Wondering how others deal with RUDE patients, docs, colleagues?????

[TrudyRN]

If you think a patient has been rude to you, do you retaliate? Do you walk slowly instead of stepping spryly to get that washcloth he requested? Or give the lower dose of pain med? Put the ER chart to the bottom of the stack? Forget to get the snack he wants? Can't find an extra chair for his visitors? Other? Or do you not allow yourself such indulgences?

How about rude docs? Do you not help them get the lab results and suture sets they need? page them late at night for things that could wait?

Rude colleagues - refuse to cover their patients while they go smoke for the 15th time that shift? not help them turn, pull up, or transfer patients? Mentally make up stories about them suffering?

I am NOT asking if you would ever deliberately harm your patient. PLEASE don't ever do that, no matter how rude they are. We have to answer to our own consciences, to the law, and to God and I don't want to see anyone in trouble on any level.

[rn/writer, RN]

I hate when patients say "I'm usually a nice person. I'm not usually like this, only when I'm sick." I truly believe people are fundamentally the same whether they are ill or healthy - nice people don't suddenly become rude and mean just because they have a cellulitis. I know the ED system we have creates anxiety and is chaotic, but to me it all goes back to many people "looking out for number 1." It seems people ignore the fact that there might be someone in the area who is sicker than they, and want what they want when they want it. But I digress.....

I DO believe people who say this for one reason: the ones who are nasty all the time don't give enough of a hoot to offer an explanation.

I also believe it because I have been on the other side of the bedrail with this exact feeling. I try hard to behave with kindness and decency, but there have been several times when I was hospitalized with serious illnesses and I didn't have the energy to be polite or sociable. I hurt like the dickens and had a hard time moving or being moved. I needed pain meds the minute I could have them. In the ICU, the sensory overload got to me. Under normal circumstances, I would have made polite requests and waited somewhat patiently. When I was ill, it was all I could do not to yell and throw things.

Fear and pain are great levelers. I've heard many nurses talk about patients who were horrible to them at some point but who were embarrassed by their actions afterward. People are often not themselves when in an environment that seems filled with hazards and discomfort. I was fortunate in being able to connect with my nurses once I was feeling a bit better and tell them they had done a great job even though I might have said otherwise during the acute phase of my illness.

That said, nasty people don't usually become nicer with additional stressors.

[VivaLasViejas, ASN, RN]

I'm one who likes to "Kill 'em with kindness". This tends to take the wind right out of peoples' sails and can defuse a volatile situation. When I was a hospital nurse, I'd take report and then go see the 'difficult' patients first; most times, investing that 10 minutes or so at the beginning of the shift in listening to their concerns and learning their preferences set the tone for the whole day, and after doing so, I very rarely had trouble with rudeness and disrespect.

Sometimes nasty patients are just scared and vulnerable, and they don't know how to articulate that, so they lash out at those caring for them. It stinks, and it's not right, but it just IS. All we can do is give them the best care we can so we can go home at the end of the day with a clear conscience. And who knows? Once in a while you find out that you made a difference in someone's life, like a dialysis patient I had some years ago who had alienated practically every nurse on the floor with her bad attitude and snippy comments---all I did was treat her with respect and care, and after the first couple of shifts working with her, she began asking for me every time she was admitted. She passed on a couple of years ago; but not before she told me, "Thank you for being here. You're the only nurse I ever had who treats me like I'm a person and not a pain in their (rear)".

As for those who persist in being ugly and nasty........well, I've found that the best thing to say is "I'm sorry you feel that way". This is a subtle way to acknowledge their feelings without actually apologizing for something that's not your fault. And once in a while, it even shuts 'em up---I've had a few people even stop yelling and apologize to ME for being rude.

[AlabamaBelle]

I'm with Tweety & rn/writer. Any of the actions stated would be unprofessional to the nth degree and in our litigious culture, quite the invitation to a lawsuit.

I've had my share of difficult families and I've had my share of fabulous families. Fabulous families are easy to work with. Difficult families/patients show me what I'm made of and make me take a good, hard look at myself and my beliefs.

There are those who will never, ever be happy with anything I say or do. I control myself and my actions - I have to go home with me at the end of the day.

I am also fortunate to have a NM and an ANM who are talented with difficult patients/families/situations and have learned much from them.

I've also been on the other side of the bed with my granddaddy. He was dying, facing many regrets and was very difficult. The nurses were very obvious in their dislike of my granddaddy and stated their objections to his MD to not admit him again to their unit. He died a week after some awful comments made about him. That influences my practice tremendously.

Cindy

[penguin2]

Easier to just view them as irrational little children. I patiently answer their questions, take care of them like anyone else, and no, I don't skimp on pain meds-- I am generous- sometimes they mellow out. I do, however, hurry along their discharge from the unit!! ;-) Another PIA is rude family members who act like we don't know what we're doing. "His heartrate just dropped from 80 to 74-- what's WRONG?!" It's all part of the job, and the grateful patients make it all worthwhile. Some days it does seem we get all the AR/high-maintenance ones though....my favorites are smokers-- they want to get the heck out to have their cig!! No issues w/docs or colleagues, I just maintain MY professional demeanor - fortunately I work w/a great group of docs & nurses.

[banditrn]

I have pretty much always looked at patient care as a challenge - to find what works with each individual patient.

I've always tried to give the very best that I could - even to the occasional rude one - sometimes I found that just stopping and looking at them, maybe using a little humor when they are being rude, will help.

I have, on very rare occasions, walked out of the room when I felt they were being abusive - after I explained why I would not tolerate that kind of treatment, and would be back.

[FireStarterRN, BSN, RN]

I think people can be different when they get sick. When my normally sweet and compliant husband was hospitalized, he was uncooperative with the nursing staff. He wouldn't save his urine for Is and O's, he wouldn't tolerate the NG tube and pulled it out. He was polite but uncooperative. So yes, being sick can bring out the baby in some people.

[All_Smiles_RN]

I'm a genuine, caring person and I believe my patients and coworkers pick up on that. After I've made quick rounds and I come back for a more thorough assessment, I say, "I understand you came here because you were having chest pain. Can you tell me what's going on?" It's a generic sort of question and lets the pt lead me to their area of concern. Some talk about the testing that's been going on and how they're anxiously awaiting results, others tell me about new diagnoses, some tell me they feel fine and want to get back to work, etc etc. Right off the bat, I typically have a feel for what their main concern is and where their thinking is at. And I address the issue at hand. "Difficult pt" or not, most people respond very well to me and I don't have the rudeness factor to deal with.

I'm fortunate that I work on a unit where we work well together. I'd imagine most issues with coworkers stem from stress, heavy assignments, etc. If you have a coworker who is running around for hours and you're twittling your thumbs, get up and help that person. Then when you're running around, they'll reciprocate. It's all about teamwork.

Rude docs... I get my orders from them and let it go. You know, I kind of feel bad for the docs. We gets days off. They don't. We get to sleep uninterrupted. They don't. We get to have uninterupted family time. They don't. If the situation calls for it, our charge nurse will step in. I've never needed that though.

When it's especially tough, I take a deep breath and realize it's only 12 hours. I'll be home with my family soon and can put it behind me.

[Ms Kylee]

The first thing I try to remember when someone is rude to me is they are not angry with me, but they're angry at the situation they are in. Once I get that established in my head, I usually ask, "Ok, please tell me what the problem is. I can't help you if I don't know what help you need." That usually diffuses the anger and attitude in a big hurry, and I can continue on and give my best care.

[psalm, RN]

I have had rude patients, and if trying to difuse the problem doesn't "work" I will say something, like, *I am sorry you feel that way, I will come back and we deal with this after I have my other assessments/whatever done. Is that ok with you?*

If a pt. is rude and then apologizes, I accept the apology and say something like, *I realize it isn't easy being a pt. and we try to do the best we can with what we have. Since your diet/meds/activity level are XXX there's only so much we can do until dr. further evaluates your labs/etc. *

With co-workers, consider the source, but don't retaliate. Be the role to follow!

Doctors, same thing. I had a doc mad at the world, and so he was going to take it out on me. He had about 6 charts and slammed them onto the counter while he was yelling at me, the night nurse...,the charts slowly dominoed to the floor, I laughed and said, "someone got up on the wrong side of the bed today!" while I helped him get the charts. He was embarrassed in front of the other docs and nurses. He apologized but not quite as loudly.

[pagandeva2000, LPN]

I will do what needs to be done and get them away from me ASAP. This means timely meds, treatments, teaching, make sure they understand and then, afterwards, mentally say "See ya...".

[FireStarterRN, BSN, RN]

I will do what needs to be done and get them away from me ASAP. This means timely meds, treatments, teaching, make sure they understand and then, afterwards, mentally say "See ya...".

That reminds me of how annoying nursing journals are with their stories of reaching difficult patients. Some nurse will keep trying and trying to help a mean, nasty, gnarly patient, and finally she wins him over with some miniscule gesture of appreciation on his part, and she writes a sappy story about it.

I'd rather spend any extra time with a sweet little old lady with interesting stories to tell, not some bitter grumpy ingrate.

[EmmaG, RN]

:lol2: