I've been a nurse for a long time and I've had many patients who have tried my patients. However, I've never had a pt fire me.
About 3 weeks ago, I had a pt. a/ox3, pleasant, up ad lib. The first 9 hrs of shift was great. I tended to pt, provided pain meds, assisted to RR, etc. Everything was great. Suddenly, the pt just started crying hysterically, called a friend, threatened to leave AMA, then said I was a horrible nurse the whole shift. Didn't want me back in the room. Told of staff members complete lies about the care. Thank goodness I had been charting the whole shift on everything. The staff told me to not let it bother me, but how do you not let it bother you? This person was saying things that could have got me in trouble and yet, I did nothing wrong. Plus, why couldn't the pt just have handled it better? Screaming your lungs out is not appropriate. I understand when in hospitals, pt's feel like they have no control over their health, they hurt, are scared, etc. But really? To insult and lie like that about your RN who there to help you and who is bending over backwards to keep you comfortable,safe,healthy? I've spent the last week trying to let it go ,and I should. But, if does bother me. How do you just let it go? I have now changed my whole nursing approach to being almost too nice. I feel like I am becoming a mat and letting some pt's walk over me,because of this one incident.
I so don't miss working in a hospital. I either hated the patients or their families. Something about the hospital really makes otherwise sane people freaking whack jobs.
The first time I had her she was coming back from a test and had a lot going on. She had compression stockings, IV, wound vac and an NG tube. She wanted to sit in the chair instead of going back to bed so I got the chair all padded with pillows, got her over there, got all the chords and the IV pole situated and made sure everything was plugged in and gave her the call bell. As I was finishing up her husband and the doctor walked in. I asked if she needed anything and she just shook her head no and I left her to talk with her doctor.
About ten minutes after the doctor and husband left I went in to check on her and as I'm straightening up she starts whining and crying and asking why I abandoned her like that. I turned and looked at her directly because at first I wasn't sure if she was really talking to me or someone on the phone. She then asked why I wasn't answering her and again asked me how I could abandon her. I asked what in the world was she talking about because I sure as heck had no idea.
She then went on to whine about how I just left her there and how nothing was plugged in and how she was in pain and all this other garbage that was just a flat out lie. I just looked her right in the face and said. "First I did not abandon you at all. When I left you husband and the DOCTOR were in the room and I did ask you if you needed anything and you shook your head no. If in fact you were in pain or needed something you should have told your doctor while she was in the room or used the call bell to call the nurse so she could get your pain meds. I'm just a PCA and I know I did my job and your not going to sit there and lie and say I didn't." Harsh? Maybe, but you know what? She never complained after that and we got along just fine for the next 6 days she was there.
I think that's just the culture on our floor though. None of our nurses or techs take crap from any of our patients or family members. Now this doesn't mean that we are verbally abusive or do passive aggressive stuff in any way but if there is nothing mentally wrong with you and you're being obnoxious you're getting called on it. 99% of the time there are no issues after that.
I do know when I got report from the RN who was taking care before my shift made the comment, 'alot of the other staff has had problems with her', so she was probably just that pt who complained about everything. I think the part that really upset me most was her false accusations. Anyway, its over,pt is not there anymore.
You have a wealth of helpful advice in the previous comments. Here's my take:
Don't take it personally. There are many reasons someone might exhibit such behavior. Check their vitals and bloodsugars, double check their meds, and tell the charge nurse. Then literally move on.
As someone else said, I would also call a patient representative or social worker.
You'd be surprised how many patients are fine all day, no pain, no nausea, never need anything every time you check on them and then the family comes and they become a hysterical crying mess. Suddenly the family is out there following you around the unit, asking the nurse for pain meds for this patient and all other kinds of things.
I wonder if the friend put some idea in her head...
Can u confront the patient? I don't tolerate behaviour like that from anyone now.
This patient was deflecting her built-up anger and frustrations (which could even be sub-conscious frustrations) out on you. Think about it: you were with her all day, she got a knot in her knickers about something (usually it's trivial stuff), and then decides you're the target. I've seen psych patients go off at the slightest, measly thing that wouldn't even bother a normal person.
The patient obviously had some unknown maybe psych issues. Usually you get this behaviour from BPD or bipolar disorder patients. And it's horrible when someone suddenly starts yelling at you - we say it doesn't bother us but it does.
The pt had issues. Better for you to confront her, or if she's been d/c, do things that calm you or write a journal every day. Also do pilates/yoga, go walking or talk to a close friend/acquaintance who is a nurse.
Three cheers to you for documenting everything - you are very smart! And maybe the hosp should flag this patient as having psych issues that haven't been explored.
I went to talk with the pt once her friend arrived, but that is when she was yelling and wouldn't allow me the chance to talk. I just left et called nursing supervisor. It was so sudden, just very bizarre. I am not sure if the pt had psych issues, but you don't just change your behavior like that, unless there is something wrong. Iam glad I was able to vent on here with other RN's. I tried not to let it bother me, but it did. I know I did everything I could for the pt, I documented everything. I never heard (as of today anyway) from the hospital or director on unit, so I'm sure the pt was d/c and nothing more will come of it. All of my co0workers told me it wasn't my fault and not let it get to me. I feel like I've got good support there.
I've more good compliments from pt's then bad, so I think I am doing a pretty good job :)
SuesquatchRN, BSN, RN
10,263 Posts
I so don't miss working in a hospital. I either hated the patients or their families. Something about the hospital really makes otherwise sane people freaking whack jobs.