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."

Specializes in CICU.

Boundaries. Learn to set them. If you are physically threatened, call a code. If you must, change assignments - for their sake and yours.

People want to be acknowledged and listened to. Notice I didn't say babied and agreed-with. I've rarely had a patient, so far, that I couldn't manage to get at least a smidgen of trust and rapport built with. There are a few FFs that simply can't be reasoned with. Still, it is not about me and I don't react to it, I do my job the best that I can despite it. I will also say that I felt FAR more threatened, far more times, in my jobs prior to becoming a nurse. Jackwagons are everywhere.

If one constantly has issues with patients and/or family, I would respectfully suggest a look in the mirror. We are the only common denominator in every one of our interactions.

Flame on.

I get what the OP is saying. Some of you are reading way too much into the post. I think what she was trying to say was don't take it personal, get help if you are unsafe, and reflect on how you interact with patients. What is wrong with that ?

I'll never forget when I was asked by administration to apologize to a patient's family member (after they pushed me into a door-frame for enforcing the facility's protocol).

Burned into my mind.

Specializes in NICU.
I'll never forget when I was asked by administration to apologize to a patient's family member (after they pushed me into a door-frame for enforcing the facility's protocol).

Burned into my mind.

And this is another issue that comes along with this problem. Patients and/or visitors complain to a Charge Nurse, management or patient relations and blame gets placed squarely on the nurse. No matter what the situation. Even if the complaint is followed with, "I just had a bad day and now that I've vented, I feel great about everything", the response is "Sir, Ma'am, we take every complaint seriously and will follow this up with your nurse." And following up involves discipline, even if the nurse did nothing wrong. Even if the nurse is following protocol (which if not followed leads to termination).

Nobody at all is on the side of nursing. I would love it if validation of the complaint was followed with, "We have the best darn nurses here. You are lucky to have had Nurse X during your shift."

And it would be nice if a patient/visitor was the cause of the problem, that an apology be offered to nurse--by them.

And just for the record, I tend to view difficult patients as a challenge (instead of horrible people) and do understand this is a bad time for them. However, poor behavior needs to not be tolerated. Ever.

Specializes in Pediatrics, Emergency, Trauma.
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.[/quote']

THIS...agreed....setting boundaries and everything in this post I have experienced in my 12 years...THIS has has kept me sane and will keep me sane for the next decades at the bedside. :yes:

I HOPE the only expectations we have to ourselves as nurses is our own expectations; self respect should be one of them-would YOU curse, threaten, hit, throw stuff-be generally lowdown NASTY at YOURSELF?

Think about it...I didn't think so. :blink:

Specializes in ICU./CCU/SICU.
And this is another issue that comes along with this problem. Patients and/or visitors complain to a Charge Nurse management or patient relations and blame gets placed squarely on the nurse. No matter what the situation. Even if the complaint is followed with, "I just had a bad day and now that I've vented, I feel great about everything", the response is "Sir, Ma'am, we take every complaint seriously and will follow this up with your nurse." And following up involves discipline, even if the nurse did nothing wrong. Even if the nurse is following protocol (which if not followed leads to termination). Nobody at all is on the side of nursing. I would love it if validation of the complaint was followed with, "We have the best darn nurses here. You are lucky to have had Nurse X during your shift." And it would be nice if a patient/visitor was the cause of the problem, that an apology be offered to nurse--by them. And just for the record, I tend to view difficult patients as a challenge (instead of horrible people) and do understand this is a bad time for them. However, poor behavior needs to not be tolerated. Ever.[/quote']

Exactly!!! Any nurse knows that our patient population can be difficult , cranky , angry at the world , etc. People are rarely at their best when sick. My problem is this overwhelming notion that when the patient/ visitor acts out, it's due to YOUR inability to successfully diffuse the situation. Hence , the battered wife reference. Throw something at a cashier at Walmart and see what happens to you......

Specializes in Hospice.

I believe nurses from your generation often think this ...probably because they are from the generation where you gave up your chair when a dr came in the room. It sounds like you have some good interpersonal skills but i have no admiration for judgment of professionals who have self-worth and take initiative to set appropriate and fair expectations of interactions. i deal with very difficult patients and they generally really like me....but its because i set some clear expectations about our interactions. I treat them with genuine respect and I expect the same in return.

Specializes in ICU / PCU / Telemetry / Oncology.

I want a job at Utopia Medical Center as you have.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

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?

THIS!!!!

I've read all the posts excoriating the original poster, but this line captured perfectly an idea that I learned long ago and learned the hard way.

When I was a new young nurse, raised on a farm in the mid-west, I went to a huge east coast city to work. The patients and their families were the rudest, most demanding people I'd ever met. Of course I was lost in the big city, lonely, scared and in the process of losing the one relationship I had -- my husband. I was a mess.

A very wise orientee of mine sat me down and told me that the reason I was encountering so many rude, nasty and demanding patients and visitors was the negative energy I was putting out there. At first, I denied it. It was all pretty "woo-woo" and I didn't see how others' behavior could possibly have anything to do with ME. But over time I learned that she was right.

If I encounter one nasty person in my day, I've encountered a nasty patient. If everyone i encounter is mean to me, that it's me.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I believe nurses from your generation often think this ...probably because they are from the generation where you gave up your chair when a dr came in the room. It sounds like you have some good interpersonal skills but i have no admiration for judgment of professionals who have self-worth and take initiative to set appropriate and fair expectations of interactions. i deal with very difficult patients and they generally really like me....but its because i set some clear expectations about our interactions. I treat them with genuine respect and I expect the same in return.

Since you didn't use the quote function, I have no idea which post or poster you're responding to. Perhaps that's part of the reason that this post makes me so angry. Another is that it's right up front there about being ageist.

Specializes in ICU/PACU.

After years of traveling I've found that at some hospitals you really do encounter rude patients frequently. It really depends on your location. I remember my first travel job I was so surprised at how thankful patients were. My first job it was pretty common to take care of a rude pt or out of control family once a week, so I was pretty shocked!

i have no admiration for judgment of professionals who have self-worth and take initiative to set appropriate and fair expectations of interactions.

Wow. Thanks for the perspective. I'll be sure to leave my humanity/self worth at home.

Also, why is it that you don't respect other professionals who set boundaries, but you said a sentence later that you yourself set boundaries to guide expectations of patient-professional interactions?

For the record, I have no respect for "professionals" who believe that because patients might be afraid or angry about a diagnosis that it is the nurse/CNA/food service/physical therapist/doctor/name-your-professional's place to take abuse of any sort.

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