Those hard clinical days....

[I♥Scrubs, LPN]

Just a little encouragement for my peers out there. When you have a difficult patient or someone who doesn't seem to appreciate the work you are doing, try to put yourself in their shoes. Today I had clinical 0640-1440 and my patient had me wanting to leave for the day at about 0730 because of being so rude and yelling/cussing at me every single time I entered the room. (The nurse that gave report from overnight had stated this patient was very grumpy so I expected it) but to have such disrespect when you are trying so hard...it is disheartening. But once he was eating breakfast and I had a few minutes I went to recompose myself. And I really thought hard about it. My patient had some issues with his home-life, and his diagnosis list was long! He had things from HTN, to CA, to CHF and other issues! He is obviously in the hospital because he is sick! And I thought about it, and I really think he just didn't cope with his diagnosis list. When I asked him a question, every answer was "I don't care". Could you honestly imagine having all these problems? I would probably be a bit grumpy too. Add in the pain he was in and I could understand. But each time I went in to his room I thought on this and I put on a smile and asked how he was doing. And ya know what? He became nicer to me and more manageable as the day went on. No more cussing at me or throwing things. We were even able to talk about his family and his life at home. So don't give up! Just because things may be hard on those certain days at clinical, remember why you are there, and try to put yourself in their place. See it from their point of view, it helps!

[yedwards42, BSN, MSN]

I read your post and while it started off rough (how the patient was rude/mean to you) I smiled at the end. You put yourself in his shoes and tried to not take his actions/words personally. Each time you walked in you were pleasant and professional; in the end he lost some of his frustration and became more pleasant and conversant! Your story inspires me, and I will remember it as I start nursing school in three weeks!

[WideOpenHeart]

Wow... thanks so much for sharing. That was/is a wonderful story!

[I♥Scrubs, LPN]

Just wanted to give some encouragement! I expected him to be a hard patient because the overnight nurse I got report from said this patient was very irritable and was a grumpy old man. Our first interaction was when I walked in to introduce myself and grab a set of vitals and he looked up from his bed and said to me "What the hell do you want?" (sorry if the language offends anyone) and I told him I had to get his vitals and then I introduced myself. The next time I went in he threw his utensils when he was eating on his tray and glared at me. I felt so unwelcome there. It was terrible. But I was persistent and by the end of the day we were talking about his family, he had two children and we talked about his ex-wife and what he eats at home. And this patient was in the hospital, not the nursing home. He had no mental/psychological diagnosis anywhere. My teacher later in post conference told me I should have told her and she could have intervened but she said she was proud of me for the progress I made. That felt good. Nursing can be challenging, but it is worth it, so keep your head up!

[Racer15, BSN, RN]

I don't tolerate being cussed at or having things thrown at me. I tell the patient that I am here to care for them, but that I will not allow them to throw things at me or use offensive language, and that I will be back when they have decided to treat me with the same respect that I give them. Usually works, and if not, I get security involved. Sorry, but I don't get paid enough to be physically/verbally abused! Dementia patients are a different story, but usually the patients I get that behave like that are not demented.

[nursefrances, BSN, RN]

Good job to OP for sticking it out and gleaning (learning) from this experience.

I have noticed this sometimes with older men. I have always thought this was a defense and coping mechanism for some when they were really scared. You know: Mean, chip on shoulder, "what's it to you!" attitude. But with most, I have found with patience, some chit chat/conversation they will relax and loosen up as the day goes on. Sometimes they will even share their feelings: afraid of going into a nursing home and dying there, losing their independence, they have been strong all their lives (military, hard worker, etc.) and now they see they are becoming sick and feeble. That would be scary.

Of course as one poster said, it is not appropriate to be cussed at or have things thrown at you. Get your instructor or the patient's RN on duty involved in those situations. Good luck to you. :)

[mzrainydayz, BSN, RN]

My clinical instructor always said to remember that it is not about you it is about the patient. They are depressed, angry or grumpy because their health is failing, or they got personal issues going on. I had a patient like that the first semester, I didn't know how to respond, I remained calm and talked to my patient and I found out he was having issues with a family member let alone his health was failing and he was afraid. Before I left for the day he smiled and told me thank you and he hopes I do good in my nursing program.

[brithoover]

No matter what a patient has going on in their life, there NO excuse to treat someone like that. You need to learn early on to stand up for yourself

[I♥Scrubs, LPN]

It's not like I didn't try to stand up for myself. One time I went in I asked to see his IV site and he became disgruntled. He told me to go ahead, and when I checked it he became even more rude. I then said to him that I asked to see his IV site, if he wanted me to wait a few minutes until he was done (doing whatever he was doing, I can't remember) that all he had to do is ask if I could come back in a few minutes and there was no need to be this way. He just sneered at me and ignored me. So it didn't help. That was when I took my mini break and decided to "kill him with kindness" as the saying goes. When I had to get his next set of vitals his daughter was there. I walked in and he said some rude comment and she even said to him "Dad they are just doing their jobs don't be mean to them, they are here to help you". He also yelled at my friend who is another student, my instructor and a surgeon who was trying to change his dressings on his legs. I actually felt bad for the surgeon. This guy was screaming at him and cussing at him and the surgeon didn't even say a word. In the end I think I did the right thing, and it turned out to be good because I was able to break through to him. :)

[SaoirseRN]

I do try to figure out how to get along with those"difficult" people, and usually there is a way. I don't tolerate rudeness directed AT me, but people can be as grumpy as they wish. Good for you for figuring that out, but remember, no matter how sick someone is or how many problems they have, it isn't an excuse for violence or disrespectful behaviour towards others. Empathize without becoming a target.

[arob1489]

I completely agree. I wish more healthcare professionals were like that. It doesn't matter what that patient is in for, I am a human being and expect to be treated like one. People should be a little more humble.

[Philly_LPN_Girl, LPN]

My clinical instructor told my group that same exact thing last week. I had a pt today who was kind of grumpy but didnt curse and or throw anything at me. I didnt take offense because I put myself in her shoes and I just laughed it off.

I understand that people have ways of coping, but I agree with racer, I dont care how sick you are I will not tolerate disrespect, being cursed at, or having things thrown at me (not counting psych and alzheimer pts). Being sick does not give someone the excuse or right to disrespect or hurt anyone.