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.
Specializes in Infusion Nursing, Home Health Infusion.
I've been in home health for many years and admitting patients with follow up myself up to 1 1/2 years ago, I still talk to many for questions and some for service recovery. There have been the rare outliers, patient's and/or caregivers, that are near verbally hostile and/or completely unreasonable in their expectations.
When I read these threads though, and there are many, about this seemingly epidemic of patients demanding hotel type treatment, I have to wonder then why in their own homes they're usually so damn grateful for our service. I mean these patients are just 24-48 hrs off of your care often still anxious and hurting, and I'm not doing handstands for them, where did the belligerence and sense of entitlement go?
I do both hospital and IV home care...You are seeing the patient population that is cooperative,willing to participate in their care or their loved ones care and those that are grateful.Those demading uncooperative patients often get referred to SNFs, get put on po antibiotics (many can't be trusted with PICCs)instead of IV and use the ED as their primary care hub.Hopsitals,unlike home care,can not refuse to provide care.On occasion on home care we get the uncooperative patient and if a contract does not work and we have given them 30 days to improve, they are kicked off the service!
Specializes in Psych, Addictions, SOL (Student of Life).
The moment patients and their families became "clients".. that's where it all went downhill. I love taking care of people, but I don't get paid to be cussed at, spit on, bitten, strangled by my stethoscope, or sexually assaulted by a patient or their family member.
I miss being in critical care, but I don't miss the BS of that hospital life.
If patient's aren't clients what are they? By definition a client is a consumer who utilizes the services of a professional or other entity educated and trained to perform a professional or specific purpose.
Specializes in Psych, Addictions, SOL (Student of Life).
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.
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.
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.
Specializes in Med-Surg, Administration, Informatics.
Oh my! I think you need to get out of patient care right now! You seem to have lost your ability to care, and without caring, you simply cannot be a good nurse.
I have been a nurse for many years, and I have never had a "bad" or "problem" patient. The behavior of patients is part of what we assess. Then we make our nursing diagnoses. Then we come up with interventions to deal with the behavior. It seems you have lost your ability to do that, which means you cannot be a good nurse to your patients with behavioral problems.
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. I find that if I look at behavior as purposeful acts designed to achieve some desired outcome, then I analyze the situation and try to figure out what outcome that patient is trying to achieve. Then I try to develop nursing interventions designed to help the patient get his or her needs met without the patient becoming anxious,m angry, or disruptive. So far, I have always been able to find a way to satisfy the patient. I believe you will be able to do that too if you can change your focus from being personally offended and upset to focusing on your power and skills as a nurse to manage patient outcomes (including behavioral outcomes) through nursing interventions.
By the way, this approach is good for your emotional health and well-being too. Clearly your patients' behavior is a source of great pain for you. This means you are responding socially (being hurt and angry) to your patients' problems rather than responding as the professional nurse you are. 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.
Oh my! I think you need to get out of patient care right now! You seem to have lost your ability to care, and without caring, you simply cannot be a good nurse.
I don't know how to respond to this ridiculous, overblown statement. It seems inevitable here that some self righteous person, after reading that someone had a negative opinion of a patient, tells that person to "Get out of nursing! " or "I'd never want you as my nurse!".
I don't know how to respond to this ridiculous, overblown statement. It seems inevitable here that some self righteous person, after reading that someone had a negative opinion of a patient, tells that person to "Get out of nursing! " or "I'd never want you as my nurse!".
And to add- a user that just joined as a member today.
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.
It seems as though there are several self-righteous folks on this thread, who always know how to perfectly soothe a complaining, abusive, manipulative, and just mean patient!
Wait, none of their patients are ever less an ideal because they make eye contact constantly, wrote the book on de-escalation techniques and therapeutic communication skills.
Why haven't these super nurses banded together to solve the world's problems?
Why haven't they individually solved the world's problems?
I do both hospital and IV home care...You are seeing the patient population that is cooperative,willing to participate in their care or their loved ones care and those that are grateful.Those demading uncooperative patients often get referred to SNFs, get put on po antibiotics (many can't be trusted with PICCs)instead of IV and use the ED as their primary care hub.Hopsitals,unlike home care,can not refuse to provide care.On occasion on home care we get the uncooperative patient and if a contract does not work and we have given them 30 days to improve, they are kicked off the service!
I understand what you're saying and if I worked for a different organization that would be true. Ours is tied into an urban hosptial and we accept the most psycho-socially difficult cases that other agencies would decline with their selective options. I support my staff in dealing with these cases and try my best to help them balance and manage the service we need to provide and the behaviors of these populations.
Changing my perspective was a game changer for me, it opened the door to better managing these predictive behaviors in that I learned how to head them off before making patient contact. Going into a patient's home where the patient and/or caregivers have documented poor behaviors in the hospital stay/s and then responding to their behaviors at face value can be less successful than proactively preparing to validate the patient/caregiver experience before they act out sets a different tone and rapport going forward. Of course the outliers exist, impossible to work with, I would say most in my experience those had a personality disorder that were far beyond managing and forming cooperation, definitely beyond my skill set.
I'm sure that sounds like complete bull crap but it took me years to learn ways that can minimize if not entirely prevent both their instinctual and learned behaviors.
I haven't work acute care in decades but I've walked cold into thousands of homes over a span of 30 years, dealing with all walks of life (the articulate caregiver who with unreasonable expectations can actually be the most difficult). In years past I've ignited their aggravation, hostility and acting out and learned that my approach and attitude make a huge difference in their regard of me from the outset I definitely set boundaries but they don't I'm doing, you will never hear me say things like, "if you can't speak respectfully.. if you can't lower your voice...." And like I said in a previous post, I don't do handstands and I'm opposed to nurses who buddy up to patients/caregiver and form unprofessional relationships in order to be liked.
All that said, I understand this is a thread intended for venting the stresses hospital nurses face and no one was looking for a different perspective, certainly not from a non hospital nurse who's not relatable.
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.
Susie, honestly this sounds like someone looking to confirm a bias. Looking to be hypercritical.
Surely you know darn good and well why the triage nurse might not employ soul-boring eye contact, a gentle pat and a hand-hold for the process of sorting through patients as quickly as possible (which is the actual role of the triage nurse).
I'm sorry, but the belief system you demonstrate here is the exact sort of belief system that sets up animosity. And make no mistake, it is mutual - - because no nurse who is trying to help people deserves his/her efforts to be critiqued quite this heavily.
This reminds me of a time I did receive "patient feedback" about my demeanor (family told a couple of my coworkers that I could stand to smile more). As it turned out, they were having a family effing party in the corner of a room where I was initiating and titrating critical gtts because their family member was critically ill. I didn't scowl or shush or scold; I just paid no attention to them because I was concentrating. But you see, they became hurt because I didn't respond to their attention-seeking cacophony the way they wanted me to. To this day I could give a **** less and if I had do-overs I would simply have them removed from the room.
They didn't have any complaint about me - there was nothing to complain about - which is why they didn't make an official complaint but rather made snide comments when my coworkers entered the room. They just wanted to sow a little discord to make up for their hurt feelings.
iluvivt, BSN, RN
2,774 Posts
I do both hospital and IV home care...You are seeing the patient population that is cooperative,willing to participate in their care or their loved ones care and those that are grateful.Those demading uncooperative patients often get referred to SNFs, get put on po antibiotics (many can't be trusted with PICCs)instead of IV and use the ED as their primary care hub.Hopsitals,unlike home care,can not refuse to provide care.On occasion on home care we get the uncooperative patient and if a contract does not work and we have given them 30 days to improve, they are kicked off the service!