When patients and visitors are rude

Nurses Relations

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I feel sorry for nurses who post (I know they are just venting) how obnoxious, demanding, ridiculous, rude, patients and family are, or will become, because hospital reimbursements (medicare) are tied into patient satisfaction. Or even somehow the ACA is going to cause patients to be more demanding.

I have worked bedside nursing in county and private hospitals for 30 years. I can't believe I am just lucky and never encounter patients or family who are so inappropriate?

When I do encounter them (yes I guess I have) I go into automatic pilot, I don't even consciously think about it, I had to Google "how to react to rude people" to realize what I guess I do without thinking. (I wish I could go into automatic pilot in codes....I freeze up and can't think at all!)

"Don't give their behavior more thought,"...... must obviously be my first reaction because I immediately forget (except for really rare occasions) what they said or did....."their behavior is out of character for them"...."they are not trying to hurt you personally, they do not care about your feelings"..."they have their own issues." (We are talking health care here...maybe they have some serious issues and concerns you don't even know about.) "Do not engage them......you don't have to prove yourself."

Really, honestly nurses, they are not out to get you! Validation of their feelings is almost 90% of the time all they want, even if you really don't agree with what they are complaining about, they believe it so just say...."yes I can see why that upsets you...I understand why you are so angry....that must really make you mad..."

If it gets to the point of fearing for your physical safety your institution is mandated to have in place a "code" to call for help with violent patients or family. Yes, I know it can get to this point...I have seen it.

Honestly if you find yourself frequently encountering rude demanding patients and family maybe it is time to think about what attitude you are giving them that they react this way?

If you can think of nothing else think "raise them to my level, don't lower myself to their level."

Really honestly nurses, they are not out to get you! Validation of their feelings is almost 90% of the time all they want, even if you really don't agree with what they are complaining about, they believe it so just say...."yes I can see why that upsets you...I understand why you are so angry....that must really make you mad..." If it's just "I'm sick/stressed - I'm not usually like this...." I let it slide. After so many years, I know genuine distress causes some strange reactions, and I don't care if they say please or thank you. Just be civil - no screaming, no swearing, no aggression. Old fashioned RESPECT. The sad truth is most people are pigs, and the BEST they will get out of me is stony silence.[/quote']

Nothing gives anyone the right to yell, scream, insult, or throw things. Nothing. People can be as grumpy as they want but I draw the line at when their behaviour is negatively directed toward myself or coworkers.

I do hear what you are saying, to a point. But there is no excuse to be horrible to another person, not even illness or stress. I will call them on the behaviour, establish boundaries, and then see what can be done to work out what is bothering them. "I can see you are having a difficult time. I am here to help, but I can't do that when you ABC," followed by, "I will be back in a couple of minutes, and we can start over." Often that breaking of the cycle is enough to change the behaviour, and makes for a better time for both the patient/family and myself.

Somebody who says, "I am sick/stressed, etc, I'm not usually like this." has already acknowledged that they've done wrong and we can work on ways to redirect their emotions.

As to the no please or thank you, it's about tone and it's about that respect you speak of. A respectful person may not always say those words, but their way of being is polite and thankful.

People who constantly demand things, "Get me water, get me a blanket" and then don't offer a thank you? I will remind them that while I am happy to help get these things, I am not a servant and would appreciate some manners. I also see nothing wrong with setting that boundary, either.

The only way is getting out of it. I know lots of nurses who get fulfillment and joy from taking care of people at the end of the day event bough the job is highly stressful. For people like myself, I get no fulfillment or joy whatsoever from taking of people. It's not cuz I am a psycho, but the joy of helping others get shadowed by high stress from management, admin, backstabbing coworkers, unappreciative clients, families, and people like me should not do nursing let alone bedside.i am looking into quitting the medsurg unit and get into ER, OR. Maybe it's the medsurg unit that burned me so quickly...

sorry, but when I have more work that can realistically be done in my 8 compensated hours, I'm hungry and thirsty, my feet and back hurt.......validating a rude individuals feelings is not going to happen. more importantly, i'm not going to make the patients who are in need of their meds/treatments wait any longer than necessary just because one patient wants to exert their control over everyone.

Rude demanding patients, although mind blowing and adding stress to an already stressful day, are not out to "get you" personally. There is a difference between personal and professional.

I have probably said this ad nauseum, however, there's resources available. If a patient is demanding and over the top, then call the social worker, the case manager, some hospitals even have patient relation nurses. Which is perhaps where a bachelor's prepared nurse would rather be than at bedside. However, most hosptials will only hire BSN's as bedside nurses, so "cleaning literal crap all day" is what facilities seem to want in a BSN.

There are rude, nasty, entitled people everywhere. It is not exclusive to nursing. Unfortunetely, we have the corner on rude, nasty, entitled people who are also ill. Yay us.

Specializes in neuro/med surg, acute rehab.

I work at a hospital with a challenging patient population (inner city, no insurance, lots of noncompliant drug using frequent fliers) and we are all used to it and I think some days it does get to us nurses but we vent to eachother (in the break room or med room) and it makes us feel better to not feel alone.

Also, it's not just us - the other staff and the doctors get a lot of it, too. I remember a few weeks ago one of my very disagreeable patients called a cardiologist a bad name right to his face - um, it was the word dick and the word face put together (not sure if allnurses will let me write dick, it is a male name!) and that doctors was ANGRY and later I heard him complaining to his peers about the SAME THING this post complains about. Anyway, just wanted to say it's not just nurses that get it, we just get the brunt of it because we are there ALL OF THE TIME.

honestly, the rude patients don't bother me anymore - it's the rude doctors and peers I deal with. Now there is no reason for that!

I really like the battered wife example. "Well if you'd just kiss their butts a little more, they wouldn't treat you like the poo you're wiping off their butt."

I actually deal with the demanding people better than most. I'm particularly good at setting limits. Because of this skill, I get the joy of the shift before me doing stuff like, "Oh, wooh should get this patient, she'll set them straight." So much fun when there's a variety of jackholes on the floor and it's a night where it's me and the "nice" nurses.

I don't care how hard things are for you. There is NO REASON to treat the people that are trying to help you like that. And what makes it worse is that administration wants you to treat these people even better. We reward people for throwing temper tantrums. Which just teaches people to throw more temper tantrums.

I'm sympathetic, but there's a limit. I understand the stress colors their perceptions. And will work with them. Some of the most OBNOXIOUS families have decided that I'm their favorite nurse in the history of nursing. But I will NOT accept that they have right to treat us with blatant disrespect just because they are stressed. It's bad enough that patients/families expect that. It's bad enough administration thinks that.

But the fact that our colleagues here are expecting that? I'm betting that just because that stress me out doesn't give me the right to violate TOS and cuss out OP and those that have agreed with OP. Too bad the hospital isn't the same way.

As an ER nurse, I can tell you that going from Med/Surg to ER will definitely NOT decrease the stress or number of angry, violent, rude, name calling, unkind people! If ever a nurse has to put on an extra shield of kindness, it's an ER nurse!

I am not sure how it can be "nonsense" to acknowledge another persons anger or feelings. That "people think nurses are about as good as crap" is a very powerful statement. A patient throwing a water pitcher at you is very threatening, I can certainly understand your being very upset and angry.

I an making a conscious choice to acknowledge all your statements. You feel what you feel and your anger at my post and towards rude patients is real.

I am sorry I gave the implication that I would advise a batter wife to acknowledge a husbands anger. However actually I did mention that if a nurse felt threatened I believe all health care facilities are mandated to have a procedure in place to call for help....ours is code Gray. I would advise a battered wife to call 911.

I guess I was simply trying to say, and did a poor job of it, is that there are ways to escalate a tense angry situation, and ways to deescalate a tense angry situation. And to call a "code" or 911, is always a valid back up plan.

I poorly worded my post and acknowledge that and thank you for your thought provoking replies.

I do understand that patients and their families are in very stressful situations. The courtroom is another example of a very stressful situation. Yet start yelling and screaming or throwing things, even if you are the victim and the judge is well within his rights to hold you in contempt of court.

Most bad behavior occurs in any situation because people can get away with it.

There are some things we're taught in school that I think are no more than foo-foo fluff and nonsense. Therapeutic communication is not one of them. I swear, it really does work when dealing with most belligerent patients.

We have a resident with some major personality disorders who will spend entire shifts wheeling around, making accusations against staff to anyone who will listen. Most nurses will either ignore him or try and argue with him which, of course, just makes him angrier and more argumentative.

It is literally impossible to try and make him see that his accusations are fabrications and lies. Yet most nurses try to engage with him. The key is to noncommittally acknowledge his absurd complaints (just muttering "oh yeah?" or "okay" works beautifully) and then change the subject.

Maybe most rude visitors/patients don't really have personality disorders, but I bet a lot of them do. Being able to tolerate and redirect such behavior is part of being a nurse. By "tolerate", I don't mean being a doormat. But, yes, we should be able to react differently to a patient calling us dirty names than, say, the housekeeper would.

The idea that floor nurses should be as respected as doctors is a pipe dream. We're front line staff and we'll always bear the brunt of their rudeness. A degree doesn't guarantee respect. Teachers are degreed professionals, you think they command unquestioning respect from students and parents?

A lot of it is just the changing times and the changing society. Back in the day, most nurses possessed little formal education. But, you bet these undereducated (by today's standard) nurses commanded more respect and obedience from patients than nurses do today.

Specializes in Hospice.

I frequently get the "difficult" patients because I am told I deal well with them. I have to admit I kind of like the grumpy old men maybe because I find it a challenge to get them to trust me. I agree to an extent with OP there are ways to escalate and de-escalate a situation and then sometimes there is nothing you can do and you just have to walk away. I have found that listening to the patient or families concerns usually works you don't have to agree with them but just acknowledge their feelings. You have to be able to discern what tactic to take with the situation...sometimes you must be stern and set boundaries and sometimes being stern will escalate the situation, I found this out the hard way with a patient who broke my thumb! Recently I had a patient that picked up his IV pole and was going to hit me with it, I stood my ground raised my voice slightly and told him to sit down that his behavior would not be tolerated. He sat down once he realized I was not afraid of him. Different situations call for different solutions you just have to be able to choose the right one.

I do agree with the OP that, a lot of times, frustrated patients just want someone to listen to them, acknowledge their feelings, and give them a clear straight explanation of what's going on. I've talked to many people just like that -- all of whom turned out to be very pleasant folks once they got their frustrations out of the way.

However, all of us have met the patients who choose to be nasty. Just because you're stressed about being in the hospital or being in pain doesn't mean you have the right to attack the people caring for you. Two years ago I had a major depressive episode. It was the worst thing I've ever been through in my life. I still went to work every day, with a smile, even though I felt horrible. I'm not so special. If I can remain polite when I'm hurting, so can other people.

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