The rudest thing that's ever been said to you by a patient or family

BonnieSc · Jul 9, 2016

"You're no nurse! Where did you go to school?" I don't even remember what that one was about. At my hospital we all get a lot of these... our population has a lot of people with mental illness, poor coping, poor social skills, unreasonable demands, etc.

For the most part I either ignore the comments or say something along the lines of "I'm sorry you feel that way" and leave it at that, which sometimes they don't have an answer to but sometimes irritates them more. But I don't think I have ever "won" a power struggle with someone who says, for instance, "You aren't doing anything to take care of me!" and then I try to list the things I've done.

However, as a charge nurse, if another nurse asks me to step in and diffuse a situation, I sometimes do get through to a patient by pointing out the good things the nurse has been doing. I think trying to do that when you stand accused just puts yourself in the wrong and gives the patient or family member more power.

"If you would prefer to have a different nurse we can arrange that" is our statement of last resort--you have to be sure your team really will support you in saying that. The patient/family usually seems a little bit ashamed and drops it.

Once a nurse with decades of experience came to me when I was in charge, holding a lovenox shot, and said "The family doesn't trust me to give this shot, will you do it?" I laughed, because this is a nurse I look up to enormously and always go to when I have questions. The nurse was matter-of-fact and casual about it; she wasn't going to let it bother her. Rather than argue with the family, I just went in, gave the shot, and left. I made pleasant conversation with them and also asked if there was some problem. They said "Well, I think she probably just isn't very experienced, I'm sure she's very nice"--I told them pleasantly that she was the best and most experienced nurse we had and they could trust her completely. I think there was an element of racism/xenophobia to that situation. The nurse was from another country/race and has a very thick accent; the family volunteered that "the nurse we had last night was so great!"--this was a nurse with two months of experience, a pretty young white woman. That's another thing we deal with a lot because our staff is very multicultural.

TheCommuter, BSN, RN · Jul 9, 2016

What's the rudest thing that's been said to me by a patient or family?

A patient called me a black ___ (rhymes with 'witch,' but starts with 'B') and told me to "go back to Africa." I told him I was born and raised in the US, as well as the preceding six generations of my family.

I also ended the interaction and turned his care over to another nurse who belonged to the same racial group as him. Life is too short to deal with people who stereotype me and do not want me around.

meanmaryjean, DNP, RN · Jul 9, 2016

"You have no idea what it's like to have a sick child!"

I have four kids, all of whom have been hospitallized, two in ICU, one needing ECMO. So yes, I DO know EXACTLY what it's like.

AutumnApple · Jul 9, 2016

To answer your question: All the comments (not just from men believe it or not) that were implying I was going to get by life on my looks. There were many different varieties of these comments, but they all said the same basic thing: "Oh, you're cute. I can see you doing well as a nurse." Some were more aggressive, some less, but same bias.

I am one who took things personally as well for a couple years. That stopped working though. As much as we like to tell ourselves we can simply ignore them or, the patient is sick so we shouldn't take it serious, eventually they start to chip our armor. Forty hours a week, every week, for two years leads to having to absorb a lot of rudeness in our profession. If you rely on just absorbing the blows, you'll crack eventually and end up saying something you regret or (sigh) being burnt out.

How I approach it is, I remember where I have explicit control versus implicit control.

1. Implicit: Not directly stated, only suggested. Indirect.

2. Explicit: Clearly and concisely stated, nothing implied. Direct.

When it comes to patient rudeness, I have implicit control. I can point out the statements they are making are not necessary or not helping, but they are not obligated to change their ways. I'm not their mother, in fact, I'm there to help them, not parent them. This does not mean mentioning that the statements are not necessary is a bad idea. It just means, don't be upset or disappointed when you don't get the reaction you wanted. I can respond with kindness (always the best first response to rudeness, whether you are on the clock talking to a patient or out in public) but again, my control over their behavior is implicit.

If the comments continue, and I've exhausted all my 'implicit' options (make it clear the statements are not welcome, respond with kindness, sometimes I let them be for a while in case I had just walked in during a bad moment) I have no other option but to begin exerting pressure where I have explicit control.

Things I have explicit control over:

1. Their care. Use the nursing process when someone's behavior is repeatedly tainted with rudeness. First assess whether something about the care is not working for them. Is their pain managed? Are they incontinent and not being cleaned up often enough? Is a room mate keeping them up at night? A lot of times, you will find something that is souring their mood a bit. Once you find the problem, continue on through the nursing process and solve it for them. Wait and see if the rude comments cease, or at least are reduced.

2. My time in the room. If step 1 has been done and I found no problems or the rudeness continues, I then move forward with the knowledge that either I can't fix their problem, or they are just rude all the time. Either way, I adjust the amount of time I leave myself open to the rudeness. I am not suggesting you avoid them though. What I am suggesting is to implement teamwork. Tell the CNA assigned to the patient that said patient is "a bit sour today and not liking the sight of me much" or however you wish to phrase it. I often left it at "there are personality differences in that room." Have them spend a little extra time with the patient, see if they get the same results. Ask a fellow nurse or two to help out and go in to say 'hello' once in a while for no real reason. With the added attention from them, the patient is less likely to be annoyed with not seeing you as much. Go in when you should for monitoring and meds, but let them lead the conversation. For me, it rarely had to go any farther than this intervention. It allows people who are just grumpy to deal with you and others in short bites that they swallow better. It also helps if they just don't like you because of personality or whatever. (runs around in circles, arms flailing in the air "Help help, someone doesn't like me, call a code)

3. My assignment. If the problem escalates, ask for a change in assignment. Don't do this in a judicial way with the patient though. Avoid giving them the impression you are somehow 'firing' them as a patient (people do it). Just accept that it might be a personality thing that you can't get beyond no matter how professional you are. Plus, giving a new nurse gives a new set of eyes that might do step #1 again and find something.

4. My life outside work. Once you clock out, it's done. But this is easier said than done. Everyone preaches not taking work home with them but, I rarely see much though put into how to actually do it. My finding is, not taking work home with you begins, at work. If I am upset about something and hiding behind the nurse station gossiping about it, I'm more likely to take it home. What works for me is, I allow myself five minutes to vent if I need, and once that is done, I do not talk about it. No need to keep adding logs to the fire. This 'forced silence' allows me to then refocus on other, more constructive things. By the time I am ready to clock out for the day, I've probably gotten over it all. If not, same rule applies at home. Five minutes to rant to whoever it is I'm talking to at home, then it's done. I find something to do if I need a distraction.

Obviously, you don't want to be 'that nurse' who needs their assignment adjusted every flipping week because they have a personality conflict with a patient. I only made it to step 3 a handful of times in my career. I was 'fired' by a patient a few times too. But this was not my usual or my baseline so, no one thought anything of it.

Debilpn23 · Jul 9, 2016

What's the rudest thing that's been said to me by a patient or family?
A patient called me a black ___ (rhymes with 'witch,' but starts with 'B') and told me to "go back to Africa." I told him I was born and raised in the US, as well as the preceding six generations of my family.
I also ended the interaction and turned his care over to another nurse who belonged to the same racial group as him. Life is too short to deal with people who stereotype me and do not want me around.

Totally agree Commuter.

meanmaryjean, DNP, RN · Jul 9, 2016

What's the rudest thing that's been said to me by a patient or family?
A patient called me a black ___ (rhymes with 'witch,' but starts with 'B') and told me to "go back to Africa." I told him I was born and raised in the US, as well as the preceding six generations of my family.
I also ended the interaction and turned his care over to another nurse who belonged to the same racial group as him. Life is too short to deal with people who stereotype me and do not want me around.

What the hell is wrong with people?

nikkole318 · Jul 9, 2016

People are always saying not to take your work home with you, but I think you def cannot help it at times, the good and the bad.

nikkole318 · Jul 9, 2016

I agree that there are some patients who just need to vent. Sometimes just asking them what's wrong goes a long way. Other times, patients are mad at you for providing care. Haha.

nikkole318 · Jul 9, 2016

WOW! Yeah, that is rude. It seems like people forget that nurses are people too, with their own struggles. What did you say?

nikkole318 · Jul 9, 2016

That is so messed up. What is wrong with people?!?!

That last part you said is an excellent point.

AutumnApple · Jul 9, 2016

I agree that there are some patients who just need to vent. Sometimes just asking them what's wrong goes a long way. Other times, patients are mad at you for providing care. Haha.

Dealing with people who are, as you put it, "Mad at you for providing care" is a reality in nursing. We, being the professionals in the story, have to learn to manage the problem or, we become bitter and tired from it.

This reality is why I believe a 'retail customer service' approach to delivering care will never work.

With retail customer service, the customer has a need and chooses to go to the store to fill that need. I need a microwave. I go to Wal-Mart. I select the appliance that suits my needs best, get the decide how much I am willing to spend. I even get to pick which store to go to if Wal-Mart doesn't make me happy.

It's not the same in healthcare. No one goes to the ER and says "I'll have an order of COPD, make that a value chronic illness. Hold the steroids, extra breathing treatments.".

Illness forces them there, they want the illness to stop but in the grand scheme of things, they don't want to be there at all. With the retail example, there were many more choices, less of a 'loss of control' taking place.

So, the way to deal with one is not going to work with the other.

Never forget that. As much as we joke about there being 'professional patients' and the like, most of our 'customers' don't want to be there at all and didn't want any of our services. They just don't have much say in the matter.