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.
Again, some patients are just jerks. No matter how much eye contact the nurse engages in.
You seem to want to absolve the patient from any responsibility, and their family too.
It's about more than just making eye contact. It's about one's whole conduct. Have you read the Nurses' Code of Ethics? It sounds as though you haven't, and as a licensed nurse you really should know what it says.
See my previous post for what I said about actions nurses can take to de-escalate patient/family member behavior when they are becoming upset or angry.
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.
But YOU are suggesting that abusive behavior from patients is acceptable.
Stalking behavior is not acceptable. It is NEVER acceptable.
I work in psych; believe me, I know my deescalation techniques. There is a line. Interestingly enough, the psych patients I work with rarely go over that line. They will hit, kick, scratch and scream under duress but that is their diagnosis many a time. I have had their family members rant at me and that was because they are feeling a wide range of emotions, all stemming from the fact that their loved one is in such a place.
When I get floated to the other parts of the ED - THAT is when I see patients, and their families, behaving badly. Yelling about remotes, complaining that their room has no view, interrupting staff members when they are interacting with other patients and becoming verbally abusive when informed that they will be taken care of momentarily.
There is a line where their stress and duress can explain only so much. Complaining? Ok. Yelling obscenities? No. Stalking? No. Throwing? No. Do I receive this behavior a lot? No. But I shouldn't receive this behavior at all, nor should any nurse, tech, respiratory therapist, PT, OT, physician...
What you are describing is a system issue. Nurses don't diagnose. We are not in charge of ratios, though we can (and do) advocate for better ones.
I can suggest a few continuing education credits for you if you'd like, to understand the differences between compassion and empathy versus apathy and abuse? I'm surprised you don't know the difference ...
It's about more than just making eye contact. It's about one's whole conduct. Have you read the Nurses' Code of Ethics? It sounds as though you haven't, and as a licensed nurse you really should know what it says.
See my previous post for what I said about actions nurses can take to de-escalate patient/family member behavior when they are becoming upset or angry.
Oh, please.
I simply used one of your examples.
I've worked in psych, I understand how to de-escalate a situation.
I was also a member of the media for 15 years, so I understand the importance of trust and how to build it.
Your insistence on blaming nurses, and specifically younger nurses, is tiresome and incorrect.
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.
I think that all nurses have been trained and know how to de-escalate. The problem is when the nurse either doesn't have time for therapeutic communication, or when it doesn't work. Not everyone will respond to the textbook result. I have been hospitalized (prior to becoming a nurse and after) as well as had family go through very serious events and I would never get angry because the nurse (or any staff) didn't make eye contact (although I agree it would be nice); nor would I spit, kick, hit, throw my food tray or other objects, scream/yell, demand to be seen by the nurse/MD/staff immediately even after told they are not available at the moment, demand a new food tray by screaming in the hallway bc I don't like meal even though that is what I ordered, call the nurse every name in the book, I could go on forever but I think you get it..
The problem is not the nurse, the problem is systemic in the hospital and admin. The nurse can only work with the resources (human/physical) available. I don't know how you can read through this thread and come up with the fact that the nurse can control the hospital situation. There are many other moving parts out of the nurses control.
As Lil Nel stated, some people are just jerks (to put it mildly) and that is there behavior in and out of the hospital and the nurse not only cannot change that but should not have to put up with that. The patient and family should be held accountable for their bad behaviors and they are not, hence this thread.
But YOU are suggesting that abusive behavior from patients is acceptable.
Stalking behavior is not acceptable. It is NEVER acceptable.
When I get floated to the other parts of the ED - THAT is when I see patients, and their families, behaving badly. Yelling about remotes, complaining that their room has no view, interrupting staff members when they are interacting with other patients and becoming verbally abusive when informed that they will be taken care of momentarily.
There is a line where their stress and duress can explain only so much. Complaining? Ok. Yelling obscenities? No. Stalking? No. Throwing? No. Do I receive this behavior a lot? No. But I shouldn't receive this behavior at all, nor should any nurse, tech, respiratory therapist, PT, OT, physician...
.
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."
I think that all nurses have been trained and know how to de-escalate. The problem is when the nurse either doesn't have time for therapeutic communication, or when it doesn't work. Not everyone will respond to the textbook result. I have been hospitalized (prior to becoming a nurse and after) as well as had family go through very serious events and I would never get angry because the nurse (or any staff) didn't make eye contact (although I agree it would be nice); nor would I spit, kick, hit, throw my food tray or other objects, scream/yell, demand to be seen by the nurse/MD/staff immediately even after told they are not available at the moment, demand a new food tray by screaming in the hallway bc I don't like meal even though that is what I ordered, call the nurse every name in the book, I could go on forever but I think you get it..
The problem is not the nurse, the problem is systemic in the hospital and admin. The nurse can only work with the resources (human/physical) available. I don't know how you can read through this thread and come up with the fact that the nurse can control the hospital situation. There are many other moving parts out of the nurses control.
Show me where I've said that nurses can control the hospital situation. And because you managed to cope with the stressors you were faced with in your specific situation when you were hospitalized this doesn't imply that everyone else will be able to cope as well with their own individual stressors (which may be worse than yours) when they are hospitalized, so what is the point of generalizing that comment to patients? You surely don't expect your patients to be just like you?
I think that all nurses have been trained and know how to de-escalate. The problem is when the nurse either doesn't have time for therapeutic communication, or when it doesn't work. Not everyone will respond to the textbook result. I have been hospitalized (prior to becoming a nurse and after) as well as had family go through very serious events and I would never get angry because the nurse (or any staff) didn't make eye contact (although I agree it would be nice); nor would I spit, kick, hit, throw my food tray or other objects, scream/yell, demand to be seen by the nurse/MD/staff immediately even after told they are not available at the moment, demand a new food tray by screaming in the hallway bc I don't like meal even though that is what I ordered, call the nurse every name in the book, I could go on forever but I think you get it..
The problem is not the nurse, the problem is systemic in the hospital and admin. The nurse can only work with the resources (human/physical) available. I don't know how you can read through this thread and come up with the fact that the nurse can control the hospital situation. There are many other moving parts out of the nurses control.
As Lil Nel stated, some people are just jerks (to put it mildly) and that is there behavior in and out of the hospital and the nurse not only cannot change that but should not have to put up with that. The patient and family should be held accountable for their bad behaviors and they are not, hence this thread.
Nicely said, Daisy.
I learned working in psych, that de-escalation techniques don't always work.
Unfortunately, in life, there are no magic wands, only human beings, doing the best they can, in most cases.
I don't make a ton of eye contact with obnoxious patients. I have very little trouble. I'm known in my department for my uncanny ability to keep everyone calm and avoid confrontation. I can find something in almost anyone to make some sort of human connection.
I think a demeanor of detached concern is vital. Their problems are not my problems. I explain stuff a lot and always offer a blanket or some other small nicety.
It's vital to not take any of this stuff personally. Also, because I am older, I can gently pull the mother card. I can scold for cussing etc. "What would your mother think of that language?"!
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."
Show me where I've said that nurses can control the hospital situation. And because you managed to cope with the stressors you were faced with in your specific situation when you were hospitalized this doesn't imply that everyone else will be able to cope as well with their own individual stressors when they are hospitalized, which may be worse than yours, so what is the point of generalizing that comment to patients?
Well, it seems that you believe that the nurse can de-escalate any situation (no matter what the problem is). When patients are upset about issues that are beyond the nurses control (ie systemic problems) that will not happen because (obviously) the nurse has no control over that, this upsets the patient/family even more because 1) they already don't have what they want and now 2) the nurse is telling them they are not going to get what they want or, heaven forbid, they will have to wait.
add r/t you added comment: No, I don't expect everyone to behave like me, but I do expect a certain level of civility and I do expect admin to step in when the patient/family is abusive.
It's vital to not take any of this stuff personally. Also, because I am older, I can gently pull the mother card. I can scold for cussing etc. "What would your mother think of that language?"!
HaHa, I am older and do this too, I use the mother tone, it works most times...
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guest52816
473 Posts
I don't see that at all.
Again, some patients are just jerks. No matter how much eye contact the nurse engages in.
You seem to want to absolve the patient from any responsibility, and their family too.