Yelled at a patient

Nurses General Nursing

Published

So I need some advice on damage control here. I've been a nurse for 2 years all of which have been on a telemetry/cardiac step down unit in a non-profit hospital in a poor metropolitan area. It's not huge hospital (500 beds), but it is big enough for CABGs/Caths/Cardio-Pulm stuff. My floor has about 16 to 20 nurses on the schedule for both nights and days and a 5 to 1 ratio on both nights and days. I've worked both shifts for a year minimum and can tell you that nights are a piece of cake compaired to days. Recently, like in the last 3 weeks, we lost our awesome manager, the best floor supervisor ever, a great night charge, and like 4 other decent-great nurses. Now there are only like 3 of us on day shift that have worked here more than a year....actually there are only 3 of us who have been nurses for more than a year and only 1 who has been a nurse for more than 5. I guess what I'm saying is that the circumstances are poopy and the reason we lost so many to begin with was because the circustances have been poopy since I've started there.

Anyhow I get a patient from the ER that comes in with chest pain. She's aggrivated on arrival because "no one has told me why I have to be admitted. I've had chest pain before, if the tests are negative they should let me go!" Well I end up going and getting her chart and pulling my computer in the room to do a little PR so that maybe she'll be satisfied and I can take care of my actually sick patients. I go over her labs and what they mean, the EKG, the doctors orders and why he probably wrote them, AND I told her about the fact that I didn't know when the doctor would be in but he would be there sometime before I left. She seemed satisfied and happy so I left and didn't go to her room for a while. I finally went to check on her and she was in a frenzy about her insurance and worried that if we didn't get precertification that she'd have to pay for her admission. Well I'm not all that great with insurance and I can understand her worry so I take the time (45 + minutes) to call registration and then the preceritfication department to make sure that they have the right insurance card and that they actually called and got approval. I went back to tell the pt and she was on the phone. I started to talk and she told me, "Don't be rude I'll talk to you when I'm off the phone." I bit my tounge and waited and then told her what I'd done. She did not seem completely satisfied because whe wanted the precertification department to call her and verify what they had done to her. At that point I was starting to get tired of her so I just told her again it was taken care of and I'd be back. About 1600 I notice that the MD hasn't made it by. I haven't been to her room but since I noticed I decide to call the doctors office to make sure they know about the consult because eventhough the ER and my secretary both say the consult has be done I just felt the need to make sure. Well low and behold the patient had called the MD's office 6 times since 10am and had been told repeatedly that the doctor was at another hospital but he knew she was waiting to be seen and that he would not finish his evening until he saw her. So I went to tell the patient that I'd also called and checked up on the situation and low and behold the butt pimple was on the phone with her MD's office AGAIN telling them that no one had explained to her why she was here, what was going on, or doing ANYTHING to care for her. Something in me just snapped. I'd spent so much time trying to make sure she had what she needed and for her to go and say something like that just sent me through the roof. Thus I ended up yelling at her and telling her point blank that she was a waste of my time and that I would no longer be caring for her. I then marched up to my charge nurse and handed her the chart and told her that I was done with her and I refused to take care of her anymore. My charge RN precedes to go into the patient's room to reconsile the issue by joking with the patient about how I need to go get a psych evaluation.:sstrs:

I feel bad. I feel bad about the fact that I don't feel bad that I yelled at a patient...and I'm ****** at my charge RN.:devil: While I know that she needed to reconsile the issue I don't feel that it was appropriate to do it by makeing a joke of my mental health. Furthermore I feel even more aggrivated because I had put in my notice for June 15th but then agreed (after lots of begging from this particular charge RN and the director of my floor) to stay, at least part time, until October to help them out because they are so short.:madface:

I don't even want to step foot into the place tomorrow. :crying2:

Specializes in ICU, PICU, School Nursing, Case Mgt.

First, I apologize to the OP and everyone else who is reading this thread going ***....regarding our witty repartee...

Paul,

Please feel free to PM me....as no one as "PM'D" me in rather a long time.... and we will discuss your career opportunities.....

sws:redpinkhe

Thus I ended up yelling at her and telling her point blank that she was a waste of my time and that I would no longer be caring for her. I then marched up to my charge nurse and handed her the chart and told her that I was done with her and I refused to take care of her anymore. My charge RN precedes to go into the patient's room to reconsile the issue by joking with the patient about how I need to go get a psych evaluation.:sstrs:

Your charge nurse was wrong for that. Denigrating you to the patient does not solve the problem it justifies the patient's actions.

I cannot support your actions either; however I do understand WHY you did that and although I am not a nurse, I have had client support situations that have gone bad and I ended up saying things which I regretted.

It can be difficult to bite one's tongue when you are getting insulted and harassed by a client/customer/patient.

My suggestion would be to tell the person "I'm sorry that you are displeased with the efforts I have made to take care of you and your situation. I will ask someone else to take over from here."

I've used those exact lines many times and often it completely de-fuses the situation and the person who is being a problem suddenly realizes what a jerk they have been and they soften up and allow you to do your job.

Of course there are always the few who will never be satisfied because they believe themselves to be the center of the universe.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

You shouldn't feel bad that you don't feel bad, Kalipso. In fact, I have a bit of a "chalk one up for the good guys" feeling. Probably next time you encounter a personality like that, you'll recognize it a little sooner. It isn't really wrong to go the extra mile if you can, but not with the bottomless pit of negativity this lady was.

I will say, I wish I had a snapshot of her face when you went off on her. .yeah I know. . me bad nurse Best of luck finding a job with the calibre of people your current job has apparently chased away. {{kalipso}}

Specializes in CVICU-ICU.

SWS RN and Paul (I believe) I have to say dont worry about who's sitting there saying ***whatever about your witty remarks/comebacks to each other because I for one found comic relief in them and we can all use that. I must say Paul I did the same as SWS RN because I too was drinking iced tea and when I read the comment about continuing and Alzheimers I choked on my iced tea...I dont know why but I found that extremely funny.

As far as handing out the AMA form I have no problems doing that to patients that are truly needing it. If I have a patient that is alert/oriented and able to make their own choices I do attempt to convince them to stay. I will remind them why they are here and what could happen if they leave and after that they are adults and can decide to do what they want to do.

No one (other than the car salesman) ever begs me to stay so I can continue to annoy them.

Sometimes I think that we as nurses attempt to feel responsible for everyone and everything and its those times that we have to remember we are not responsible and if someone choses to go AMA thats their choice just like the alcoholic or the drug addict that comes to us for treatment....we do our best to care for that patient and we hope that possibily we might be able to provide care and teach regarding the effects but if they choose to continue it is not our fault.

Specializes in Obs & gynae theatres.

I personally find it unprofessional to shout at a patient and to handover their care to another person just because you did not like their attitude. You were not in danger from this patient. Over here I'm sure the NMC would have something to say about it.

I personally find it unprofessional to shout at a patient and to handover their care to another person just because you did not like their attitude. You were not in danger from this patient. Over here I'm sure the NMC would have something to say about it.

the OP didnt hand off this patient d/t not liking her attitude, but the attitude made it impossible to give appropriate care.

I can totally appreciate your frustration, but I wouldn't have even gotten involved in the whole insurance issue.

I get that you wanted to help your patient, but the time you spent on something that isn't part of your job is time that could have been spent taking care of other patients, or other needs of this patient.

When I have a patient ask me about costs and insurance issues on occassion, I just tell them I have no idea, I'm not an insurance expert, and they will have to call their insurance company. I've never had anyone push it any further with me.

Also, while I'm sure it was annoying that she was calling the doctor's office so frequently, that's their problem, not yours. I'm not saying this to be harsh, but so you realize which issues you need to deal with and which you don't in order to manage your time and keep your sanity.

Prior to nursing school I worked in retail, dealing with irate customers is very different than working with sick people, do other nurses find that there is a difference working retail and with sick patients?

I suggest you take an inservice which most hospitals given, also read the peer reviewed articles by Martha Griffin, you may find some answers on how to deal with this situation again.

Specializes in LTC.

The charge nurse shouldn't have made a joke out of you , but I'm sorry yelling at a patient and saying what you did is unprofessional and just wrong. I can understand why you did it and have been very tempted to do it myself...but sorry I totally disagree with it.

I personally find it unprofessional to shout at a patient and to handover their care to another person just because you did not like their attitude. You were not in danger from this patient. Over here I'm sure the NMC would have something to say about it.

It would be difficult to care for someone after this situation-my judgement may be clouded and that could be called into question if something DID happen to this patient.

otessa

Insurance issues during the day are handled by case management or patient's wait until the AM when case management is available. I have NEVER inquired about this since it is not my area of expertise.

otessa

Trust me...I've had my fair share of patients like this and working in LTC, I wish I could just not take care of them. One patient like this and 20 others. It seems like we are getting younger and younger rehab patients that are very demanding and rude they want it all and want it right then and there. (gosh...sometimes I miss the dementia residents..at least they have an excuse for their behavior)

So...I have to admit or agree with another poster. Your manager was WRONG in what she said about you. Totally wrong and she was trying to please or appease the "customer" but you were wrong in yelling. Think about what you will do when you get another patient like her. Trust me...there will be a next time and a next time and and next time........

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