attention because they have underlying stressors and inadequate coping mechanisms: we need the time to assess and deal with this...and so on.

A violent patient who is dead-set on finding a punching bag, a patient who wants a personal assistant and is disrupting critical care on another patient, a demanding family member who is coping with loss of control by trying to forcibly take it back....all of these things further complicate our job. Do they have valid needs too? Sure, but it's not always what they're asking for. It's OK to express frustration with that.

To dismiss it with "get out of nursing" or "simply re-read my response X number of pages ago where I told you to make better eye contact".... well. I question y'alls cool heads in difficult, high-stress situations if you can't even read these responses without belittling the HUMANS behind the posts.

I would like to "like" this post x1000! SPOT ON.

No, I'm not suggesting that abuse from patients is acceptable. To help your reading comprehension here's part of what I said in my last comment to you again:

"Now, just to clarify, no-one is suggesting that abusive behavior from patients/family members is acceptable, but the great majority of patient/family member behavior is not abusive, and usually there is enough time for an observant nurse to recognize when a situation is escalating and to take steps to de-escalate it. Again, one of the ways to de-escalate patients/family members becoming upset/angry is to listen to their concerns, acknowledge them, look at them when they are talking to you, don't cross your arms when they are speaking, and show them by your actions that you are doing your best to help them."

You sound very defensive with lack of empathy towards patients/family members. I have posted my comment to you again, as I think you could benefit from reading it and reflecting on it:

"You sound as though you are struggling for insight into patients' behavior. You ask why your father behaved uncharacteristically; I'll offer a suggestion - he was suddenly in a situation that was very stressful for him. I already explained in my earlier post that you reacted to some of the stressors that patients and family members experience. As nurses we are expected to make allowances for patients/family members behavior. You are offended that a patient/family member raises their voice; ask yourself what they are experiencing at that moment; delays in diagnosis and treatment are common stressors and can mean the difference between life and death or serious permanent injury for a patient.

No, when people are stressed receiving medical/nursing care of course they don't behave as calmly and reasonably as they would otherwise. I am very surprised that this seems to be a foreign concept to you, but there are numerous continuing education courses available that could help you to further your understanding on this subject that may also increase your compassion towards your patients and their families. Without the ability to feel empathy it is really difficult to form good relationships with patients/family members.

I'll give another example; I was recently in the ED with a family member who was receiving care. From the very beginning, from triage, the nurses made poor eye contact with both of us. Body language is very important. You have to look at people when you are talking to them if you want to communicate well with them; you are not delivering a monologue; and if you do this, don't be surprised when patients/family members don't respond well to this and find you to be rude and unapproachable and become defensive.

Now, just to clarify, no-one is suggesting that abusive behavior from patients/family members is acceptable, but the great majority of patient/family member behavior is not abusive, and usually there is enough time for an observant nurse to recognize when a situation is escalating and to take steps to de-escalate it. Again, one of the ways to de-escalate patients/family members becoming upset/angry is to listen to their concerns, acknowledge them, look at them when they are talking to you, don't cross your arms when they are speaking, and show them by your actions that you are doing your best to help them."

Only three words. Get over yourself.

I had no idea how easy it'd become to spot a non-bedside nurse just by listening to their views on nursing.

You have my sympathy, OP. I'll be moving on after my year of med-surg in no time.

I believe in customer service and doing my very best to meet their needs. Most people are decent, even if they feel entitled, they will relax if they see that you're trying and that you care. I've had patient's wait 15 minutes for pain medications and still act decently when they see I'm sincerely sorry and care about their pain.

Still there comes a time that we should be able to tell a patient "there's nothing that is going to make you happy, I'm not even going to try and you're a selfish entitled pig".

If only.....

As I said - if the patient is not actively psychotic I can de-escalate anyone, but that's why they call me the patient whisperer.

Patient behavior is driven by staff actions or the patient's perception of staff actions.

Hppy

Patient behavior is often driven by their mental illness.

What you are referring to, are rational, mentally balanced patients.

Unfortunately, the incidences of mental illness are increasing in our society, and many of us see and deal with those issues at the bedside.

But please, you go right on patting yourself on the back.

I stand by my original statement.

Nothing works all the time.

If it did, there would be no Hadol shots.

If it did, there would be no Ativan shots.

CPR for doesn't work all the time.

Rescue inhalers don't work all the time.

Chemotherapy doesn't work all the time.

Nothing works all the time.

Please, if you are that good, fix the world!

Is that Susie person gone? Is it safe to go back to following this thread?

What was the advice passed out earlier? Dont make eye contact-or was that do make eye contact?'I forget...

There is a vast difference between believing:

1) I may be able to make this situation better (and if I don't comport myself professionally I may make it worse)

and

2) Everything a patient does is in response to me; I am the "driver" of the situation; if the patient is having a problem or is dissatisfied for some reason, it is in relation to me/us.

Regarding #1. I find this to be true. I don't have too shabby a record, myself, of being able to remain professional/therapeutic - which almost always results in a situation improving. I've become actually very good at this over time. A very classic (if simple) example of #1 can be found in the scenario of the intoxicated/belligerent ED patient. Most often, the flood lights are on and a handful of people are standing over/around the stretcher yelling about "If you don't stop that...." or chastising one thing or another about the patient's behavior. In other words, grown adult professionals engaged in a pi$$ing match with someone who is drunk. Meanwhile, if you lower the lights, speak in a calm/pleasant-not-perturbed-or-threatened voice, introduce yourself and your role/purpose - you will most likely be able to calm things down in about 30 seconds flat. So that's that.

But....

#2) Heck no. When appropriate professional/therapeutic decorum is maintained, I will not take responsibility for others' behaviors. Whatever is going on was in the works looong before I became involved and has nothing to do with me. You can dice this up any way you want (they're sick, they're tired, they're going through a lot, they're facing a loss, their dog died yesterday on top of everything else, the nurse on the previous shift upset them by [blah, blah, blah], the room's too cold, the room's too hot, hospitals are noisy, they had a problem and we didn't fix it fast enough) - - all of these and a thousand more were not caused by me.

This profession has let the truth of #1 morph into an idea that #2 is somehow true. It is not. It's one thing to say that if you treat someone poorly or if you engage in unprofessional behavior with a patient, you're part of the problem. It's a completely different animal to act like that means that if there's a problem, the nurse obviously has some sort of culpability. Patients' perceptions are important, but they are often skewed for a variety of reasons that also have nothing to do with me.

I will return to the personal example I gave earlier in this thread: Unbeknownst to me (until after the fact) a patient's family had their feelings hurt that I did not engage in their laughing and story-telling. Meanwhile, I was focused on providing direct and urgent intervention to their critically-ill family member. You could say I, as a professional nurse, "missed their cues" or didn't understand their manner of "dealing with stress" - and that I could've thrown a smile or a little chuckle in their direction and maybe they wouldn't have had their feelings hurt nor had reason to make snide comments about me. So I could've prevented all of this if only I would've been more compassionate and more therapeutic. Well - - - - I'm not going there. I am intuitive and perceptive, and sensitive. But I am not willing to accept responsibility for always being everything to everyone.

#1 is something to contemplate and strive toward improving upon.

#2 is what causes good people to despair.