I'm so over it. I'm so over dealing with ahole patients who are so entitled and disrespectful to staff and think that they are in some damn hotel with room service. I'm so over management choosing to side WITH these patients and not backing up staff. I am tired of the ridiculous pay, the crazy assignments, over-the-top patients, the cliques, and how hospital-based care is now some big business and how I am a glorified pill-pushing waitress. I'm tired of patients cursing at me, lying, manipulating and everything.
I'm tired of not feeling supported by management. I don't feel like I can talk to my manager. I am no-nonsense and I don't tolerate absolute disrespect or cursing from completely alert and oriented young people. Yet the manager thinks *I* am the problem and states I should take a class in how to deal with difficult patients....but seems to forget that these patients have a tendency to fire MULTIPLE nurses and even entire hospitals/nursing homes.
No. Nurses aren't the problem. PATIENTS and SOCIETY are the problem. Don't get me wrong. Not every patient or their family is bad...but the ones who are rotten ruin everything. And they are becoming more frequent.
Am I the only one who thinks nurses shouldn't have to put up with nonsense? We should be allowed to say that being cursed out or told to shut up by "with it" patients is unacceptable. Would you go over your manager's head to the Director of Nursing to have this addressed?
I am ready to escape the bedside. I am done with adult med/surg (which I do on a contingent basis). Any other contingent jobs out there that are decent paying and not at the bedside? I am done with acute care for adults...it keeps getting worse and worse.
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.
Yes, of course, to everything you wrote.
And let us not forget, those patients suffering from Borderline Personality Disorder.
Nobody can de-escalate them, unless THEY want to be de-escalated.
They thrive on the attention, no matter how negative.
Frankly, I am sick of these super nurse types.
Again, they need to go out and heal the world, if they are as good as good as they claim, and believe themselves to be.
Specializes in hospice, LTC, public health, occupational health.
And let us not forget, those patients suffering from Borderline Personality Disorder.
Having been raised by one, I can assure you that people with BPD do not suffer from their condition. Any and every negative consequence of their behavior is enjoyable to them, because it's further evidence to bolster their belief that everyone is against them. *insert image of damsel with hand on forehead here*
Having been raised by one, I can assure you that people with BPD do not suffer from their condition. Any and every negative consequence of their behavior is enjoyable to them, because it's further evidence to bolster their belief that everyone is against them. *insert image of damsel with hand on forehead here*
The rest of us suffer.
I took care of several BPDers during my time in psych. And I've run across several in subsequent jobs.
*shots fired* This should get interesting fast. I have to wonder if the gratitude has to do with you showing up when promised and doing the care they need.
Having been on both sides in the hospital, most memorably as the mother of a child in ER after a car accident whose call light went unanswered for over 20 minutes, and as the busy CNA responsible for 13 tele patients who couldn't get out of a contact room to answer the call light for over 12 minutes, I think much of the attitude and frustration comes from not just feeling ignored but *actually being ignored.* I know staffing ratios suck and it's hard, but I'm sure it's contributing. When I was that CNA, I worked with nurses who wouldn't answer a call light if a patient was on fire. Not saying anyone in this thread is like that, but I know it was a major problem where I worked and it created huge patient safety issues because patients would give up on getting help and get up by themselves.
Now that you are an LPN, do you understand that a nurse has duties that might need to come before answering a light?
Specializes in Psych, Addictions, SOL (Student of Life).
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!
I do so love it when something I said is taken out of context. For the record part of effective commination is to not to allow your argument to be clouded by emotion as it takes away from your credibility.
For the record I said: For a non-psychotic patient de-escalation when properly applied always works. The problem is that most nurses and it's not their fault don't know how to properly apply it. It takes more than a CEU class or annual in-service to learn these techniques. They need to be practiced with intensive role-playing which few facilities have the time or budget for.
Again my comment about patient behavior being driven by staff was not about the mentally ill patient which I clearly stated. The mentally ill patient requires and even higher level of training and depending on their psychosis may not be able to respond to de-escalation. Haldol and Ativan when given as an emergency injection is considered chemical restraint and a facility and nurse better be able to document all the level's of non restraint used prior to their implementation.
I also never said I wanted or could save the world. To do so would require a much larger skill set than I have. I'll leave such errands for the crusaders. Going back to my corner of the sandbox now.
Specializes in Nursing Education, Public Health, Medical Policy.
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.
Specializes in Mental Health, Gerontology, Palliative.
I think part of the problem for at least you all living in the US, you live in a country where people can successfully sue when they dump hot coffee in their own lap
It seems your managers are so terrified of lawsuits that they have lost the ability to actually stand up for their staff
Violence against staff is not tolerated here, people get arrested and charged
Specializes in Mental Health, Gerontology, Palliative.
Also, for the capable patient:
Patient: I need you to fix my pillow.
Me: Well, part of your improving is your ability to do things for yourself. You fix the pillow.
Patient: (pathetic) I can't.
Me: I'm sorry it's so difficult. Let me fix the pillow for you. I'm going to put in an order for case management to see you, assess you, and I expect you'll need extensive recovery in a Nursing home. We will ensure you are given the care you obviously need. I expect a two to three month stay in a nursing home should get you to where you need to be.
Patient: Fixes own pillow/wipes self/helps moves self
Me: Or if you continue to make the improvements you've shown here, you may be able to go home! It's amazing how much you can accomplish on your own.
And for the leacherous male who all of a sudden becomes unable to lift his willy into a urinal, I recommend completing the task using sharp tooth forceps
I do so love it when something I said is taken out of context. For the record part of effective commination is to not to allow your argument to be clouded by emotion as it takes away from your credibility.
For the record I said: For a non-psychotic patient de-escalation when properly applied always works. The problem is that most nurses and it's not their fault don't know how to properly apply it. It takes more than a CEU class or annual in-service to learn these techniques. They need to be practiced with intensive role-playing which few facilities have the time or budget for.
Again my comment about patient behavior being driven by staff was not about the mentally ill patient which I clearly stated. The mentally ill patient requires and even higher level of training and depending on their psychosis may not be able to respond to de-escalation. Haldol and Ativan when given as an emergency injection is considered chemical restraint and a facility and nurse better be able to document all the level's of non restraint used prior to their implementation.
I also never said I wanted or could save the world. To do so would require a much larger skill set than I have. I'll leave such errands for the crusaders. Going back to my corner of the sandbox now.
Hppy
For the record, communication. You misspelled the word.
LOL if you think my response "clouded" by emotion.
You and I don't know each other. My emotions don't run high for strangers.
I am sure your "patient whisperer" skills are need somewhere in the sandbox.
Specializes in Mental Health, Gerontology, Palliative.
And I have learned in psych that unless the patient is actually psychotic all negative behavior from a patient goes back to the actions of the care team and de-escalation when properly applied in a timely manner always works.
Hppy
I'm talking about 20 years ago, I'm going to tell you a story.
This was way back when I was seriously out of control, mental illness had a grip. I was sectioned and the only way I had control was in self injury and suicide attempts. I was a pretty foul human being to be around alot of the time.
I remember my treatment team wringing their hands one day and couldnt understand why I had threatened to physically hurt a particular nurse if they came anywhere near me again.
Me being the naive person that I am was like "go read the notes that will tell you what you need to know"
It wasn't until I got a hold of my notes about 10 years after the fact that i found out nothing had been documented about that night that was a precursor to me threatening grievous bodily harm
See what had happened was during a stinking hot night I had walked out of the room looking for a window that I could get fresh air out of. (I had been put on room boundaries for self injury). I was told I had to go back to my room and I said I would in a few minutes. I walked back to my room on my own accord litterally two minutes later. The door slammed shut after me and about another few minutes 6 nurses came in and told me that because I hadnt been compliant I was going to be placed in stitch gear and secluded.
Of the 6 nurses, 4 were male, 2 were female. As FIFTH as I was I recognised that it could be a safety issue and asked that if the male nurses couldnt leave the room could they at least turn their backs to allow me some semblance of privacy. The nurse i mentioned told me "they arent going to go out of the room, they arent going to turn their backs, and if you dont strip and put on the stitch gear, we will force you.
Having been the recent victim of rape, I was like "hell no" needless to say it ended up me being forcibly stripped and in my dissociating from my body getting traumatised by the people that were supposed to be helping me. Which resulted in me saying that if that nurse came anywhere near me, I would beat the crap out of her
The point of this long winded story? Sometimes bad stuff happens and there is absolutely nothing we could have done to change the outcome.
We should always look at our interactions with patients to see if there is anything we could do differently to achieve a different outcome.
Forcing me to strip naked in front of six staff including four male nurses wasnt about safety, it was about humiliation pure and simple.
guest52816
473 Posts
Yes, of course, to everything you wrote.
And let us not forget, those patients suffering from Borderline Personality Disorder.
Nobody can de-escalate them, unless THEY want to be de-escalated.
They thrive on the attention, no matter how negative.
Frankly, I am sick of these super nurse types.
Again, they need to go out and heal the world, if they are as good as good as they claim, and believe themselves to be.