What do I say to rude patients?

Tait, MSN, RN · Jul 16, 2009

Wow...I am sorry you had to deal with this.

Personally after a simple polite apology I would have told them that due to an incompatibility in care ideals I would have to refer them to the charge nurse and would have them reassigned.

Do not ever let these kinds of people beat you down.

:icon_hug:

Tait

PS. The closest I have gotten to this was when I had a patient who was very panicky about pain. She wanted to be woken up every time her pain med was due, but she hadn't slept all night. I had religiously kept her medicated with two alternating PO meds all night so at 6am I didn't wake her since she was finally resting. She called the front desk (I picked up the call light) right before shift change and told me she had been waiting for hours for her meds. I went in and she reamed me up one side and down the other for not thinking of her pain and ignoring her. I dryly told her (as I am not very good at hiding my emotions) that I had wanted her to rest. I then turned around, calmly rewrote the times on prattled on about timing and how I screwed up her schedule (which for all intesive purposes was exactly the same "two hours apart" it had been all night). I proceeded to walk out of the room without comment as she then switched gears (when she realized I was ******) and told me what a good job I had done.

I didn't feel bad at all for not doing walking rounds that morning!

meadow85 · Jul 16, 2009

I'm amazed you were able to bite your tongue for that long. If you were doing your best and they are treating you so badly then what are you afraid of? Speak to your charge nurse. Don't be afraid that they will complain to the charge nurse. You can explain your side of the story. Tell them you are doing your best and it is inappropriate for them to speak to you that in that manner. Nobody deserves that kind of treatment. I have had rude family members before and I bite my tongue, yes, when they are rude and speak you you in a demanding (telling you how to do your job) or condescending (maybe because I am younger, I don't know) tone. I let it slide the first or second time, but after that ... my thinking is "I am sorry if you are going through something and cannot deal, but please do not take it out on me when I am doing all that I can to help!". Most patients/family members are great, but there are the odd ones that are just rude/mean by nature. Don't take it personally (I know its hard) ... but also learn to stick up for yourself especially if they are making false accusations.

cariboujenny · Jul 16, 2009

I would like to understand why some pt/rt are rude. Personally, I listen until the person is done and then ask, "What can I do to make it better?" In my experience that stops them dead in their tracks. The pt were all about venting/complaining and not about any solutions. This suggests to me they are just unhappy and want to express it. :twocents:

loriangel14, RN · Jul 16, 2009

I have told pts like this point blank that rudeness is not tolerated at our hospital and totally not acceptable. If it persists then the charge nurse will have a stern word with them. We are a small hospital with one doctor and she has stepped in if rudeness and verbal abuse continues. There is no reason to accept that from pts.

flyakite80 · Jul 16, 2009

You do NOT have to take that kind of abuse from a patient. Just because you're the nurse doesn't mean you are someone's personal doormat. If someone were treating you that way in any other situation, would you tolerate it? You have rights too. There are ways of communicating to a patient (without being nasty) that you won't tolerate that type of treatment. You simply tell them you are sorry they are unhappy with the care you are giving them, that you are doing the best you can but you will not tolerate being spoken to in that way. If they continue to do so then you get the supervisor/manager involved. I don't think accepting verbal abuse is part of your job description. :nono:

nerdtonurse?, BSN, RN · Jul 16, 2009

You are a nurse, not a door mat.

I've had that kind of patient. What gripes me about these folks is that usually, they are the healthiest people in the hospital. When one was calling me everything in the book, complained to the CEO on down about the way everyone was treating him, even the poor janitor who's never tried to be anything but helpful, had the aides refusing to go back in his room alone, I walked in and slammed down an AMA form. I told him that I'd already spoken to his doctor, the charge nurse, and the admin rep (our nightshift house supervisor) and that he would either act like an adult or sign out AMA -- the doc said he wasn't going to come to discharge him, but he was going home in the morning. He was flabbergasted, and I heard later he was trying to use his multitude of complaints as a way not to pay his bill.

What you should do:

Document, Document, Document. And I mean exactly what he says, bad language and all.
When you've got to go in the room, do the meds, line change, assessment, whatever, all at one time. Get in, do what you have to do, and get out.
When I've had people really off the chain, I make a point to ask another nurse if they think the pt needs a psych eval where the pt can overhear. Usually, that clues someone in that they are over the top. And sometimes a psych eval is exactly what they need.
Notify your charge, your admin rep, your boss of the situation. Most of the time, you get, "Oh, Mrs. Smith's here again."
Treat them fairly, but don't do favors. This makes them worse, not better, and they will play one nurse off another -- "well, the dayshift nurse let me go out and smoke with a nicotine patch on" -- yeah, buddy, she was hoping you'd have an MI and go to ICU, too.
Set boundaries. If they start cursing you, say, "Sir, it's obvious you're upset, and I'll be back in 5 minutes after you've had time to calm down." IMMEDIATELY tell your charge nurse. They don't act out when they don't have an audience.
Finally....tell yourself that they eventually go home.

07302003, ASN, RN · Jul 16, 2009

With a big smile "Would you like me to get the charge nurse / my manager / the hospital supervisor in here to address your concerns? I'd be glad to."

And do it.

It shows you have nothing to hide, they can diffuse the situation and do what needs to be done. It's their job to take care of this cr@p.

Because YOU need to keep your smile and your good mood to give the very best care to all of your patients. Don't let one beat you down, ruin your day, or monopolize your time.

And I do this now because I've been in situations where these people lodged a complaint against me to management, and been written up. Now I call in management ASAP to protect myself.

NurseNora, BSN, RN · Jul 16, 2009

Yes, set boundaries. "I can't stay in the room when you use foul language, I'll leave for 5 min so you can calm down, then I'll come back and we'll continue with this." Every time foul language is used, use the same statement, leave, and come back at the time you said you would.

They do often feel frustrated and unheard, so that using a previous poster's statement, "What can I do to make it better?" and then listening carefully and trying to hear what the patient is really saying (not the words, the message behind them) often will help.

I know that some people are just a waste of oxygen, but most patients are just scared and disoriented and in pain and can be brought around to behave more appropriatly .

When I have a patient like that, I usually drop a note or email to my boss preparing her for the troublemaker's complaint that I'm sure will come. I can be more exact and express some of my frustration in a nonofficial note like that than I can be in the chart. Tell her what you did, how the patient responded, what you did to try to remedy things, and how that worked out. You know, just like the nursing process: evaluation, intervention, reevaluation and so on.

To keep yourself sane, you can be thinking up things you'd love to say to the patient but can't, "You do realize, don't you, that it's really stupid to be this mean to the person who is in control of your pain medicine." Then come back here to allnurses and share your brilliant and witty unspoken responses in the thread "Things I wish I could say to patients, but don't" OR something like that. It's here in General GAbbery

As an L&D nurse, my favorite unspoken comment is "My Lord, if you'd carried on this much nine months ago, you wouldn't be in this situation now!"

mommiof2kids · Jul 16, 2009

I have dealt with a patient's parent on more than one occasion who has been rude and abusive. I look at the parent. State "You may not speak to me that way. When you are able to speak to me in an appropriate manner then we will continue this discussion." That usually does the trick. The other choice is to ask who they would like to speak to, as stated by another post, to resolve their concerns. And if none of that works, you tell your CN that this patient is being abusive and you will not be their nurse anymore. It is your RIGHT to not tolerate abusive behavior.

Luv2BAnurse · Jul 16, 2009

Good old therapeutic communication. 'I sense that you are not happy with the care you are receiving? What would you like to see different, and how may I help?"

As always, complainers are complainers.

TheCommuter, BSN, RN · Jul 16, 2009

This might not have been very professional of me, but I have made this statement to a rude and abusive patient who was giving every staff member the blues:

"If you don't like this facility, feel free to go somewhere else for your care."